The patient link between digestion and depression
Patients joke about “eating their feelings” or “stress eating” when you ask about how they are holding up during the current COVID-19 crisis. Of course, your patients may also be experiencing a significant increase in digestive issues, as a result of falling into bad eating habits and not exercising. You may also even find yourself indulging more than usual in the same unhealthy eating habits, as a way of coping with depression over the past year, leading to both digestion and depression issues.
As much as we may joke about eating as a way of dealing with mood swings, research shows there may be some truth to the connection between digestion and depression. This link between the digestive system and depression offers some intriguing possibilities, not only in treating both issues, but in but in preventing them before they start.
Digestion and depression stats
The prevalence of digestive issues among Americans is on the rise. A 2018 article in the Journal of Neurogastroenterology and Motility placed the prevalence of gastroesophageal reflux disease (GERDS) as high as 28% in North America, with cases among younger patients on the rise.1 Similarly an article from just last year in the American Journal of Gastroenterology noted that the prevalence rate for chronic idiopathic constipation among Americans is 20%, although it may actually be higher, due to gaps in patient self-reporting to their doctors.2
The rise in depressive symptoms among the general population has also been examined closely in both research and the popular media. According to the Centers for Disease Control and Prevention (CDC), symptoms of depression had considerably increased among Americans during April-June of 2020, compared to the same time period in 2019.3 Furthermore, almost 41% of American adults surveyed during the week of June 24-30, 2020 reported at least one pandemic-related mental or behavioral health issue, including symptoms of depression or anxiety (31%), or a trauma- or stress-related disorder (26%).3
An article published earlier this year in Nature Communications reported the findings of a study examining the common genetic factors contributing to four gastrointestinal disorders and symptoms of depression.4
The researchers examined the genomes from more than 450,000 individuals and found eight genetic variations that could make individuals more susceptible to peptic ulcer disease (PUD), gastro-esophageal reflux disease (GERD), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD). At the same time, there was a significantly increased risk of each of these digestive disorders with depressive symptoms.
This risk is bi-directional, meaning that depression could also increase the risk for the digestive disorders as well. The researchers explained: “Psychological factors can decrease the pressure of the lower esophageal sphincter and change esophageal motility. The reflux symptom itself could result in depression through potentially disabling effects on occupational or social function, or if patients are constantly feeling upset about their condition.”
Fortunately, there is good news about how you can help patients not only improve their diet, but also their mental health. Sales of both probiotics and prebiotics have shown a sharp upswing starting early last year, just as lockdowns took place all over the globe. One major marketing survey showed increased consumer interest in probiotics and prebiotics, even among those who were not regular supplement users. This means you have a great opportunity to educate your patients about digestion and depression and the connection between gut and brain wellness.
- Yamasaki T, Hemond C, Eisa M, et al. The changing epidemiology of gastroesophageal reflux disease: Are patients getting younger? Journal of Neurogastroenterology and Motility. 2018;24(4):559-569.
- Oh SJ, Fuller G, Patel D, et al. Chronic constipation in the United States: Results from a population-based survey assessing healthcare seeking and use of pharmacotherapy. American Journal of Gastroenterology. 2020;115(6):895-905.
- Czeisler MÉ, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic – United States, June 24–30, 2020. Morbidity and Mortality Weekly Report. 2020;69:1049-1057.
- Wu Y, Murray GK, Byrne EM, et al. GWAS of peptic ulcer disease implicates Helicobacter pylori infection, other gastrointestinal disorders and depression.Nature Communications. 2021;12(1):1146.