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Gut-Brain Connection–Part Two: Action Steps for Healing Depression

The Gut-Brain Connection is a central pillar to healing depression–as well as the myriad mood and thought imbalances we struggle with. While depression can be a complicated issue, with inputs from many aspects of our lives–our thoughts and beliefs, past trauma, stress, and the situational challenges we all face–persistent and recurrent depression almost always has roots in the body–and most notably, the Gut-Brain Connection.

I recently presented the story of Kathleen and her remarkable recovery from lifelong depression. She did this through a simple self-care program that centered around healing her gut and reducing systemic inflammation. Kathleen is an excellent example of how depression was a symptom, and not a disease, in her case the manifestation of an inflamed brain.

There are universal action steps we can all implement in our daily lives to improve our gut health. They will fix how our gut functions (and feels) and restore a healthy microbiome–the friendly bacteria we need in our gut for optimal health. These simple steps will reduce the systemic inflammation and toxicity that invade our brains–that can lead to depression because of the powerful Gut-Brain Connection.

Action Steps for Reversing Depression by Healing the Gut-Brain Connection

  • Avoid the use of gut lining irritants (if possible): antibiotics, anti-inflammatory drugs (steroids, Ibuprofen, Aleve, Aspirin, and the like), alcohol, irritant foods (see next bullet point).
  • For at least three months, avoid food groups known to damage the gut lining (making it “leaky”) through immediate or delayed-type immune activation: animal milk products, all grains (yes, even “healthy, whole grains”), eggs, beans (including coffee and vanilla) and legumes, nuts, nightshades (tomato, white potato, sweet and hot peppers, eggplant). This degree of restriction will not need to be lifelong but is necessary to give the gut a “rest” and allow the mucosa to heal. Reintroduction of “culprit” foods should be done carefully–just one at a time (in a week), noting any problems that may arise. In my opinion, testing for IgG or T-cell responses to foods is not enough to identify potential problem foods–elimination of all potential culprits is the best strategy.
  • Remove all sugars and processed foods: including “healthy” sugars like maple syrup, honey, agave, dates, brown rice syrup–stevia is okay.
  • Support digestion with digestive enzymes and betaine HCl (choose a product from a trusted source and follow manufacture’s instructions as a starting point), especially if you tend to experience bloating or excessive fullness after meals. Also support digestion through relaxed eating (rather than on the run), slow chewing, and cooked or lightly steamed foods (rather than raw).
  • Re-inoculate your gut with healthy flora: use a combination of lactobacilli, bifodobacteria, and saccharomyces boulardii at a dose of 60+ billion organisms per day. I like to combine these with soil-based organisms. Yeast sensitive? Nix the saccharomyces.
  • Support your microbiome with pre-biotic non-digestible fiber sources: most plant foods will contain these, so those with high plant consumption will typically not need to supplement. You can also use potato starch (Bob’s Red Mill) 1/4-1 teaspoon twice daily for added support (start low–1/4 tsp and work up to adjust to increased gut fermentation). Note: for those with small intestinal bacterial overgrowth issues, both probiotics and prebiotics may exacerbate symptoms. If so, stop them and work with a trusted Functional Medicine practitioner to help you sort this out.
  • Nourish your gut lining:
    • Through systemic intensive nutrition: eat meals that contain healthy protein sources (pasture-raised, wild-caught), plenty of healthy fat (coconut cream, coconut oil, medium chain triglyceride–MCT–oil, fresh-pressed or extra virgin olive oil, olives, avocados, avocado oil, fatty meat and fish), a wide variety of plants–emphasize crucifers (cabbage, kale, broccoli, cauliflower), dark green leafy and darkly colored vegetables and berries, and the onion family (onions, green onions, garlic, leeks, shallots).
    • Through targeted gut nutrition: bone broth 1 cup twice daily, l-glutamine 5 grams twice daily, fish oil 2-3 grams of combined EPA and DHA daily.

Bi-Directional Support to the Gut-Brain Connection: Heal the Gut AND the Brain

  • Stress Reduction: excesses of stress activate the nervous system and stress hormones in ways that both injure the gut lining and disrupt brain chemistry balance. There are so many in-roads to this–pick your favorites and stick to them every day… take baby steps to improve sustainability: meditation, being in nature, walking, journaling, use of positive affirmations, laughter and lightheartedness, petting your dog, engaging in pleasurable activities, spending time with trusted friends.
  • Treat systemic inflammation of all kinds: our primary focus in this article is on healing the gut-derived sources of inflammation, but systemic sources will hurt both the gut and brain, so must be addressed as well.
    • Seek help to treat allergies or infections.
    • Normalize blood sugar:
      • Avoid all sugars in your diet.
      • Eat healthy fat at every meal.
  • Exercise and movement of all kinds will help reduce systemic inflammation, and leads to improved gut and brain health.
  • Sleep is another way we can reduces systemic inflammation and support both gut and brain health. Sleep deprivation alone can result in persistent depression and fatigue.
  • Mobilize your support team: Most of us need the strength and fortification we receive from helpers on our healing journeys. You may need to build a team to support you.
    • Consider working with a Functional Medicine practitioner who will be well versed in the Gut-Brain Connection and how to heal it.
    • You may also benefit from working with a trusted counselor to help you explore yourself, develop self-awareness, learn new tools for managing stress, and who can love and support you on your journey. I recommend that you work with someone who is trained in mind-body approaches to mental health.  They are likely to be the most familiar with the mind-body interplay in mood disorders and critical need to address the physical aspects of depression.


Karyn Shanks, MD. The Gut-Brain Connection: Root Cause Solutions for Depression. 2017.

Karyn Shanks, MD. Eight Unexpected Ways to Boost Your Mind Power. 2017.

Karyn Shanks, MD. Create a Healthy Microbiome. 2017.

Karyn Shanks MD


Karyn Shanks, MD, is a physician who lives and practices in Iowa City. Her work is inspired by the revolutionary science of Functional Medicine, body-mind wisdom, and the transformational journeys of thousands of clients over her twenty-eight year career. She believes that the bones of healing are in what we do for ourselves.

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