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The Gut Feeling

21/6/2022

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The gut feeling Is your gut following you or are you following your gut?

signs
When was the last time you had this gut feeling about something? Did you listen to it or did you dismiss it? My guess is that quite a few people know what it is like to have a gut feeling but then decide to "rationalise it away" with logic. Given what we know about how our brain developed differently from other species - it may seem like the "logical" thing to do, right?

As it turns out, the connection between the brain and the gut is surprisingly strong. So much so that its importance shows in our language: talking about a "gut feeling", "butterflies in your stomach", "having the guts to do something", "hating someone's guts" etc. What is this hard-to-describe intuition we call "gut feeling" though? And can it possibly go together with our rationalising brains?

The second brain

 A lot of people consider the gut as a "second brain". Why?
  • It is surrounded by a nervous system (so-called "enteric nervous system", ENS) that comprises between 200 and 600 million neurons. (As a comparison: this is equal to the number of neurons in your spinal cord, a cat's brain contains around 250 million neurons, and the human brain around 86 billion.) 
  • The intestinal surface area is actually the largest body surface (around 100 times larger than the skin surface), it contains oh so many microorganisms (again, the largest population in the human body), and even has its own immune system (around ⅔ of your body’s immune cells).
It’s safe to say there’s a lot going on in our guts. In recent years, research has picked up impressively in attempting to find out how much this second brain influences us, our behaviour, thoughts and overall (mental) health. Like so many things in life, the connection between brain and gut seems to be rather like a two-way street so let's try to disentangle it based on that.​

The chicken and the egg: Brain to gut

Obviously, our brains control everything we do from breathing in and out to deciding whether to study psychology or mathematics (and then actually doing that!). To anyone who’s ever been told to “go with your gut”, it should come as no surprise that the gut is actually quite helpful in terms of making difficult decisions. In fact, stress, anxiety, and depression can quite literally punch you in the stomach. Many fellow migraine sufferers will most definitely know what I am talking about as nausea is a common symptom of migraines. If you don't get migraines (lucky you!), you may know this feeling from the last time you have given a presentation.
“Abdominal pain and nausea can be caused by stress.”
What's the point of this though? Shouldn't our brain be protecting us in times of crisis, helping us to deal with stress? Well, yes that’s exactly what it’s doing. If the brain perceives something as a threat (e.g. you’re on a hike and meet a bear), it activates the most basic human reactions - fight, flight, or freeze. It prepares the body to run and for that - evolutionarily - it needs to be as light as possible so anything that can go, goes without much processing of any nutrients (#priorities). That's what acute stress does and it's great - when there's a bear.  ​
What we see in our modern lives more often than a bear (depending on where you live I guess) are constant stressors which put our bodies in this state more or less continuously. That's not very helpful because a stressed gut also means that your brain doesn't get the nutrients from that healthy balanced diet which you're working so hard to stick to! 

The egg and the chicken: Gut to brain

This all makes a lot of sense but have you ever considered that maybe, the lump feeling in your stomach happens first and only then your brain interprets it as anxiety? It turns out there are a lot of ways the gut can send signals to the brain and we won’t be able to discuss all of them here but let’s take a look at some of the ones most important to mental health:
  • One really obvious effect is related to food intake: Babies cry as a reaction to being hungry - that’s a clear example of gut-to-brain communication. 
  • It’s also very important for homeostasis, it motivates us to go out and get food. For that, we need the brain’s ability to release dopamine because without that, we’re not going anywhere to get food. This kind of communication is vital for survival. 
  • In terms of mood, consider this: Ingesting food that tastes good and has nutrients makes us happy. Ingesting food that is potentially harmful for one reason or another usually causes nausea. Being in a hungry state for a longer period of time is also known to make some of us quite… let’s say cranky (#hangry).
“Gut-to-brain communication is vital for survival.”

Decision-Making

To make it a bit more complicated - what’s it like to actually make a decision based on a gut feeling? Have you ever done that? Interestingly, there’s a part of the brain that is specifically devoted to intuitive decision making - a subpart of the insula (we already talked about how the insula is related to loneliness). The basic difference between a complicated “informed” decision and an intuitive decision (aka gut feeling) is that the latter is the result of a very fast, split-second kind of assessment of a good vs. a bad outcome based on past experiences (rather than long and painful attempts at reasoning). Scientists are not quite sure how exactly this works but it is possible that it relates to the so-called “interoceptive memory” - a kind of map of gut responses that has been acquired all of your life. 
“A gut decision is essentially a very quick assessment of good vs. bad outcome based on previous experience.”
All of this (and lots of other insights in this direction of gut-brain communication) have led to the awareness of how important it is to listen to our gut. There are even specific kinds of therapeutic approaches (such as mindful awareness in body-oriented therapy, MABT) that have developed as a result of this awareness and focus on learning skills that enable you to detect and evaluate the messages your body sends you (aka “interoceptive awareness”). 

Chronic pain and disorders

Talking about the directionality of gut-brain communication, we should also consider chronic pain and disorders. Irritable bowel syndrome (IBS) and inflammatory bowel diseases such as Chron’s disease and ulcerative colitis are quite common in our society, affecting 10-15% and 0.2% of the population, respectively (with increasing tendencies). While it was long believed that these conditions to a large part were psychosomatic, the scientific community remains divided over this. Given the high rates of depression and anxiety in patients suffering from these gastrointestinal disorders (even though mood problems remain often undiagnosed), it’s likely that there is some sort of connection. However, it appears to be more like a vicious cycle with stress and anxiety symptoms exacerbating gastrointestinal symptoms and vice versa. A whole new chicken and egg discussion. 

Take-home message

What can I say? Learn to listen to your gut.Here are some things that you can do: 
  • Practice mindfulness and breath work (yes, breath work has a significant impact on the body)
  • Reflect on your bodily reactions, try to filter out the nuances of them, describe them and if possible, try to link them to a trigger  
  • Normalise asking yourself “how does that make me feel?” - literally. Where in your body do you feel an emotion? 
  • Embrace the bodily feelings of emotionality - they’re essential to well being.
Written by Johanna Perschl, Intern Psychologist at AntiLoneliness

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