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Integrative Psychiatry

Listening to Your Gut: the Importance of Microbiome Diversity

By October 9, 2024No Comments

Everywhere we look in nature, diversity creates resilience. Imagine a healthy forest containing biologically diverse plants, animals, and microorganisms like fungi. Each organism plays a specific role, working interdependently, keeping the ecosystem in dynamic equilibrium, so that no single species dominates. 

In genetics research, the term “homogeneity” describes similar genetic makeup and can cause a population to get stuck, susceptible to the same diseases, shortcomings, and strengths. Meanwhile, “heterogeneity”– greater diversity of genes– creates opportunities for continued growth and survival of a population. A similar dynamic occurs within the human gut. Diverse microbial species perform various functions, from digesting food and synthesizing vitamins to regulating immune responses and communicating with the brain through the gut-brain axis. 

When the gut microbiome is rich in diversity, it’s better equipped to handle disruptions, much like a diverse forest can recover from fires or diseases more effectively than a monoculture. A lack of diversity is also called “dysbiosis,” resulting in weakened ability to cope with stressors, both internal and external. This imbalance has been linked to a variety of health problems far beyond gastrointestinal disease, ranging from metabolic diseases like diabetes to mood disorders like depression.

Resilience in Body and Mind

The gut and the brain communicate through a complex network of hormones, neurotransmitters, and immune signals, including both bottom-up communication (signals that are influenced by the microbiome) and top-down communication (signals that are influenced by the brain). Often, these lines of communication impact each other and work in tandem. Research has shown that microbiome diversity and stability can play a key role in how well this communication works.

Similar to the forest analogy, a well-functioning microbiome serves as a barrier against harmful pathogens by outcompeting them for resources and space. In a microbiome that lacks diversity, opportunistic microbes can overgrow, leading to infections or the production of toxic metabolites. Maintaining microbial diversity supports the integrity of the gut lining, preventing leaky gut syndrome, a condition where harmful substances leak into the bloodstream, triggering inflammation and metabolic dysregulation. Physiological imbalances of this kind are strongly associated with autoimmune disease and mental illness, while the ability to bounce back from these states is associated with improved mental health.

Inflammatory processes are deeply tied to emotional states and mental health symptoms. Beneficial microbes in the gut can help regulate immune responses, preventing the body from overreacting or underreacting to various stimuli. Studies show that a diverse microbiome leads to a greater production of anti-inflammatory molecules like short-chain fatty acids (SCFAs). SCFAs can act as a buffer against stress-related pathology by regulating metabolic hormones and neurotransmitters, repairing gut and blood-brain barrier permeability, and supporting neuronal growth.

The gut microbiome also plays a critical role in the digestive system, breaking down food, producing many vitamins, and supporting absorption of nutrients. Diversity of gut microbes ensures that a wide range of nutrients are extracted from food efficiently. Microbial diversity can also keep blood sugar levels and fat storage in check, both of which are crucial for preventing metabolic disorders like obesity and diabetes. In essence, when the gut has access to a wide array of microbial “tools,” it’s better able to maintain metabolic balance.

Several strains of gut bacteria are involved in the production of neurotransmitters such as serotonin, dopamine, glutamate, and gamma-aminobutyric acid (GABA), which are critical for regulating emotion and cognitive function. A diverse microbiome ensures that multiple pathways for neurotransmitter production are supported, providing a more stable environment for mood regulation.

Nurturing Microbial Diversity

Given the critical role of microbial diversity in promoting resilience, both physical and mental, how can we nurture a healthier gut?

Body to Brain: The most evidence-based intervention you can make is to consume as wide a variety of plant-based foods rich in fiber (a type of prebiotic) as possible. Fermented foods like yogurt, kefir, sauerkraut, and kimchi can introduce beneficial bacteria (probiotics) directly to the gut. Remember, everything in moderation is often more sustainable than always eating one type of food. Limiting processed foods is recommended.

Brain to Body: Chronic stress negatively impacts gut health by reducing microbial diversity. Find ways to manage stress that make sense to you, and schedule them into your day. Some ideas include exercise, community/friend gatherings, practicing mindfulness or relaxation techniques, pursuing a creative passion, or seeking therapy. If you don’t know which habits are most helpful for you, try each one and see how it makes you feel.

Conclusion

Feeling good in the mind is a two way relationship with feeling good in the body. Microbiome diversity establishes greater stability of gut-brain processes, providing a foundation for resilience that is not easily shaken. This foundation helps us to thrive amidst unexpected life challenges. Emphasizing gut health through diet, lifestyle, and targeted interventions allows us to cultivate a sense of wellbeing and harmony, from the inside out.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.