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Integrative Psychiatry

Gut, Brain, and The Microbiome By Christopher A. Lowry, PhD

By August 31, 2020No Comments

A fat molecule coming from a bacterium originating from the soil when taken up by an immune cell shuts off and takes over the molecular machinery of the immune cell and shuts of the inflammatory cascade.

A product of hundreds and millions of years of co-evolution of bacteria and mammal and the relationship between the two is incredibly important for both out physical and mental health.

Start by considering the risk factors and which risk factors that can impact in a way that it reduces the risk for developing psychiatric disorders.  Part of the two types of neuro-connections that allow bidirectional neuro-communication is the Vagus nerve which innervates the GI tract-brain communication.

Microbiomes are very important in PTSD according to clinical trials conducted with the involvement of trauma which is an important risk factor for depression.

FULL TRANSCRIPT:

A fat molecule coming from a bacterium that originates in the soil that when taken up by an immune cell shuts off, takes over the molecular machinery of that immune cell and shuts off the inflammatory cascade. And we think this is a product of hundreds of millions of years of coevolution of bacteria and mammal and that this relationship between bacteria in mammals including humans is incredibly important for our physical health, and our mental health. Our lab has been interested in approaches for prevention, not only treatment of psychiatric disorders, but also prevention. We should start thinking about prevention strategies for psychiatric disorders. And if this is one of our goals, where should we start? We should start by considering what the risk factors are and are there risk factors that we can impact in a way that would reduce the risk for developing psychiatric disorders. And so, known risk factors for psychiatric disorders include, genetic predisposition but also, environmental influences and interactions between genes and environment. This is how we think this works.  Here we’re talking specifically about bacteria that we think drive immunoregulation and production of anti-inflammatory cytokines. Graham rook coined the term old friends, but these are the organisms that can drive this immunoregulation that keeps inflammation under control. The same organisms that we think we have reduced exposure to when we move into an urban environment.  What they have the capacity to do, these old friends, is bind to receptors on what are called immature dendritic cells a type of immune cell that’s part of our innate immune system that causes these dendritic cells to mature into regulatory dendritic cells, the bias the differentiation of naive T-cells into regulatory T-cells that have this anti-inflammatory function. So these old friends, these bacteria are biasing the immune system in a way that results in anti-inflammatory responses and protection from chronic inflammation.

There are two types of neural connections, general categories that allow this bi-directional neural communication. One you may have heard of, which is the Vegas nerve which innervates the gastrointestinal tract. it has thousands and thousands of nerve fibers in the Vegas nerve, some of those are going from the brain, to the gut, and some are going from the gut, to the brain. And so that’s what we’re talking about when we refer to this bi directional communication.

We also think the microbiome is very important in post-traumatic stress disorder. Our clinical trials that we’re conducting at the VA are individuals with post-traumatic stress disorder. But here we have, by definition, the involvement of trauma. Of course, we know from earlier toxic trauma is also an important risk factor for depression but this is a diagnostic criterion for PTSD. And many of the same mechanisms that are involved in the relationship between the microbiome and this bi-directional microbiome gut brain axis are also we believe important in PTSD.

Psychiatric disorders associated with decreased regulatory T-cells that didn’t show the data for that but we know that’s the case. Decreased immunoregulation and increased inflammation, and microbiome-based interventions to prevent anti-inflammatory immunoregulatory signaling to increase anti-inflammatory immunoregulatory signaling might be considered for prevention and treatment of psychiatric disorders.

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.

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