Hi friends,
It’s been a while! Sheesh. How I missed writing. I missed the clarity that comes when I can see thoughts click-clatter onto the page. That…aaah, that’s actually what’s been on my mind and seeping into my daydreams and night sweats.
Before I get into rumblings on art and beauty, come on a thought detour with me, peppered with some of my favorites from Frieze.
Over the last week, I caught up with three friends who suffered from anxiety and depression. They tried everything — pills and talk therapy and CBT and light therapy and water therapy, among all the other things one tries at the edge.
What seemed to work for all of them: probiotics and diet changes (!). The thing that helped restore mental health targeted the gut, not the brain.
The common thinking is that the mind controls the body. The reality is bidirectional. The gut and brain are in constant communication.
I’m a perfect case study. Throughout my life, I’ve struggled with stomach issues. Parasites at 10, ulcers at 13, ulcerative colitis at 16, IBS forever. Throughout these experiences, the common refrain from doctors? “Try not to get stressed. It’s hurting your gut.”
There were shortsighted. My stomach problems were contributing to my stress.
Simply put, gut health impacts mental health.
For anyone with a mindfulness practice, this might feel obvious. But the research is still limited and rarely put into clinical practice.
“For decades, researchers and doctors thought that anxiety and depression contributed to [IBS and bowel problems]. But our studies and others show that it may also be the other way around,” Pasricha says. Researchers are finding evidence that irritation in the gastrointestinal system may send signals to the central nervous system (CNS) that trigger mood changes.
“These new findings may explain why a higher-than-normal percentage of people with IBS and functional bowel problems develop depression and anxiety.”
Source: Hopkins Medicine
The gut-brain connection is not limited to anxiety and depression.
Take hunger.
More than just a drive, hunger is also a psychological state, one that has a profound effect on the way a person sees the world. People joke about being “hangry”—that is, feeling irritable as a result of hunger. But according to Kristen Lindquist, an associate professor of psychology and neuroscience at the University of North Carolina, hunger activates many of the same stress-related hormones as emotions, which is why it can change your mood for the worse.
…[Hunger] experienced early on—especially during the first three years of life, when a child’s brain is developing rapidly and highly sensitive to chemical influences— can actually shape the brain’s architecture…The result is a compromised mental foundation, which, when combined with hunger’s everyday effects, puts kids at a severe learning disadvantage that is hard to reverse.
Source: The Atlantic
The research on the “gut-brain axis” was trending in the late 2010s, but it has yet to hit the mainstream. Few, if any, of the mental health startups benefiting from the $5.5Bn in capital deployed in 2021 are integrating gut health in their approach. Instead, the focus is on digitizing talk therapy and psychiatry — the latter particularly a hard pill to swallow given that antidepressants only work for 2 out of 10 patients. This is by no means to imply that talk therapy or psychiatric interventions are not valuable, but they are only one piece of the puzzle.
So why are we still treating mental health with a brain-centric approach?
To name a few reasons:
Medical care is siloed. Mental health and physical health have distinct educational tracks, with nutrition only getting 20 hours of airtime in med school. And very few traditional healthcare delivery models have built-in interdisciplinary teams. There are innovators at the forefront of integrative medicine working to change this - from functional medicine (Parsley Health) to “root cause medicine” (Rupa Health) - but these remain on the frontier.
There’s no one size fits all. It’s hard to develop gut-first interventions given that “each person’s microbiome is unique – so any treatment that targets the gut flora should take account of those differences. Overall, the exact composition between any two individuals only overlaps by around 10%…The hope, Foster says, is “to map out ‘bio-types’ or clusters of individuals who share the biology that might be driving their symptoms”. You might, for instance, first test whether a patient has high or low inflammation before deciding on the treatment.” (Source: BBC)
Western culture has a brain-centric bias. People commonly equate the brain with the mind, despite extensive research demonstrating that thinking occurs both inside and outside the brain: in our bodies, in conversation, and in the space around us (see my last post, Mind Blown). We’re only at the early stages of a paradigm shift that elevates body-centric information.
If you sense passion in my writing about this subject, it’s because I’m angry. I’m angry for the teenage Carine who was told that she was at fault for her stomach issues because she was stressed. I’m angry for all the people who are not receiving appropriate or effective care for mental health issues. And I’m angry that despite the funding and focus on mental health, we’re still treating humans like collections of body parts.
If anyone has read / listened to anything good on this subject, please send my way. I’d love to go down a rabbit hole.
Saving beauty.
In his essay "Saving Beauty,” cultural theorist Byung-Chul Han argues that society is enamored by a cult of smoothness:
This got me inspired to look for art and design that confronts, subverts, resists, or leaves the viewer unsettled (for good reasons).
Here are a few finds.
"Hugh Hayden, Surrealist Sculptor, Addresses the Education Debate" in the NYT
His public art installation in New York’s Madison Square Park takes on the thorny issues roiling American classrooms.
"This Is What Makes Demna Gvasalia Tick" in Vanity Fair
With headline-grabbing shows and subversive celebrity projects, the Balenciaga creative director is the runway’s reigning renegade.
"The Rise of the $2.5 Billion Ugly-Shoe Empire" in Bloomberg
From shearling Uggs to Hoka dad sneakers and rainbow Tevas, Deckers Outdoor Corp. keeps selling us the most hideous uglycore footwear.
Is the good life painful?
My friend Alex Kleeman likes to joke about how much he loves Type 2 fun, i.e., the “fun” that comes from doing hard things like running marathons, arduous hikes, sailing across the Pacific, starting a company, etc.
I find myself seeking out Type 2 fun (topic for a therapy session, I know…), so I was intrigued by this conversation with psychologist Paul Bloom about the role of suffering in happiness.
“Sean Illing talks with psychologist Paul Bloom about his new book The Sweet Spot, and whether it's necessary to experience suffering in order to live a fulfilling, meaningful life. They discuss the rich philosophical history of the question: what does it mean to be happy? They also talk about why some people are drawn to scary movies, whether or not to plug in to the Matrix, and why a good paradigm for a well-lived life might be found in the example of... a stand-up comedian.” (Vox)
Final thought
I have the hardest time straightening my arms in yoga, a fact which my instructor Papo never fails to remind me on Zoom.
The other day, he said something that’s stuck with me:
You have to spiral to straighten.
Have a great weekend, y’all. 👻