Learning to Trust Our Gut: What Workers’ Comp Can Glean from the Connection of Digestive Health to Mental Wellness

By: | October 3, 2023

Maja Jurisic, MD, CPE, vice president and medical director of strategic accounts at Concentra®, is a leader in applying research findings to improve patient care. Board-certified in emergency medicine and occupational medicine, Jurisic is a leading advocate of a pain scale alternative that is actively reducing opioid use. She has served as a consultant for various states in a federal initiative to improve return-to-work/stay-at-work outcomes for injured employees.

When trying to improve workers’ compensation outcomes, there is a mental health aspect that must be considered. According to a large epidemiological study conducted by the University of Michigan, 50% of the U.S. population will struggle with a mental health issue at some point in their lives.

This study also revealed that suicide is the 10th leading cause of death overall. World Health Organization (WHO) data revealed that 25% of all health-related disability is due to mental health and substance use conditions — eight times more than disability caused by heart disease and 40 times more than cancer.

The workers’ compensation arena is not immune to this increase in mental health issues. Yet there is a shortage of mental health professionals, and in many cases, access is not easy. However, in the face of this bleak landscape, there are stirrings of change that offer hope of help from an unexpected quarter.

The Gut-Brain Connection

Did you know our gut can affect our mental health? The newest branch of psychiatry, nutritional psychiatry, is taught and practiced in places like Harvard Medical School and Massachusetts General, and it focuses on how our diet affects our mental health. Our gut microbiome, the community of both harmful and helpful organisms that live in our gut, has a profound effect on mental health. In fact, all it takes is two hours’ worth of psychological stress to completely change the bacteria in our gut.

We have long recognized that our gut mirrors emotions that arise in our brains; our language reflects this. When we talk about our stomach being “tied up in knots,” having a “gut-wrenching experience” or feeling “butterflies in our stomachs,” it’s the emotion-generating circuits of our brains that are responsible. The drama of emotion that plays out in our gut might not become a painful melodrama if we fed our gut bacteria a more nourishing diet.

The primary reason that gut bacteria have such a profound effect on mental health is that they are responsible for making many of the brain chemicals necessary for good mental health. Dopamine, serotonin, glutamate and gamma-aminobutyric acid (GABA) are critically important neurotransmitters for the regulation of mood, memory and attention. Without enough “good bacteria” in our gut, their production is negatively affected.

As medicine has become ever more specialized, it has become easier to lose track of the big picture — looking only at single organs or body parts to determine what is wrong and needs “fixing.” Now, we are learning that changes in mental health are a signal that one or more of the body’s connections with the brain has gone awry, and this often starts with the gut.

Hippocrates, the father of modern medicine, recognized this connection. He warned that “bad digestion is the root of all evil” and that “death sits in the bowels.” Granted, he was indulging in a bit of hyperbole, but we are now learning that he was making an important point.

When the brain and the gut work well together, our body responds to challenges such as injuries more effectively. &

Part two of this series will cover the gut-brain axis and continue to dive into the profound effect this relationship can have on injury recovery.

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