Gut thinking: the gut microbiome and mental health beyond the head.

Grace Lucas

doi:10.1080/16512235.2018.1548250

Abstract

ABSTRACTBackground: In recent decades, dominant models of mental illness have become increasingly focused on the head, with mental disorders being figured as brain disorders. However, research into the active role that the microbiome-gut-brain axis plays in affecting mood and behaviour may lead to the conclusion that mental health is more than an internalised problem of individual brains.Objective: This article explores the implications of shifting understandings about mental health that have come about through research into links between the gut microbiome and mental health problems such as depression and anxiety. It aims to analyse the different ways that the lines between mind and body and mental and physical health are re-shaped by this research, which is starting to inform clinical and public understanding.Design: As mental health has become a pressing issue of political and public concern it has become increasingly constructed in socio-cultural and personal terms beyond clinical spaces, requiring a conceptual response that exceeds biomedical inquiry. This article argues that an interdisciplinary critical medical humanities approach is well positioned to analyse the impact of microbiome-gut-brain research on conceptions of mind.Results: The entanglement of mind and matter evinced by microbiome-gut-brain axis research potentially provides a different way to conceptualise the physical and social concomitants of mental distress.Conclusion: Mental health is not narrowly located in the head but is assimilated by the physical body and intermingled with the natural world, requiring different methods of research to unfold the meanings and implications of gut thinking for conceptions of human selfhood.

Highlights

In recent decades, dominant models of mental illness have become increasingly focused on the head, with mental disorders being figured as brain disorders
Since the anti-psychiatry movement of the 1960s [3] and the analysis from critical psychiatry that has followed [4], debates have continued about what is constitutive of mental illness or mental disorder, especially given the changing nature of psychiatric diagnostic manuals over time [5]
Neuro-explanations of mental health have dominated the last decades of mental health research with mental disorders being re-cast as brain disorders [6], but often on shaky evidential ground and widely contested, especially by social psychiatrists [7]

Summary

Introduction

Dominant models of mental illness have become increasingly focused on the head, with mental disorders being figured as brain disorders. Objective: This article explores the implications of shifting understandings about mental health that have come about through research into links between the gut microbiome and mental health problems such as depression and anxiety It aims to analyse the different ways that the lines between mind and body and mental and physical health are re-shaped by this research, which is starting to inform clinical and public understanding. In recent years, research into the microbiome–gut–brain axis has foregrounded the impact of the gut microbiome on mental health [10], inverting these dominant top-down models of mental illness This emerging evidence, which shows observable links between gut dysbiosis and some mental health conditions, suggests that mental health is not all about the head, after all, leading to some paradigm shifting interpretations and conclusions about what is meant by ‘mental’ health, and how it should be treated [12]

Objectives

Methods