Probiotics And Anxiety: Does The Gut Hold The Key To Better Mental Health?

According to the World Health Organization (WHO), anxiety disorders may be among the most prevalent mental illnesses, generally impacting around 300 million people worldwide. Many of those experiencing these disorders seek strategies to reach a better overall quality of life. These strategies may include probiotics, dietary shifts, and other treatment modalities. While these disorders can be rooted in stress, it may also be linked to a form of gut dysbiosis. Probiotics have been scientifically supported as a potential treatment for dysbiosis, which may impact mood management and quality of life. However, probiotics may not fully treat mental health symptoms, and it is generally recommended to attend therapy sessions as well, whether you choose to do so online or in person.

What is a microbiome, and what is gut bacteria?

The term “gut microbiome” may be used to describe the balance of healthy and unhealthy gut bacteria and fungi, known as gut microbiota, within any bodily system, such as the gastrointestinal tract. 

Although the word "bacteria" may be related to illness for many, science suggests that there may be other types of “good” bacteria that play a role in human health.  

Harvard Medical School has also found that while there may be an empirically proven link to a balanced microbiota and lessened instances of anxiety disorder-related symptoms, prolonged anxiety can also disrupt the proper balance within the gut. This could reinforce the concept of a potential “two-way road” between the gut and the brain (the gut-brain connection), which may function as its own evolutionary and instinctually based communication channel. 

Working toward achieving microbiota balance in the gut through a steady intake of prebiotics, probiotics, and digestive enzymes may result in a better overall quality of life. Before any dietary amendment or supplementation takes place, you may consider speaking with your physician.

The gut-brain axis: How does the gut impact mental health?

Recent research has supported the theory that there may be a “two-way road” between the gut and the brain. This can be called the “gut-brain axis” or “gut-brain relationship.” Although many may think of neurological functions when we talk about hormones and mood management, new evidence supports that mood management can be influenced by our gut bacteria and dietary habits. Research suggests that individuals with small intestinal bacterial overgrowth may experience depression and anxiety. 

Researchers have also found that the majority of the body's serotonin receptors usually live in the gut for many patients, and they are believed to have identified five out of the seven known serotonin-signaling families throughout the GI tract. This may have an impact on your mental health and experience with anxiety disorder, as serotonin has often been scientifically documented as a key controller of anxiety disorder-related symptoms, sleep quality, and more.

How does anxiety impact the gut?

Although your gut may directly impact your central nervous system and personal experience with anxiety disorder, anxiety disorder-related symptoms may also directly affect your gut.  

Research and physician accounts suggest that the onset of anxiety symptoms can cause an increase in stomach acid, which can irritate your gut lining. Stomach acid imbalance or excess can lead to poor absorption of nutrients, poor breakdown of food, acid reflux, and ulcers.

Chronic stress can also increase gut permeability, which may be related to heightened instances of bacterial overgrowth in the gut or further gastrointestinal disturbances. 

Related inflammation in the gut can lead to an immune system response in which inflammatory response proteins called cytokines may cross the blood-brain barrier — which may directly impact anxiety disorder-related symptoms.  

Probiotics for mental health: What does science say? 

Probiotics can help support a healthy and balanced bacterial colony in the gut. They have also been scientifically suggested to modulate and maintain immune and inflammatory gut responses.

If you’re looking for a helpful probiotic strain, you may find several in commercial probiotic supplements. These probiotic strains may include variations from the Lactobacillus and Bifidobacterium genera, such as:

• L. acidophilus 
• L. johnsonii
• L. rhamnosus
• B. bifidum 
• B. breve 
• B. longum

Restored gut balance may support a higher quality of life for those living with an anxiety disorder or exacerbated symptoms of an anxiety disorder due to gut dysregulation.

Working with a qualified medical professional to determine if probiotics or prebiotics are right for you is a first step you can take if you’re considering using probiotic supplementation to mitigate symptoms of an anxiety disorder. 

Are probiotics safe? 

Probiotics may be considered safe for many people. However, there may be risks any time you engage with supplementation that directly impacts your body’s natural processes. These risks can include: 

• Antibiotic resistance in certain situations or with certain antibiotic groups 
• Bacterial overgrowth with excessive supplementation 
• Possible infection or infection exacerbation if there is an underlying weakness in the GI tract 

Your physician can help you determine whether probiotic supplementation is appropriate in your case. They may also advise that you take precautions to minimize your risk of adverse effects. 

Impact of probiotics on general mental wellness 

While science may suggest a link between probiotic supplementation and enhanced quality of life for those living with anxiety disorders, it may also support a higher overall state of mental wellness. 

One specific double-blind placebo-controlled study suggested that mental functioning, stress, and anxiety were usually improved in individuals taking a probiotic compared to those in the placebo group.

In a meta-analysis of the anxiety and depression scores from several randomized controlled clinical trials, researchers found that the use of probiotics generally suggested a decrease in depressive symptoms in those who live with depression compared to the placebo group. Clinical trials suggest that stress can also be decreased in individuals taking probiotics. One study found that probiotics typically helped healthy young adults with their sleep, gut health, and overall mental wellness while undergoing stress.

High quality probiotics may improve the function of the cenetral nervous system, which plays a role in the prevention of anxiety and depression. Also, the bacteria present in probiotics may have beneficial properties for the immune system. Since certain anxiety symptoms may weaken your immune system, probiotics may be a valuable tool for mental health and well-being.

For more information on probiotics, see the following study, titled “The anxiolytic effect of probiotics: A systematic review and meta-analysis of the clinical and preclinical literature”.

Can we consume probiotics naturally through food?

Every probiotic formulation tends to be unique, which is why many may find that they have a better overall experience with clinician supervision over the course of their treatment. 

Some probiotic supplements may be fortified with unnecessary additives, sugars, and other ingredients, which can contribute to the proliferation of gut health issues and the acceleration of anxiety disorder symptoms in some cases.

You may choose to consume probiotics naturally by eating foods such as: 

• Yogurt 
• Miso 
• Pickles
• Sauerkraut 
• Sourdough 
• Fermented cheeses 
• Tempeh 
• Kimchi

Science suggests that certain fermented foods may have rich stores of probiotics, potentially providing extra support for gut health. Maintaining a healthy, probiotic-rich diet filled with gut-friendly foods may be an easier lifestyle change for some than formal supplementation. You might consider speaking with a licensed medical professional about ways to maintain beneficial bacteria and healthy gut flora.

Going beyond probiotics with online therapy

While supplements can be helpful for those living with anxiety disorders, they may be most effective when used in conjunction with more traditional treatment options, such as therapy. Today, many opt for online therapy, as it is often more convenient and affordable than traditional in-office therapy.

Online therapy can be an effective form of treatment for those who live with mental health conditions like depression and anxiety. Those experiencing this disorder may not feel comfortable opening up about their experiences in an unfamiliar or clinical setting. This could potentially pose a barrier to treatment and support. However, with online therapy, those who live with anxiety can seek support via in-app messaging or scheduled calls and video chats in a safe, familiar environment, which may mitigate excessive anxious thoughts or feelings around getting support and assistance.

Is online therapy effective for anxiety disorder? 

While online therapy can be different in delivery from in-person therapeutic sessions, research shows that online therapy can be effective for anxiety, major depressive disorders, and other mental disorders. A meta-analysis of over 20 separate and unrelated studies suggests that online therapy can provide comparable therapeutic benefits to in-person therapy sessions, specifically in those who live with anxiety disorders.