The link between SIBO, depression & anxiety: insights from 5 expert practitioners

In today’s post I’m getting REALLY real (and vulnerable) – talking about a subject that’s hard for many people to broach: depression and anxiety.

Listen – I didn’t want to accept I had Small Intestine Bacterial Overgrowth (so not sexy), or Lyme Disease (from a bug!), so you can imagine my reaction to even considering depression & anxiety as factors in my health.

Didn’t wanna go there…

But that’s why this topic is SO important (and why I’m sharing my own story). Depression, anxiety, and gut health are all linked (in big and little ways).

Today, I’m going to share my OWN story and experiences, and then I’ll share excerpts from discussions I’ve had with various gut health experts about depression and anxiety.

The link between SIBO depression & anxiety
What’s the real connection between gut health and mental health?

My Story of Depression & Anxiety

First, I should say I never thought I had problems with anxiety or depression.

But I didn’t realize until I got my neurotransmitters balanced how whack-a-doodle-do they were. They were off!

I had genetic testing that showed I had some imbalances in serotonin and dopamine. My practitioner prescribed low dose naltrexone (LDN) (not an antidepressant – but it can help balance dopamine levels).

It changed my life!

My entire life I’ve struggled with anxiety, which I thought was normal. It would come and go. I would walk to that edge. And it was uncomfortable.

But I thought it was normal.

With the right neurotransmitter treatment, my whole entire being has transformed.

I don’t live on that edge of an anxious, nervous breakdown anymore. And I feel like, “Oh, my gosh! Is this how people that don’t have neurotransmitter imbalance live all the time?”

I share this so that you know: it can happen to ANYONE. And the signs aren’t always the ones we think of first (like unable to get out of bed, crying all the time…).

What helped me might not help you – but I hope something in these next excerpts WILL help you.

Dr. Lisa Shaver, ND, MSOM, LAc on Neurotransmitters

Dr. Lisa Shaver: So, absolutely, I would say there could be a link between addictions to anything—addictions to food, addictions to watching TV, addictions to social media, gaming online, to sex, to working out…

Shivan Sarna: Shopping…

Dr. Lisa Shaver: …shopping, absolutely, because of malabsorption of amino acids which feed our neurotransmitters. And neurotransmitters is what we need to feel balanced inside and balanced in the world out there. It helps us interact with us and interact with the outer world.

Shivan Sarna: And who sits around and thinks about “Hey, well, my quadriceps are doing great. My biceps are doing great. How are my neurotransmitters today?” No one talks that way.

Dr. Lisa Shaver: Even the word “neurotransmitter,” people are like, “I think I’ve heard of that before. What does that mean? How do you go about it?”

But I’ve done what I’d call targeted amino acid therapy or neurotransmitter balancing, gosh, for 18 years. And it’s so easy. You just use basically the breakdown of nutrition. You’ll be able to feel whether your balance that day and if you’re taking the right dose that day.

And so every person, again, individualized medicine. You could have a big, burly guy with severe depression and severe anxiety take a very low dose, or you could have a petite person with mild symptoms really need to go high on their dose because it all has to do with the internal biochemistry and our receptor years being able to take that signal and tell the brain and tell the body, “This is what you need.”

So, it’s individualized. You can’t have a standard dose for every person.

Dr. Stefani Hayes, ND, LAc on The SIBO-Depression Link

Shivan Sarna: You were talking about how you help people with SIBO, who have—it manifests also some depression and some anxiety, it’s part of the cascade. What do you think is causing that and what do you do for them? How can we help somebody today who maybe feels anxious or has bouts of depression that could be linked to their SIBO? What’s your take on all of that?

Dr. Stefani Hayes: As a naturopath, we’re trained in understanding the physiology of the body, and thinking about pathology along those lines. And what we know is that a large percentage, over three-quarters of our immune system lives around our gut. And so when there’s some dysfunction with the membrane of our intestine, then some big molecules can come through that can be inflammatory to the immune system, and also across that blood/brain barrier, or irritate the blood/brain barrier in a way that’s maladaptive.

And also, if the body can’t fully break down, let’s say, the amino acids, into the components where they can be turned into neurotransmitters, that can be really hard for depression and anxiety.

For me, it’s about finding that middle ground between helping with the inflammation component, so if it’s a neurotoxic effect, like often times, we talk about gluten for some individuals, and depending on their genetics, gliadin, if it’s not broken down well can be neurotoxic, so then an inflammatory component.

And sometimes just treating the SIBO, tightening up those gap junctions in the small intestine, really decreasing that inflammation in that whole region can help their brain because their body is not under this onslaught of inflammation can help their immune system for autoimmune conditions, where their body is confused.

Again, that smog, a lot goes on when the bulk of your immune system is living in that smog, and then it can mistake, it can attack the small intestine itself because one of the main theories about SIBO is that it’s an autoimmune condition.

It can attack the thyroid, it can attack the joints. And also, thinking about how can we minimize some of these chronic conditions, other chronic conditions, autoimmune conditions, that are really debilitating.

But then the other piece of how do you optimize because the main way to really help people with their products that build amino acids is to hopefully help them break down their foods well for that, or give them supplements, or even if they’re taking pharmaceutical medications, you want to make sure that they’re able to absorb them and assimilate them and get them to the brain in a way that’s efficient. And you can’t do that unless the small intestine is nice and healing.

Trudy Scott, CN on The IBS-SIBO-Anxiety Trio

Shivan Sarna: I know Dr. Siebecker and I have spoken about that, about how people—I mean, it’s pretty well-known if you’ve been studying your SIBO or depending on where you are in it, or IBS, that it is associated with anxiety. And like which came first, the anxiety or the SIBO/IBS, or the IBS/SIBO came first and then the anxiety…?

Trudy Scott: Yes. I’ve got two. And these are quite old ones which is interesting. When I wrote my book in 2011, I didn’t really know much about SIBO. But I did know that it was an issue for me. I didn’t actually have a name for it. I knew it was these digestive issues.

Well, the book came out in 2011. But it had to be delivered in 2009. So this was as of 2009—not ’09, 2010. But I did find two studies then. And these still apply. One was a paper. It was a published in 2008. It’s called State & Trait Anxiety and Depression in Patients Affected by Gastrointestinal Diseases.

And what they found is that “people with digestive complaints such as IBS, food allergies and sensitivities”—and they actually used the term “small intestinal bacterial overgrowth,” but the word SIBO wasn’t really well-known in those days. I didn’t learn about it in school—“the small intestinal bacterial overgrowth and ulcerative colitis frequently suffer from anxiety and depression.

And then, this other one which was published in 2001, Irritable Bowel Syndrome, Anxiety and Depression: What are the Links?

So, this is before there were the studies connecting IBS with SIBO. Now we know that a large proportion of people who have IBS, it is actually SIBO. But what they find in this particular study was that 50% to 90% of people with IBS who visited a doctor, all their digestive issues also had panic disorder, general anxiety disorder, social phobia and even post-traumatic stress disorder, and major depression.

So, there’s the research there. And now, we’ve got newer research that I know you and Dr. Siebecker has talked about. But it’s pretty interesting that this research has been around a long time.

Shivan Sarna: I’m just so glad we have concrete numbers on it to help people who are not believers. It really does help. The rest of us sometimes don’t need the double blind study. We get it. It’s there, it’s there.

Niki Gratrix on ACEs, Trauma, and SIBO

Shivan Sarna: So what if I’m just getting through my life, I’m getting through my day. I’m struggling. I’m hanging in there. I have some joy. I’ve got some days off where I actually relaxed. My gut is not in great shape. I don’t feel traumatized. I mean I’m stressed, but isn’t everybody stressed?

What should we be thinking about in a new way to help ourselves because I think most people are operating like that—actually if they’re lucky. They’re lucky to be operating like that, right? That is a champagne problem right there. How can we dive deeper?


Niki Gratrix: So, “stress” is a widely used word. And we’re going to define more closely what we mean by the word “stress” and dive into that. But what most people don’t realize is, when you’re stressed, most people just think of that as maybe they’re stressed in their mind, and actually you are truly a stressed organism when you have stress. The whole body responds to stress.

And the issue is that most people don’t realize, when you look at the stress literature about adult stress, you use that word, most people kind of think about having too much to do, too many emails, the school runs, that is somewhat stressful. But what people don’t realize is that most of your stress response is actually set up in childhood.

In the stress research, when you have an external stressor, something big like maybe losing a job, or a job stress, the big things that can happen when you’re an adult, it’s not the event itself, it’s the perception and how we respond to it. The problem is that one person actually deals with that fine, and another person, they’ll tell you that “I had this stressful event, and that’s when all my gut problems started” or “That’s when I got this chronic illness. I had this stressful event.”

The point is that you have a bit of stressor at the time. But most likely, it was caused by early life experiences because someone else has had the same stress as you and didn’t catch a physical illness.

And bear in mind that you’re not just stressed in your mind, you are a stressed organism. Your whole body is responding to stress. And we’ll talk about that a little bit more.

If early life stress is what is setting us up for our resilience to stress in adulthood, how sort of prevalent is early life stress?

I’m going to talk about the Adverse Childhood Event Studies which were studies of early life stress in children where they were looking over 17,500 adults. It was done by the CDC and Kaiser Permanente, sort of mainstream researchers. It was a massive study of that many people. And they basically looked at the correlation between the amount of early life stress and the onset of chronic complex illness in adulthood.

The researchers said that, from the time the trauma is happening in the child, they are marinating in inflammatory cytokines from the date the trauma happens.

So, when you get a physical expression of gut dysbiosis, you develop SIBO, you develop whatever digestive issues, it probably started 20 years before. It was cumulative over time. And then, you probably had a trigger event, and then you had a more of a physical manifestation of symptoms.

Dr. Steven Sandberg-Lewis, ND, DHANP Explains Depression & SIBO “Cross Talk”

Shivan Sarna: I know this is a rabbit hole, but I’m okay with this because I really think a lot of people are dealing with this. Are they called SSRI? Is that what they’re called?

Dr. Sandberg-Lewis: That’s the original group, and now, we have the SSNRIs also that affect not just serotonin but norepinephrine as well.

Shivan Sarna: So is the SSNRI, is that Wellbutrin?

Dr. Sandberg-Lewis: I believe so, yes. So those things modulate serotonin receptors as well. At least they affect the reuptake of serotonin from the interneuronic space, and make a stronger serotonin effect.

Shivan Sarna: Could this possibly be one of the connections between the brain and gut? Is this where they’re saying that people—this is such a reach, but people with the altered microbiome could be more prone to depression and mood disorders? Is that the same deal?

Dr. Sandberg-Lewis: It’s a real thing. It is true that even—yes. Digestive problems can definitely cause or add to depression and anxiety through many mechanisms—which I love to get into if you want to, but maybe you don’t want them. There are some mechanisms, but we’ll try to make it more practical.

Shivan Sarna: Would it also be the reverse? So you are depressed, and that leads to more digestive problems. You have digestive problems, that can lead to you to being more depressed. That’s depressing. That whole thing that I just said is depressing.

Dr. Sandberg-Lewis: We call it crosstalk. It goes both directions—from the central nervous system, to the gut, and the enteric nervous system, and the enteric nervous system is interacting very intimately with the microbiota that make up the yeast, the bacteria, the viruses that make up the GI microbiome.

No Shame  – Just Information

Since my own journey with these issues, I’ve realized that the stigma around these conditions causes many people to suffer for YEARS in silence.

That’s got to stop. No more shame!

So where do you start if you want to learn more?

First things first – you should always talk to your doctor or practitioner. Every situation is unique and you need someone who can make specialized recommendations for you.

But I also have a quick resource to share: 21st Century Solutions to Depression eBook.

This is a free eBook produced by GreenMedInfo that I found helpful personally. It has lots of new information on depression and anxiety that I hadn’t heard before.

I’d also love to know what your experience with SIBO, gut health, and depression anxiety has been. I think open dialogue on this topic is the MOST important thing we can to get rid of the stigma and get more people the help they deserve. Please leave a comment and share your thoughts!

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13 thoughts on “The link between SIBO, depression & anxiety: insights from 5 expert practitioners”

  1. Jennifer Donovan

    I started having digestive issues along with a terrible, bitter taste in my mouth 7 months ago. I also started suffering near-constant, debilitating anxiety. I have just been diagnosed with SIBO but my insurance won’t cover the antibiotic prescribed and it costs $1,800! I am retired, on Social Security and can’t afford that. Is my anxiety likely connected to the SIBO? And is there anything I can do? I’ve tried an SSRI and an SNRI, and both just increased my anxiety enormously.

    1. Hi Jennifer,

      I’m so sorry to hear all that!

      First of all, Dr. Siebecker does say that, with her SIBO patients, she has three treatment options – one of which is pharmaceutical antibiotics (like what you’ve been prescribed), but there’s also herbal antibiotics and there’s the elemental diet. If you’d like to learn more on her protocol, we recently did a webinar with her on her 9 Steps to Treating & Beating SIBO. It’s free. And you can watch it here.

      On your other note about anxiety… we’ve done a lot of work with a lot of different digestive experts. And a lot of them do feel that by working on your digestive health, you can tremendously impact mental health. That being said, SIBO may be contributing to your anxiety, but it doesn’t mean it’s the only one. Still… I would be curious to know what impacts treating the SIBO would have on your mental health…

      Good luck! Keep on marching!!!

  2. Hi I just recently found out I have SIBO. I have been suffering from gut issues, anxiety, and depression for a year now. It all started last summer in 2019. I took three rounds of antibiotics during my trip to Puerto Rico from continuous ear infections. Shortly after I got back I noticed I started having major problems with my gut. I went and seen my PCP who told me to take an over the counter probiotic and take some stool softeners. Nothing worked. He also started me on 50 mg of zoloft and told me it seemed I had some anxiety about this. But I can tell you then when he prescribed this medication I didn’t feel the way I feel now. I have tried six different medications with 5 out of those 6 having adverse reactions. Right now I am on 300 mg of nefazodone. It has helped for the most part. I still feel my anxiety and at times my depression. I got the call today that they are discontinuing nefazodone and will be putting me on trazodone. My question is, is there a reason why these meds have not worked fully for my anxiety and depression? Could it possibly be because of the SIBO? Not sure how antidepressants work on the brain when its a gut disruption thats causing my anxiety and depression. I know I have a lot of childhood trauma but know that I have never felt anxiety and depression before all this started. I need help. I am seeing a naturopath who is starting me on the SIBO protocol to get rid of the SIBO and will be getting my good bacteria back in balance after I get rid of the SIBO. I am looking for answers. Thank you.

    1. Also I suffer from IBS within the last year as well. That is why I am commenting on here because I read about how IBS, SIBO, anxiety and depression are all linked. I don’t like these meds. I don’t like how I feel on them and would eventually like to get off.
      Thank you

      1. Hi Patricia,
        It sounds like you’ve been on a REALLY long digestive and mental health journey! But it’s so promising to hear that you found yourself a good practitioner…
        I’m sure there are other things that can contribute to mental well-being – and many of our go-to experts really subscribe to the idea that digestive health is one of those MAJOR contributing factors. But the only way to know for sure if that’s YOUR one and only contributing factor is to work through those digestive issues and see if it improves the anxiety and the depression.
        We’re rooting for you! I’m glad you’re on a SIBO protocol. We’d be curious to know how that affects your mental health symptoms… so keep in touch!
        PS if you’re in the Facebook group, we’d love to have you on there so we can keep up with you in a more real-time kinda fashion 🙂 Keep on marching!

  3. Hi. After reading this I wonder if this could be what’s going on with me. Anxiety and depression hit after years of trying to conceive. IBS, I believe, as long as I can remember and now sibo. What type of MD would I see to get tested and do you know if insurance generally covers it?

    Thx, Tami
    Valparaiso, Indiana 46385

    1. Hi Tami, wonderful to hear from you! We certainly subscribe to the connection between gut health and brain health… and also, hormonal health for sure!

      Getting a functional doctor onboard might be a great start. But you’ll need to call in to their individual offices to see if they offer coverage.

      Have you had a chance to look into our featured experts list? It’s basically just a list of the people we’ve featured in our programs and series along with their general practice location and contact information. If you can’t find anyone near your area – since we know it’s a bit tricky to find a good practitioner match – I suggest considering online consults. That’s certainly a possibility (in fact, I know that’s how Shivan started working with Dr. Allison Siebecker who gave her first win’s and successes… she’s an ND though. And unfortunately, she also happens to be in hiatus).

      You can find the FREE speakers’ list here.

  4. Do you have a referral for a doctor in the Ann Arbor/Jackson Michigan area? I’m in CA. Mom is 83yrs old. Suffered with this for years but lately it’s become debilitating. Because of the belly and back pain with the diarrhea, she sleeps ALOT. That, we think, has caused her to become so weak she was hospitalized, following a colonoscopy. She could walk the necessary amounts to satisfy PT and therefore wasn’t eligible for a rehab stay. They discharged her, and she subsequently fell at night while trying to get to the bathroom, and now has a compression fracture of T-12. She’s in rehab. The morphine for the pain of the fracture, stemmed the diarrhea until they took her off the morphine this Friday. Now she’s back to the IBS and it’s pain. She sees a gastroenterologist but he’s at his wits end. She sees a psychiatrist who has her on a med that is the seratonin and norepinephrine reuptake kind. She’s tried gluten free, dairy free, supplements from a pharmacologist. Just wondering if we’re missing something, or you can recommend a doctor in her area that specializes in this illness. She’s still in rehab but guessing will be released soon, at which time I’ll go back there to help til she gets stronger.

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