Depression & constipation – which came first? The chicken and the egg

Depression & constipation – which came first? The chicken and the egg

Constipation tends to go hand in hand with low mood, and research has shown that individuals experiencing depression are far more likely to also suffer from chronic constipation.

The neurotransmitter serotonin is often associated with contentment and mood regulation however, serotonin also plays a significant role in gut motility & stool transit time. Therefore, low serotonin levels may lead to dysregulated mood as well as constipation.

Are you constipated?

Constipation is generally described as passing a stool less than 3 times per week and having dry, hard stools which are difficult or painful to pass.

However, the nutritionist in me feels that aiming for more than 3 stools a week is far too low. Whilst we all have varying transit times and diets, we should ideally be striving to get our health to a place where we can pass a stool daily and with ease.

This becomes even more pertinent when someone is experiencing dysregulated moods.

Why might constipation make depression worse?

So, is your constipation making your low mood worse? Here are several different ways why this might be the case:

  • Quality of life – as with many digestive conditions, constipation can have a significant impact on quality of life and often can be painful too, leaving people feeling fatigued, bloated, and uncomfortable. Feeling low in energy understandably doesn’t make it easy to enjoy activities and can lead to social withdrawal and potential worsening of mood.
  • Disrupted gut bacteria – constipation is linked to dysbiosis, an imbalance in the composition of friendly bacterial species in the digestive tract. When food sits for too long in the colon, it can encourage ‘unfriendly’ bacteria to proliferate, crowding out beneficial species. Hormones and neurotransmitters associated with depression are produced and regulated in the gut via beneficial bacteria, therefore dysbiosis may disrupt their synthesis and signalling to the brain, ultimately affecting mood. I frequently conduct gut health tests as part of my one-to-one programmes due to the impact this can have on how a person feels.
  • Inflammation – stools sitting in the colon for too long can lead to detoxified products being reabsorbed via the gut wall and back into the blood stream, leading to an increased toxic load and inflammatory substances recirculating in the body. Inflammation can directly drive the substrates required for the synthesis of serotonin down an alternative pathway causing a reduction in its overall availability for optimum mood regulation.

Why might depression make constipation worse?

Likewise, although constipation can make depression worse, depression may also lead to constipation. Here are some reasons why:

  • Reduced physical movement – it is understandable that often when feeling low, exercise is the last thing we feel like doing, but physical movement is essential to stimulate the large intestine and encourage healthy bowel movements. Decreased physical activity and increased sleeping can slow digestion down and make constipation worse.
  • Poorer foods choices – similarly, it is common the reach for comfort foods when experiencing low mood, such as cakes, crisps, and biscuits. However, these foods often have little nutritional value and are usually very low in fibre, encouraging less bulky stool formation and therefore having the potential to compound constipation symptoms.
  • Stress – stress and low mood often understandably present together, and stress can have a direct effect on the digestive system. In times of perceived stress (emotional or physical) digestive secretions are inhibited, as your body prioritises resources elsewhere, prolonging transit time and contributing to constipation.  
  • Medications – some medications used for dysregulated mood can cause constipation. Whilst it is important to continue prescribed medications, it is worth considering taking extra dietary and lifestyle steps care to minimise constipation (see below).

Tips to alleviate constipation:

Here are some simple strategies to try at home to help get things moving in the right direction:

  • Chew! – chewing food thoroughly is the first stage of successful digestion and stimulates the release of gastric juices, vital for overall gut motility.
  • Water – dehydration is a major contributor for constipation. Try to drink 2 litres of water each day for optimum digestion.
  • Fibre (e.g. oats, whole grains, rye bread) – fibre helps bulk out stools which stimulates the colon and reduces constipation. Try to go for whole grain varieties of pasta, rice and bread and include a serving of whole grain with each meal.
  • Up your fruit and vegetable intake – fruit and vegetables add water and fibre to the digestive tract. Aim to eat 5 portions of vegetables and 2 fruit daily.
  • Chia & flax seeds – adding chia or flax seeds to porridge, for example, is a great way to help increase stools. They are a great source of fibre and can encourage bowel movements – ensure that you are well hydrated before eating these.
  • Heed the call! – if you feel the urge to go to the toilet, try to ensure you listen to your body and not put it off. This is common, especially amongst women, however, ignoring the signs can lead to a more sluggish digestive system and make constipation worse.  
  • Movement – gentle daily movement is extremely beneficial– even if it is simply a spot of gardening or a few trips up and down stairs at home each hour.

I hope that was helpful.

I specialise in personalised & evidence-based one-to-one programmes which focus on identifying the root causes of low mood & anxiety, pulling together the nutrition and lifestyle changes that make a HUGE difference – helping you feel calmer, happier, and more optimistic.

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