Understanding The Gut Health & Anxiety Connection

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Geoffrey Whittaker

Updated 01/03/2023

A lot of people without advanced degrees in science have parroted the phrase “you are what you eat” over the years, but according to recent studies, most of them have no idea how right they were. There are so many connections between the foods we eat and our health that we hardly have room to explore them all, but one that’s more important than you may know is the connection between gut health and anxiety.

The connection between your gut health and anxiety isn’t a simple one. 

There’s no study saying that a certain number of Oreo® cookies causes anxiety disorders, and nobody that we’re aware of has pinpointed the precise number of mozzarella sticks a person needs to consume per year to induce panic attacks. 

The gut-brain connection is slightly more nuanced than that. But there are some real connections between the flourishing or failure of the microbiome in your stomach and your own quality of life.

To understand how gut health and mental health are connected, we need to take a look at an important communication link between your digestive system and the rest of your body: the gut-brain axis.

Your gut and your brain are constantly connected and affecting one another. And all of this minuscule connection is taking place in a communication system often referred to as, “the gut-brain axis.”

The gut-brain axis is the connection between the gut’s microbiome composition and the central nervous system’s nerve cells. It goes both ways. 

Your intestinal bacteria and microbiota can also act as chemical messengers that send signals to your nervous system, which are then sent along to your brain. In return, your brain sends signals through your nervous system to your endocrine function, immune response and other systems, which eventually affect your gut flora.

We don’t fully understand the weight and depth of the connection between brain function and digestive health, but we’re finding that they have a deep connection that can both amplify existing psychiatric disorders and increase your risk of ones you don’t have.

There’s evidence, for instance, that antibiotics (which kill bacteria and other flora) are bad for the gut and might affect your mental health. Likewise, there’s evidence that probiotics (which increase activity in your guy) have the opposite effect. But the effects of probiotics are in their earliest stages of research, and the picture of their relationship is far from clear.

Oh, and in case you were wondering about those stomach cramps and other maladies and their relation to mental health, a 2010 study explored the connection between aches and pains and anxiety and depressive disorders, and found that there was indeed a deep link. 

Anxiety and depression, it turns out, can exacerbate conditions and also make us feel discomfort more intensely, which means a person with depression or anxiety (or both) technically could feel more intensely the pain of a stomach ache, even if it’s not directly related to their mental health.

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We’ve looked closely at how anxiety and depression can make your gut health worse already, but you might be wondering whether your gastrointestinal tract health can affect your mental health. It turns out, there’s a connection here, too.

That anxious nausea you feel before a big public speaking occasion probably answers all the questions you have about the connection between your mental health and your digestive system, but on a deeper, macrobiotic level, poor gut health can also cause mental illness.

A 2017 review looked at inflammation and dysbiosis — the loss of beneficial bacteria and flora in the gut— as it related to mental health. The authors acknowledged a wide collection of research that shows gut issues like those we just mentioned can indeed cause mental illnesses, including anxiety and depression.

The review explained studies that examined gut flora found that when they thrived and were diverse, there was a connection between the normal function of the digestive tract and the normal function of the immune cells and neurological systems. 

When that flora died off, however, it changed the molecular makeup of blood in ways that can affect the brain’s function and can therefore lead to depression.

Now, lest you think science has cracked the case in some way, we still have more questions than answers. 

There are a lot of elements to this relationship. Everything from medications, to diet, and immune function plays a role in the gut microbiome, and so simply stating that gut problems equal brain problems would be inaccurate. 

But, further studies into the effects of diet, metabolism, harmful bacteria and other elements of this connection will hopefully someday yield a better picture of this connection. Who knows — maybe one day a “crash diet” to address mental illness will trend on social media.

As for the modern solution to mental illness, gut-based treatments have limited qualifications. Research has shown that when antagonists to gut health are removed and gut health returns to normal, it can reduce the signs of anxiety and depression — but this has only been clearly observed in mice so far.

More particularly, there’s not currently an understanding of how to best utilize things like probiotics. While we do believe they can help, knowing how and when and in what quantities we should utilize them is an important (and yet undefined) part of the solution.

For the time being, the gut biome is one largely unexplored element of physical and mental health management. And when it comes to depression and anxiety, it shouldn’t be the only one you address.

Anxiety treatment may consist of any (or all) of the following:

  • Seeking therapy

  • Taking medication

  • Enjoying a healthy diet

  • Stopping smoking

  • Abstaining from stimulants and depressants (like drugs and alcohol)

Practically speaking, a good treatment plan for anxiety may  include something like cognitive behavioral therapy, which can help you deal with anxiety on the “anxious thoughts” level. 

CBT is a great system for learning to take that “what if” scenario and eliminate it before it gets your thoughts spiraling out of control. And medications like antidepressants and beta-blockers have demonstrated benefits for anxiety sufferers — both for their mental and physical symptoms of depression, respectively.

As for the upset stomach problem, treating it with the appropriate medications and having any serious digestive symptoms of diseases like irritable bowel syndrome or inflammatory bowel disease looked at by a healthcare professional will reduce your discomfort. When paired with anxiety treatment to address the physical and psychological symptoms you’re experiencing, the combo can make whatever is going on in your head and gut more manageable.

Learn more in our blog about foods to avoid with anxiety.

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Let’s take things from the microscopic level to the 30,000-foot view for a moment. 

Whether your gut-brain axis is at fault for (or even related to) your mental health is ultimately not a certainty—even people who eat a healthy diet and take care of their bodies can be susceptible to anxiety and other mental illnesses. 

But the gut-brain axis is one of the many areas where a healthcare professional will look for answers when you show up with depressive symptoms or irritable bowel syndrome, and questions. 

That’s why it’s so important to involve a healthcare provider as soon as possible when mental health conditions appear or worsen. 

If you’re ready to get tailored help and support, consider our online therapy and mental health resources for their convenience. We’re available 24/7, but whether you go with us or another healthcare provider, get help today. You shouldn’t have to stomach another day of discomfort.

4 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. NIMH » anxiety disorders - national institute of mental health (NIMH). (n.d.). Retrieved November 22, 2022, from
  2. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017). Gut microbiota's effect on mental health: The gut-brain axis. Clinics and practice, 7(4), 987.
  3. Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015 Apr-Jun;28(2):203-209. PMID: 25830558; PMCID: PMC4367209.
  4. Woo A. K. (2010). Depression and Anxiety in Pain. Reviews in pain, 4(1), 8–12.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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