Overthinking, Constipation, & Persian-Inspired Salad

I spent August 2017-May 2018 getting off of stimulant laxatives. I had been taking them for about 10 years at that point, and was completely dependent. When I started embarking upon the laxative-quitting journey, I realized there was no roadmap. There were no resources. I had to forge my own path.

Luckily, this is something I’m really used to.

I feel like all of the positive changes I’ve made & accomplishments I have are the result of me forging my own path. I low key think that this is part of my karma for this lifetime, I’m supposed to figure things out for myself so that I can teach others.

Anyway, back to quitting laxatives. During that time period, I found that I was extra anxious. I was always overthinking, thinking the worst, and spiraling.

I later learned that this made complete sense: the constipation was affecting my GABA levels, which in turn, were making my constipation worse. Let me explain…

GABA & Overthinking

What is GABA? Gamma-aminobutyric acid (GABA) is a non-proteinogenic amino acid and the chief inhibitory neurotransmitter in the mammalian CNS. It is synthesized from glutamate through the action of the enzyme glutamate decarboxylase (GAD) and acts primarily through GABA receptors, which are classified into GABA-A and GABA-B receptor subtypes. GABA-A receptors are ligand-gated ion channels, while GABA-B receptors are metabotropic G protein-coupled receptors. GABAergic neurotransmission plays a crucial role in maintaining the balance between neuronal excitation and inhibition, thereby regulating various physiological processes, including motor control, sensory perception, and emotional regulation.

Role of GABA in Psychological Functioning: GABAergic neurotransmission is closely associated with psychological functioning, influencing mood, cognition, and behavior. Low levels of GABA have been linked to symptoms of anxiety, depression, and sleep disturbances. Moreover, deficient GABAergic inhibition may contribute to cognitive deficits, such as impaired attention, memory, and executive function. Of particular relevance to mental health is the association between low GABA levels and maladaptive cognitive patterns, including overthinking, rumination, and negative self-perception. Chronic stress and trauma have been shown to dysregulate GABAergic neurotransmission, leading to alterations in emotional processing and vulnerability to psychopathology.

Low GABA and Psychological Symptoms: Low GABA levels have been implicated in the pathophysiology of various psychological disorders, including anxiety disorders, depression, and post-traumatic stress disorder (PTSD). Individuals with low GABA activity may experience heightened physiological arousal, intrusive thoughts, and exaggerated emotional responses to stressors. Furthermore, deficient GABAergic inhibition can disrupt the balance between excitatory and inhibitory neurotransmission, leading to hyperactivity within neural circuits implicated in anxiety and mood disorders. Symptoms associated with low GABA levels may manifest as persistent worrying, rumination, self-criticism, and feelings of inadequacy or worthlessness.

Causes of Low GABA: Several factors can contribute to low GABA levels, including genetic predisposition, environmental stressors, and lifestyle factors. Genetic polymorphisms affecting GABA receptor function or GABA synthesis enzymes may predispose individuals to altered GABAergic neurotransmission and increased susceptibility to mental health disorders. Chronic stress, trauma, and adverse childhood experiences can disrupt GABAergic signaling pathways, leading to long-term alterations in neurotransmitter balance and stress response systems. Additionally, lifestyle factors such as poor diet, inadequate sleep, gut issues, and substance abuse can impair GABA function and exacerbate symptoms of psychological distress.

Strategies for Increasing GABA Levels: Given the critical role of GABA in psychological functioning, strategies aimed at enhancing GABAergic neurotransmission may have therapeutic potential for treating mood and anxiety disorders. Pharmacological interventions targeting GABA receptors, such as benzodiazepines and GABA analogs, can enhance GABAergic inhibition and alleviate symptoms of anxiety and insomnia. However, long-term use of these medications may be associated with tolerance, dependence, and withdrawal symptoms. Alternatively, non-pharmacological approaches, including dietary interventions, lifestyle modifications, and mind-body practices, may offer more sustainable strategies for increasing GABA levels and promoting emotional well-being. For example, dietary factors such as consumption of GABA-rich foods (e.g., fermented foods, whole grains) and nutrients involved in GABA synthesis (e.g., vitamin B6, magnesium) may support optimal GABAergic neurotransmission. Furthermore, lifestyle practices such as regular exercise, mindfulness meditation, and relaxation techniques have been shown to modulate GABA levels and reduce symptoms of anxiety and depression. Incorporating these interventions into comprehensive treatment plans may offer synergistic benefits for individuals with low GABA activity and associated psychological symptoms.

GABA x Gut Health

The gut microbiota, composed of trillions of bacteria, fungi, and other microorganisms, plays a crucial role in gastrointestinal function, immune regulation, and overall health. Emerging research suggests that certain bacteria in the gut are capable of producing neurotransmitters, including GABA. For example, species of Lactobacillus and Bifidobacterium have been shown to produce GABA through the decarboxylation of glutamate, an amino acid precursor.

The gut-brain axis is a bidirectional communication system linking the central nervous system (CNS) to the enteric nervous system (ENS) and the gastrointestinal tract. This communication occurs via neural, hormonal, and immune pathways, allowing signals to be transmitted between the gut and the brain. The gut microbiota, through its metabolites and byproducts, can influence neurotransmitter synthesis and signaling along the gut-brain axis, including GABAergic neurotransmission.

GABA is not only produced in the brain but also in the enteric nervous system (ENS), the "second brain" located in the gut. GABAergic signaling in the ENS helps regulate various aspects of gastrointestinal function, including intestinal motility, secretion, and sensation. Dysregulation of GABAergic signaling in the gut has been implicated in gastrointestinal disorders such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).

Alterations in the composition and diversity of the gut microbiota, known as dysbiosis, can disrupt GABA production and signaling in the gut. Dysbiosis has been associated with changes in neurotransmitter levels, including GABA, and alterations in mood, cognition, and behavior. Conversely, interventions that restore microbial balance, such as probiotics or dietary modifications, may help normalize GABAergic neurotransmission and improve mental health outcomes.

GABAergic signaling in the gut can influence intestinal permeability and immune function. GABA receptors are expressed on intestinal epithelial cells and immune cells in the gut, where they modulate barrier integrity and immune responses. Dysregulated GABAergic signaling may contribute to increased gut permeability (leaky gut) and immune activation, leading to systemic inflammation and susceptibility to gastrointestinal and neurological disorders.

Constipation x GABA

I have no brain scans or neurological testing to prove it, but I’m convinced that my constipation was affecting my GABA levels, which was causing the overthinking and spiraling. Chronic constipation can act as a physical and psychological stressor, leading to increased levels of stress hormones like cortisol. Elevated cortisol levels can negatively impact GABAergic neurotransmission. High stress can deplete GABA levels in the brain, contributing to anxiety, depression, and further disruptions in gut motility. Plus, constipation often results from or leads to an imbalance in the gut microbiota (dysbiosis). Dysbiosis can affect the production of neurotransmitters, including GABA, by gut bacteria. Beneficial bacteria such as Lactobacillus and Bifidobacterium species are involved in the synthesis of GABA. Chronic constipation and dysbiosis can reduce these beneficial bacteria, leading to lower GABA production. Constipation can lead to gut inflammation due to the prolonged presence of stool in the colon, which may irritate the gut lining and disrupt the gut barrier. Inflammatory cytokines released during gut inflammation can cross the blood-brain barrier and influence brain function, potentially reducing GABAergic activity and increasing the risk of neuroinflammation and mood disorders. Another potential cause is via neuroendocrine disruptors: The stress associated with chronic constipation can dysregulate the hypothalamic-pituitary-adrenal (HPA) axis, leading to altered stress hormone levels and disrupted neurotransmitter balance. Dysregulation of the HPA axis can negatively affect GABA synthesis and receptor sensitivity, exacerbating both stress and constipation. Lastly, chronic constipation can affect the absorption of essential nutrients required for GABA synthesis, such as vitamin B6, magnesium, and zinc. Poor nutrient absorption can lead to deficiencies that impact the enzymatic processes involved in GABA production, resulting in lower GABA levels.

As the gut-brain axis is bidirectional, low GABA can also affect constipation. GABA is involved in the regulation of the stress response via the hypothalamic-pituitary-adrenal (HPA) axis. Chronic stress can lower GABA levels, leading to increased activity of the HPA axis and elevated levels of stress hormones such as cortisol. High cortisol levels can negatively affect gut motility and fluid secretion, further contributing to constipation. GABA helps in the fine-tuning of signals between the brain and the gut. Low GABA levels can disrupt this communication, leading to impaired neuromuscular coordination in the gut. This disruption can manifest as irregular or insufficient contractions of the intestinal muscles, contributing to constipation. Moreover, low GABA levels are associated with increased anxiety and depression, which can exacerbate gastrointestinal issues. Psychological stress and mood disorders are well-known contributors to functional bowel disorders, including constipation. Anxiety can lead to hypervigilance and increased muscle tension, including in the gut, which may impede normal bowel movements.

Breaking the Cycle

To address the bidirectional relationship between constipation and low GABA levels, the following strategies may be beneficial:

• Dietary Interventions:

  • Increase dietary fiber intake from fruits, vegetables, legumes, and whole grains to promote regular bowel movements and support gut microbiota health.

  • Include probiotic-rich foods like yogurt, kefir, sauerkraut, and kimchi to enhance beneficial gut bacteria that produce GABA.

• Hydration:

  • Adequate fluid intake is crucial for preventing constipation and maintaining optimal digestion.

  • Lately I’ve been OBSESSED with fresh coconut water for hydrating, but also check this link for some mineral-rich beverages that can properly hydrate you.

• Stress Management:

  • Incorporate stress-reducing practices such as mindfulness, yoga, and deep breathing exercises to lower cortisol levels and support GABAergic function. You can check the Blush Academy for guided meditations, breathwork, and other resources to regulate your nervous system & manage stress levels.

• Exercise:

  • Regular physical activity can improve gut motility and overall mental well-being, helping to break the cycle of constipation and low GABA levels.

• Nutrient Supplementation:

  • Ensure adequate intake of nutrients involved in GABA synthesis, such as vitamin B6, magnesium, and zinc, through diet or supplementation if needed.

This Dish

Inspired by the Persian “Salad Shirazi,” which is a salad of chopped tomatoes, cucumbers, red onion, in lemon juice & olive oil; this salad includes the traditional tomato, cucumber, red onion, and lemon; but we added brown lentils and arugula, and have a light & bright pistachio-lemon dressing. I garnished mine with arugula flowers, corn flowers, and radish flowers, but those are optional obviously!

The Benefits

The ingredients in this salad are designed to improve overall gut health, keep you regular, support GABA production, and help reduce feelings of anxiety, depression, and overthinking. Specifically:

• Fiber: Fiber is abundant in ingredients like arugula, cherry tomatoes, cucumbers, red onion, brown lentils, and zucchini. Dietary fiber plays a crucial role in maintaining gut health by promoting regular bowel movements, supporting the growth of beneficial gut bacteria, and reducing inflammation in the gut lining. A healthy gut microbiome is linked to improved mood and cognitive function, as well as reduced anxiety and depression.

• Prebiotics: Prebiotics, found in garlic, onions, and lentils, are non-digestible fibers that serve as food for beneficial gut bacteria. By promoting the growth of these bacteria, prebiotics can enhance gut health and contribute to the production of short-chain fatty acids (SCFAs), which have anti-inflammatory and neuroprotective effects.

• Probiotics (from miso): Miso is a fermented soybean paste rich in probiotics, beneficial bacteria that colonize the gut and support digestive health. Probiotics play a crucial role in maintaining the balance of gut microbiota, which in turn influences neurotransmitter production, including GABA. By promoting a healthy gut microbiome, probiotics may indirectly contribute to GABA synthesis and reduce anxiety and overthinking.

• Omega-3 Fatty Acids (from pistachios): Pistachios are a good source of omega-3 fatty acids, particularly alpha-linolenic acid (ALA). Omega-3 fatty acids have anti-inflammatory properties and are essential for brain health and neurotransmitter function. Research suggests that omega-3 fatty acids may help regulate mood and reduce symptoms of anxiety and depression by modulating neurotransmitter activity and neuroinflammation.

• Magnesium (from pistachios and lentils): Pistachios and lentils are both excellent sources of magnesium, a mineral that plays a critical role in neurotransmitter regulation and stress response. Magnesium deficiency has been associated with increased levels of anxiety and overthinking, as magnesium is involved in GABA receptor function and the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress response.

• Vitamin C (from cherry tomatoes and lemons): Cherry tomatoes and lemons are rich in vitamin C, an antioxidant nutrient that supports immune function and reduces oxidative stress in the body. Vitamin C also plays a role in neurotransmitter synthesis, including GABA. Adequate vitamin C intake may help maintain optimal GABA levels and protect against anxiety and overthinking.

• GABA-Enhancing Nutrients: Certain nutrients found in the salad ingredients may directly or indirectly support GABA synthesis or activity. For example, vitamin B6 (found in lentils and pistachios) is a cofactor in the conversion of glutamate to GABA. Zinc (found in lentils) is involved in GABA receptor function, while glutamine (found in lentils) is a precursor to GABA synthesis.

The Recipe

Salad Ingredients:

• 2-3 cups cherry tomatoes

• 1 big cucumber

• 1/3 red onion

• 1 can brown lentils

• a couple handfuls arugula

Dressing Ingredients:

• 1 big zucchini, raw, chopped

• 1 whole lemon, peeled

• 1/4-1/2 cup pistachios (just depending on how rich you want it)

• 2 tbsp white or chickpea miso

• 1 clove garlic

Instructions:

1. Blend the dressing ingredients together until super smooth!

2. chop the tomatoes, cucumber, and red onions. I spiraled the cucumber, but that's really only for aesthetic purposes/because I think it's fun to eat that way. You slice or chop however you want

3. drain & rinse the lentils

4. combine everything & toss with dressing

Links & Brands from the Recipe

• This is my handheld spiralizer. There are prob better ones out there (I bought this years ago!), but I have no complaints about this one, and it’s compact & easy to store.

• I really like the BioItalia brand of legumes in general, including the brown lentils

• I love these extra cups for the vitamix so you can make things in smaller batches

• vitamix itself

For more on Overthinking, Self-Esteem, and GABA

To hear more on gut health, the nervous system, anxiety, and more, listen to episode 181, “Am the A**hole: Overthinking, Spiraling, & Constipation on Keto,” available everywhere you listen to podcasts (including on Apple here), and you can WATCH the whole episode on Spotify (available here).