We saw in the last article on gut health, that inflammation causes an increase in pro-inflammatory molecules that weaken and cross the blood brain barrier (BBB) into the brain. This article will detail that process and explain how the traumatized brain is affected by that inflammation. For adults with childhood trauma, this inflammation in the brain can occur for years and contribute to many of the mental health issues these patients face every day.
We have previously discussed in this series how chronic toxic stress activates the HPA stress response system in the body and causes it to become hyperactive. This hyperactive state in and of itself has an impact on the health of a person, however, when cortisol is released, it also activates the inflammatory mechanisms in the body. When this happens, pro-inflammatory cytokines are released into the body and contribute to a detrimental loop; toxic stress increases pro-inflammatory cytokines, which in turn increase the stress response of the body by hyperactivating the HPA axis. The adrenal glands then release an abundance of glucocorticoids (cortisol among them) which throws the negative feedback loop controlling the HPA axis off balance. [1] So basically, the more toxic stress a person experiences in early life, the more the HPA axis will be dysregulated and increase inflammation; the more inflammation, the greater the HPA dysregulation. This gives us the basic mechanism by which trauma increases inflammation in the body. Now we can look at the effects this increase has on the mental health of a person.
Pro-inflammatory cytokines such as interleukin 6 (IL6), and tumor necrotic factor alpha (TNF-alpha) activate neuronal inflammation and upregulates inflammation pathways in the brain. This activation produces an observable behavior change in an individual and may be responsible for symptoms of mood disorders and/or other psychiatric disorders such as schizophrenia.[2] Pro inflammatory cytokines also reduce growth factors such as brain derived neurotrophic factor (BDNF) reducing neuroplasticity, neural differentiation, and neurogenesis, making trauma recovery more difficult. Neuroplasticity and neurogenesis (formation of new neurons) is necessary to form new neural pathways in the brain, allowing childhood trauma patients to establish new patterns in their adult lives. When this ability is hampered by chronic neuronal inflammation, the ability to recover from trauma and establish healthy patterns in life is also hampered despite therapeutic interventions.[3]
The pro-inflammatory state that adult trauma survivors often find themselves in can be helped with dietary interventions. One of the main substances found in the body that helps reduce overall inflammation is glutathione, often called the master antioxidant. Research shows a correlation between reduced glutathione levels and an increase in mental health disorders, indicating this antioxidant is highly important in helping the brain regulate neuronal activity. [4] In the brain, glutathione donates specific molecules to reactive oxygen species (ROS) to effectively neutralize their damaging activity to brain tissues. Endogenous ROS, such as hydrogen peroxide and super oxide, are increased by the presence of pro-inflammatory cytokines and are the specific molecules that cause damage to existing neuronal cells.[5] When there is an increase in the production of ROS due to chronic inflammation of the system, as is the case with childhood trauma survivors, this cellular damage is also chronic in nature and prevents the brain from functioning properly.
This increase of ROS would also require an increase in antioxidants to combat the damage they cause. When this need is chronic and not accounted for in the diet, the levels of glutathione available to the body is depleted over time, while the level of oxidative damage increase, potentially causing some of the aforementioned mental health issues as an adult survivor. Glutathione is formed in the body from three conditionally essential amino acids (cystine, glutamine acid and glycine) and enzymatic reactions. It is therefore essential to provide the body enough amino acids and support the enzymatic function necessary to produce glutathione endogenously. Research is mixed on supplementing with glutathione itself, as it sometimes does not pass-through stomach acid intact. If supplemental glutathione is used, liposomal, sublingual, or injections may work better for that reason. 4
There are several sulfur rich foods that can be included into the diet that contain glutathione itself, along with some of the precursors such as N-acetyl cystine (NAC- containing the amino acid cystine). Asparagus, cucumbers, avocados, broccoli, and bananas are some of the foods that top this list and could be included in the diet of someone wanting to boost their glutathione levels. Selenium is an important co-factor in one of the enzymatic reactions needed to form glutathione. Including foods like shrimp, salmon, chicken, beef, and scallops which are rich in that mineral is also advised. In addition to those foods, adding in bone broth is also a good way to boost glutathione production. Bone broth contains cystine, glutamic acid, and glycine, along with sulfur, all of which are necessary for the body to boost glutathione production.
Along with including these types of foods in the diet, adult trauma survivors may also benefit from following an anti-inflammatory diet until their nervous system is calmed down and they are no longer producing large amounts of pro-inflammatory cytokines. This type of diet would aim to reduce the amount of omega 6 fatty acids, processed foods, sugars, processed grains and industrial produced meats/seafoods from the diet. It would be designed to increase omega 3 fatty acids from quality sources, whole fresh vegetables and fruits, grass fed meats and wild caught seafoods. Dairy and grains can cause an inflammation reaction in some people, so those types of foods would have to be looked at on a case-by-case basis and may also need to be eliminated for a time. An anti-inflammatory diet would also include probiotic foods such as fermented pickles, sauerkraut, and kvass to help with any gut issues which can contribute to systemic inflammation, as discussed in the previous article here.
In this series we have delved into the realm of childhood trauma and how it impacts the biological stress response system throughout adulthood. We have seen how the stress response system becomes hyperactive and causes changes in the brain, body, and gut which research shows all contribute in some way to the potential mental health issues adult survivors often suffer from. We also looked at ways diet and nutritional therapy can help support more traditional talk therapies, psychotherapies, or cognitive behavioral therapies that many adult survivors find themselves participating in. Hopefully this information provides some optimism for the future for individuals suffering from this type of trauma as an adult and gives some valuable tools to help aid in recovery of a convoluted matter.
References
[1]Schiavone S, Jaquet V, Trabace L, Krause KH. Severe life stress and oxidative stress in the brain: from animal models to human pathology. Antioxid Redox Signal. 2013;18(12):1475-1490. [2]Jin Y, Sun LH, Yang W, Cui RJ, Xu SB. The Role of BDNF in the Neuroimmune Axis Regulation of Mood Disorders. Front Neurol. 2019;10:515. Published 2019 Jun 4. [3] Kiyimba, N. (2016). Developmental Trauma and the Role of Epigenetics. BACP Healthcare Counselling and Psychotherapy Journal. 2016 October, p18-21. [4]Minich DM, Brown BI. A Review of Dietary (Phyto)Nutrients for Glutathione Support. Nutrients. 2019;11(9):2073. Published 2019 Sep 3. [5]Yang D, Elner SG, Bian ZM, Till GO, Petty HR, Elner VM. Pro-inflammatory cytokines increase reactive oxygen species through mitochondria and NADPH oxidase in cultured RPE cells. Exp Eye Res. 2007;85(4):462-472.
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