Why do mainframers feel the way they do? Part 2

This week, we continue our look at what can affect the mental health of mainframers. Having discussed genetics, a person’s history, and the effects of adrenalin, we start looking at how a person’s GI tract affects their mind, and vice versa.

Intestinal permeability (ie leaky gut) occurs with chronic low-grade inflammation, which happens more often in disorders such as anxiety or depression.

It is estimated that 90 percent of the body’s serotonin is made in the digestive tract. In fact, altered levels of gut serotonin have been linked to diseases such as irritable bowel syndrome, cardiovascular disease, and osteoporosis.

Stress can affect the composition of, and the total amount of, biome (bacteria etc) in a person’s gut. The biome can be directly affected by neurons, immune cells, and enterochromaffin cells (neuroendocrine cells found in the gastric glands, that aid in the production of gastric acid through the release of histamine).

The brain also modulates gut functions such as: motility; the secretion of acid, bicarbonates, and mucus; intestinal fluid handling; and mucosal immune response. These maintain the mucus layer and biofilm where individual groups of bacteria grow.

Plus, the brain may affect the biome composition and function by changing intestinal permeability, allowing bacterial antigens to penetrate the epithelium and stimulate an immune response in the mucosa (mucous membrane). So, through the autonomic nervous system, the brain modulates immune function, which can increase epithelial permeability to bacteria, which facilitates their access to immune cells.

Changes in the composition of the gut flora due to diet, drugs, or disease correlate with changes in levels of circulating cytokines, some of which can affect brain function. Cytokines are small proteins that affect the behaviour of cells around them. They are especially important in the immune system.

The brain and the gut are connected by the vagus nerve, which wanders (its name comes from the same source as the word vagabond) round the body and contains nerves sending messages from the brain, and nerves sending messages to the brain. It affects how the gut behaves (trying to keep everything well – a homeostatic role), but it’s also part of the Gut-Brain Axis, sending messages from the gut to the brain, which then impact on mood.

The gut is also closely linked to the body’s immune system. Most of the body’s immune system works on the gut! When our immune system identifies an invader, it releases cytokines, and the body is protected by inflammation as white cells attack the invading organisms. However, some people have low levels of inflammation all the time.

It’s worth noting that the brain and the immune system have two-way links.

Stress can cause inflammation. Stressful events include bereavement, poverty, debt, social isolation, and maltreatment as a child. Being overweight causes inflammation. Even public speaking can increase inflammation!

Most inflammation occurs on the inside of the body, which people can’t see. One of the ways that the body naturally keeps the levels of inflammation down is through the vagus nerve. It controls the inflammatory reflex.

The inflammatory reflex is a neural circuit that regulates the immune response to injury and invasion. If cytokine levels in the body rise, the vagus nerve will detect the change and send a message to the brain. A signal is then sent down the vagus nerve to the spleen, acting on macrophages (white blood cells) to reduce the cytokine level. Cytokines can cause collateral damage to the body’s cells near them. Interestingly, vagal nerve stimulation can reduce inflammation. Increased vagal signalling inhibits inflammation and prevents organ damage.

The health and fitness of the vagus nerve is called vagal tone. A high vagal tone equates to a better capacity to keep inflammation down.

Other factors associated with increased inflammation include: obesity; sedentary lifestyle; disordered sleep; emotional and physical trauma; medical illnesses such as cardiovascular disease, diabetes, cancer, and autoimmune; infections (including exposure to unsanitary living conditions and poor hygiene); medical treatment such as surgery, chemotherapy, or radiation; and antidepressant treatment resistance.

The body’s natural immune response can trigger oxidative stress temporarily. This type of oxidative stress causes mild inflammation that goes away after the immune system fights off an infection or repairs an injury. Oxidative stress refers to an imbalance of free radicals and antioxidants in the body, which can lead to cell and tissue damage. Free radicals are molecules with one or more unpaired electron that are very reactive. Antioxidants are substances that neutralize or remove free radicals by donating an electron. The neutralizing effect of antioxidants helps protect the body from oxidative stress. Examples of antioxidants include vitamins A, C, and E.

The blood-brain barrier protects the brain. We used to think it was impenetrable.

The neuroimmune system is composed primarily of glial cells and mast cells (a type of white blood cell). During a neuroimmune response, cytokines send inflammatory signals across the blood-brain barrier, which activates microglial cells in the brain, which then release more cytokines. As a consequence, this can kill neurons or shrink them, reduce the number of synaptic connections, and the synaptic supply of neurotransmitters can be disrupted. And it can block the regenerative process that would create new cells. Tryptophan is a serotonin precursor. Microglial cells can instruct nerve cells to make other end products such as kynurenine. This makes less serotonin available in the brain and kynurenine (and other alternative end products) are toxic. So, inflammation in the body can have a negative impact on the brain – perhaps, leading to depression.

There’s lots of research evidence linking inflammation in the body with depression.

What I’m suggesting here is that the mental health of mainframers and others can’t be taken in isolation and needs to be looked at along with the physical health of their body.

But even that isn’t enough. The mental health of a person depends on a much bigger picture. George Engel in 1977 first came up with the idea of a biopsychosocial model. He suggested that in order to understand a person's medical condition more than just biological factors had to be considered. It’s also important to look at psychological and social factors. And these three types of factors are interlinked. In 2017, Wade and Halligan said, it is generally accepted that “illness and health are the result of an interaction between biological, psychological, and social factors”.

Psychological factors include: stress management; positive thought; resilience; mental discipline; and giving and receiving love. Social factors include: support from social groups; and access to medical and health education. Lastly, biological factors include: healthy diet; exercise; freedom from addiction; time to relax; and no genetic predisposition to disease.

And, maybe, we can take that a stage further. How a person feels depends very much on their employer’s attitude towards their staff, and politics – how keen national and local government are to ensure a person feels safe and has somewhere to live; whether they have access to education and health services; whether there are shops and places of entertainment nearby; and whether there are affordable and green transport links for business. And so much more.