By Nicole Trister, LCSW
A few thoughts on the gut, the mind, and the conversation we keep avoiding.
A month ago I sat in on a talk about the relationship between gut health and mental health, and I haven’t quite stopped thinking about it since.
That’s usually a good sign — when an idea keeps tugging at me long after the room has emptied. It wasn’t that any of it was new. Most of it I already knew in the loose, background way we “know” so many things: filed away, vaguely true, rarely examined. But there is a difference between knowing something and actually sitting with it, and this was one of those talks that pulled a familiar idea to the front of the room and made me look at it directly.
So I want to do that here — out loud, with you. Not as an expert; I’m not a nutritionist, and I won’t pretend to have any of this solved. Just as a therapist, and as a person, thinking through something I don’t believe we talk about nearly enough.
Two conversations that were never separate
Here is a number that gets thrown around a great deal: somewhere between 90 and 95% of the body’s serotonin is produced in the gut. Serotonin — the molecule we tie to mood, to feeling steady, to the whole architecture of anxiety and depression — and nearly all of it is made nowhere near the brain.
It’s a striking fact. It also happens to be true. But I want to slow down here, because it’s precisely the kind of fact that gets flattened into something it doesn’t quite mean. It is tempting to read it as your gut is quietly running your emotional life — and that isn’t it. Under ordinary conditions, the serotonin made in your gut doesn’t even cross into your brain. The popular version smuggles in a tidy cause-and-effect story the biology never actually promised.
Which, to me, is the more interesting version anyway. Not a body pulling the strings from below, but a body and a mind in continuous conversation — and a stubborn habit, inherited and rarely questioned, of treating them as two separate appointments. Physiology in one room, psychology in another. I have never quite believed it works that way.
How gut health and anxiety feed each other
I see it most clearly in the room with clients. So many of the people I sit with who are working through anxiety or depression are also, quietly, managing IBS, SIBO, a gut that seems to have a mood of its own. That overlap isn’t a coincidence, and it isn’t lost on me.
IBS is a useful example of how tangled this can get, because it lives at the intersection of the gut, the brain, and the nervous system — never purely one or the other. And so much of the suffering isn’t the sensation itself but the meaning we assign to it. We have a word for the capacity to register what’s happening inside our own bodies: interoception. When someone is anxious, that inner signal grows loud and hard to interpret. A perfectly ordinary gut sensation gets read as a warning. The warning breeds fear. The fear sharpens vigilance, and vigilance, in turn, makes the sensation louder still.
That’s the symptom-fear cycle, and once you’ve seen it you can’t unsee it: the body offers a signal, the mind appraises it as a threat, and the two begin to feed one another. Which is exactly why I don’t think you can pull them apart. You cannot fully soothe the gut without attending to the fear, and you cannot fully address the fear without taking the gut seriously.
The part that is genuinely hard
And then there is food itself — which is where all of this turns tender.
Food is never only fuel, or only a trigger to be managed. It is one of the plain joys of being alive: the meal shared with people you love, the dish that tastes like home. So there is a quiet grief in watching someone try to manage their physical symptoms through an ever-narrowing diet, whittling one of life’s real pleasures down to a short list of what feels “safe.” I think about this with the rise of GLP-1s, too — how something that genuinely helps in one register can, in another, dull or erase the pleasure and connection a meal once carried.
Food is also, for many of us, a way to cope. We reach for it to take the edge off. For some, that tips into overeating or bingeing — which does offer relief, real relief, for a moment, before it turns around and talks back to that gut-brain conversation, leaving the whole system more dysregulated than it found it. None of this makes anyone weak, or broken. It makes us human. And it makes the whole subject one to approach with considerable gentleness.
Trying to choose well in a world built to overwhelm us
Now set all of that inside the world we’re actually living in.
We are in a dopamine-saturated moment where nearly any food you can imagine sits a few taps away — DoorDash, Uber Eats, the next craving met before the last one has faded. And layered over that, we are drowning in information, in a marketplace where everyone has something to sell: a supplement, a diet, a protocol, a shortcut. Drink more water. Sleep eight hours. Take this. Cut that. It is an enormous amount to hold, and most of it arrives wrapped in someone’s incentive.
So how do we make sense of it — beyond the deceptively simple work of tuning into our own bodies and noticing what feels good and what doesn’t? I don’t have a clean answer. But I keep returning to the small, unglamorous things. Mindful eating. Actually chewing your food — twenty, thirty times — because the first phase of digestion begins in the mouth, and because slowing down is itself a form of attention. These sound almost too modest to matter. I suspect they matter precisely because they are a way of attending to the body rather than overriding it.
For me, the clearest version of this is running. I love it — and not only for the reasons people tend to list. Endurance training turns out to be a quiet, almost sneaky education in listening to your own body, a skill a great many of us have never really practiced. Run after run, you begin to notice what you would otherwise talk right over: how hydrated or how depleted you feel, how heavy or light your legs are today against yesterday, how one meal carries you for miles and another leaves you dragging. It is interoception you can feel in your legs — the body keeping an honest record, if you are willing to read it.
The thing we think about but rarely say
Here is something I notice, in myself as much as in anyone: most of us think about food far more than we ever actually talk about it. It runs like a low background hum — what to eat, what we shouldn’t have, what we already did — and it almost never surfaces into open conversation. That, I think, is exactly what needs to change: in the therapy room, yes, but also in ordinary, honest talk among friends.
Because none of us truly knows how to make sense of all this stimulation and choice. But we do know, underneath the noise, that it has to be made sense of somehow. It is a complicated, interwoven mess — and the work is not to solve it in one clean stroke. It is to untangle it slowly: to notice which threads actually generate anxiety, to troubleshoot those one at a time, and to make the whole thing mean something rather than simply weigh on us.
Where I land
Let me be clear about what I’m not saying. I’m not reporting breaking news. None of this is a discovery, and I am not claiming to know something no one else does. I am not handing you a solution.
What I’m saying is quieter than that: these things are connected. The gut and the brain, the body and the mind, what we eat and how we feel — connected, in ways we still tend to overlook, and nowhere more so than in the therapeutic space where I spend my days. And if you’ve found your way to this little corner of the internet, then I think it’s worth looking at — and looking at critically, with curiosity rather than one more rule to obey or one more product to buy.
Maybe it comes down to this. In a world forever pulling us toward the next click, the next video, the next thing we were never quite sure we needed, it is worth trying to eat as if our mental health depended on it.
Because, quietly, it does.
Curious about the connection between how you’re feeling and how you’re living? Therapy can be a space to slow down and listen to what your body and mind are telling you. Reach out anytime at therapy@nicoletrister.com.