What Is The Connection Between Gut Health & Anxiety? Understanding The Gut-Brain Axis

Experts often describe the gut as the “second brain” due to its connection to our thoughts and emotions. Researchers are increasingly uncovering the intricate connection between gut health and anxiety, with findings suggesting that imbalances in gut bacteria may influence stress responses, balancing moods, and anxiety symptoms. Here, you’ll learn about the gut-brain connection and how it may impact mental health and anxiety, plus strategies to support both your digestive health and mental well-being.

Gut health and mental health: an overview 

The connection between the brain and gut (i.e., the stomach and intestines) is a relatively new area of research, but recent studies suggest a strong link between gut health and mental health. Research indicates that the gut microbiome—the diverse community of microorganisms living in the digestive tract—may play a critical role in influencing mood and mental health, including anxiety.

Understanding the gut-brain axis

While it can be easy to think of the mind as distinct from the body, the brain and digestive tract in fact work in tandem via the nervous system. Scientists call this pathway the gut-brain axis: a two-way system that allows the brain and gut to send signals back and forth. 

This network also involves the autonomic nervous system (ANS), the enteric nervous system (ENS), and the hypothalamic-pituitary-adrenal (HPA) axis. The ANS sends signals between the brain and gut, with the vagus nerve acting like a direct line. The ENS manages many digestive functions independently but still communicates with the brain. The HPA axis—the body’s main stress response system—releases hormones like cortisol, which influence both the brain and gut during times of stress.

Gut microbes are also thought to play a major role, as they help the body produce chemicals like serotonin (important for mood) and manage short-chain fatty acids (which reduce inflammation). They communicate with the brain by sending signals through the vagus nerve, hormones, and immune cells, allowing the brain and gut to influence each other.

The connection between gut health and anxiety: what the research says

Scientists are still working to fully understand the gut-brain axis and its role in anxiety disorders. However, the current body of research suggests that imbalances in gut bacteria—referred to as dysbiosis—may be linked to anxiety symptoms, while improving gut health may reduce them. 

Brain imaging studies show that gut bacteria may influence brain activity

Brain imaging studies reveal that gut bacteria and probiotics may impact brain activity and mood. These studies suggest that people taking probiotics showed changes in brain activity related to emotions and decision-making as well as improved energy and mood. These effects may be linked to gut bacteria's role in producing neurotransmitters like GABA and serotonin, which influence brain function and balancing emotions.

Anxiety disorders linked to reduced microbial diversity and fewer beneficial gut bacteria

Stress and anxiety disorders are associated with lower diversity in gut bacteria and a reduction in beneficial microbes. Studies indicate that individuals with anxiety often have fewer beneficial bacteria like Firmicutes and Tenericutes while harmful bacteria such as Escherichia-Shigella tend to be more abundant. These imbalances may contribute to anxiety severity by disrupting the gut-brain connection and increasing inflammation.

Gut bacteria patterns link irritable bowel syndrome (IBS) and mental health

Anxiety, depression, and IBS frequently overlap, and research suggests that similar gut microbiota imbalances may play a role in each of these conditions. People with both irritable bowel syndrome and mental illness often have lower gut bacterial diversity as well as specific patterns linked to inflammation, disrupted gut-brain signaling, and reduced short-chain fatty acids, which may contribute to both IBS and mental health symptoms.

Improving gut health may help improve anxiety symptoms

Some research suggests that improving gut health may help alleviate anxiety symptoms. Probiotics may help support gut bacteria balance, which is linked to improved mood management—especially when combined with antidepressants and therapy. Additionally, nutritional changes like consuming more fruits, vegetables, fermented foods, and dairy may enhance gut microbiota diversity, potentially reducing stress and anxiety.

The gut microbiome may play a significant role in sleep and mental health

Studies investigating the link between sleep and mental health suggest that altered gut bacteria may be linked to sleep disturbances in those with psychiatric conditions like anxiety, major depressive disorder, and bipolar disorder. Higher levels of beneficial bacteria may improve sleep quality, which is known to be essential for maintaining mental health and cognitive function/..

Improving gut health typically involves practices that help your body maintain a healthy balance of bacteria. Combined with other lifestyle improvements and mental health care, this approach might help in managing anxiety symptoms.

Incorporate gut-friendly foods into your eating patterns

Eating gut-friendly foods is a simple way to potentially improve gut health, which may help with both mental and gastrointestinal symptoms. Fermented foods like yogurt, kimchi, and kefir are rich in probiotics, which may help replenish and maintain healthy bacteria in your gut. In addition, fiber-rich foods like fruit, vegetables, whole grains, and legumes can act as prebiotics, feeding these beneficial bacteria. 

Limit processed foods and sugar

Research suggests that ultra-processed foods (i.e., heavily manufactured products that contain additives, preservatives, and artificial flavors) may negatively affect gut bacteria by encouraging the growth of harmful microbes. 

High sugar intake may also disrupt gut balance and increase inflammation, which could contribute to mood and anxiety symptoms. Limiting these foods might help support gut health and improve overall well-being.

Consider gut health supplements

Gut health supplements like probiotics may support digestive and mental health by influencing the balance of bacteria in the gastrointestinal tract. Studies in rodents indicate that probiotics may affect behavior and brain chemistry, and human trials suggest limited but promising benefits for reducing anxiety and depression symptoms. Speak to your doctor or nutritionist before taking vitamins or supplements.

Coping strategies for anxiety

While gut health can be one way to help you keep a clear mind, effective anxiety management often requires a combination of strategies. Incorporating self-care, mindfulness, and professional support may be the most effective way to reduce anxiety symptoms and improve overall mental well-being.

Prioritize self-care

Taking care of your physical and emotional health tends to be one of the more effective ways to help manage anxiety. To this end, you might focus on getting enough sleep, eating balanced meals, and staying physically active. Regular routines and hobbies that bring you joy can provide stability and reduce stress, helping you build resilience in the face of anxious thoughts. Socializing and investing in close relationships can also be helpful. 

Practice mindfulness and relaxation techniques

Mindfulness involves practicing a non-judgmental observance of the thoughts, feelings, emotions, or sensations that may arise in a given moment. This skill can help you stay grounded in the present, potentially mitigating stress and worry. Relaxation techniques like deep breathing, visualization, and progressive muscle relaxation may also help enhance mindfulness and reduce both physical symptoms and mental symptoms of anxiety.

Seek professional mental health support

Professional help can be vital for managing anxiety. Cognitive behavioral therapy (CBT) may be an especially effective way to treat anxiety in many cases. It’s a talk therapy approach that offers clients the tools to reframe anxious thoughts and improve lifestyle habits. Medications may be prescribed in addition for more severe symptoms, but remember to not start, stop, or change any medication without consulting a licensed healthcare provider. A therapist, counselor, or psychiatrist can guide you toward effective treatment options and provide the support you need to manage your anxiety.

Online mental health support for anxiety

If you are experiencing persistent anxiety symptoms such as trouble controlling worry, racing thoughts, difficulty concentrating, difficulty falling or staying asleep, and/or physical tension, it may be worth booking an appointment with a licensed therapist. 

In therapy, you’ll generally learn to recognize anxiety-provoking thoughts and replace them with healthier patterns that may reduce anxiety. As well as building a practical toolkit for managing your thought patterns, your therapist can be a source of guidance and encouragement for making any lifestyle improvements that could help with anxiety, like adjustments to exercise, nutrition, or sleep habits.

If there aren’t many therapists in your area or you can’t travel to and from in-person therapy appointments each week, you might consider online therapy instead. With BetterHelp, you can attend weekly therapy sessions remotely by phone, video, or live chat. BetterHelp also offers a full suite of tools and features designed to help you get the most out of your time in therapy, including guided journaling and digital therapy worksheets. Research suggests that online therapy can often be just as effective as in-person treatment, and it may be preferable for those seeking an affordable and convenient way to receive evidence-based mental health care.