Mind-Body Connection: How Health, Thoughts, Feelings
and Behaviors Interact
Counselor Toolbox Podcast Episode 433
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs.com
Podcast Host: Counselor Toolbox, Case Management Toolbox

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– A healthy body is essential to health and happiness.
– Explore…
– How emotions are created
– How physical symptoms including pain, fatigue are created
– How is this done (general overview)
– HPA Axis
– Circadian Rhythms
– Gut-Brain Axis and the Vagus Nerve
– The bidirectional relationship between the mind and body
How are Emotions Created (Simplified)
– Born with the capacity for anger (fight), fear (flee/freeze), depression (f-It)
– Emotional responses are regulated by the autonomic nervous system (ANS)
– SNS- Sympathetic (Fight or Flee)
– PSNS- Parasympathetic (Rest and Relax)
– The limbic system helps control the ANS and PNS
– Hippocampus (memory consolidation, learning, attention, olfaction)
– Amygdala (fight or flee/survival)
– Hypothalamus (hormone regulation (HPA-Axis))
How are Emotions Created
– Unconditioned emotional responses are reactions to stimuli which did not need to be learned– i.e. present from birth
– Startle (puppy)
– Pain-Cry (shots)
– “Love”/ “contentment” (kangaroo care)
How are Emotions Created
– Conditioned emotional responses are learned emotional reactions to stimuli
– What things get conditioned and how can they cause or reduce stress-
– Dogs/Fire/Police/Guns
– Phone Calls
– Being Alone (child vs. adult)
– Transference
– Failure
– Rejection
– Loss of Control
HPA –Axis (Threat Response System)
– Secretion of adrenaline, norepinephrine and corticotropin releasing hormone (CRH)
– Cortisol is released
– Glutamate is released and GABA is inhibited
– Blood pressure increases
– Blood glucose is elevated
– Some 5HT receptors are activated, others are inhibited

Neurobiology of Attachment
– Hormones including dopamine, norepinephrine, cortisol, oxytocin and the serotonergic system modulate attachment
– Opioids may inhibit oxytocin and reduce feelings of social connection
How Physical Sensations Are Created
– Nociception can occur in the absence of awareness of pain, and pain can occur in the absence of measurably noxious stimuli
– CNS receives a pain signal from the PNS (peripheral nervous system)
– This triggers the Autonomic Nervous System and HPA-Axis
– All pain “information” is transmitted via glutamate
– An “inflammatory soup” is created which results in signals to the CNS as well as initiating inflammation which releases substance P and causes vasodilation, leakage of proteins and fluids into the extracellular space near the terminal end of the nociceptor (swelling), and stimulation of immune cells
– Substance P is associated with depression and anxiety symptoms
Neurotransmitters Pain & Fatigue
– Serotonin
– 5-HT2A receptor produces anxiety, pain, insomnia
– 5HT1A receptors reduce anxiety, pain, insomnia
– Serotonin directly and indirectly regulates dopaminergic neurons
– GABA may decrease the perception of pain.
– Dopamine
– Helps relieve pain
– Increases energy
– Norepinephrine
– Activated during pain (emotional and physical) and causes decreased sensitivity to painful stimuli (hypoalgesia) and pain relief (analgesia).
– Mobilizes the brain and body for action

Gut-Brain Axis
– Up to 95% of some neurotransmitters are made in the gut
– The gut communicates with the brain via the vagus nerve, the enteric nervous system
– Lactobacillus produces acetylcholine
– Controls voluntary movement, memory, learning, and sleeping patterns. Excess can cause depression whereas deficiencies cause Dementia
– Candida, streptococcus, E. Coli and enterococcus produce 5HT
– Serratia (gram neg. bacteria) produces dopamine
– Lactobacillus, Bifidbacterium, candida and streptococcus secrete GABA and regulate endocannabinoid expression
– A healthy gut microbiome can decrease depression and anxiety, regulate sleep, appetite and improve cognition (1000 species)
– An unhealthy gut microbiome contributes to an exaggerated HPA-Axis response
Gut-Brain Axis
– The effect of acute stress is limited due to microbiota's long time relative stable state, but chronic stress can disturb this balance
– The structure of intestinal microbiota is strongly influenced by diet and environmental stressors
– Corticotrophin-releasing factor (CRF) plays an important role in changing intestinal permeability
– Research suggests that gut-brain axis dysfunction may be involved in the development of mood disorders, schizophrenia, addiction, and neurodevelopmental and neurodegenerative diseases as well as age-related cognitive decline*
– The treatment of these conditions may adversely affect the composition of intestinal microbiota since antipsychotics and antidepressants are antibacterial agents
Endocannabinoid System
– Clinical studies revealed altered endocannabinoid signaling in patients with chronic pain and depression
– Dysregulation is associated with
– Schizophrenia and depression
– (CB1) plays a crucial role in preventing the neurotoxicity caused by activation of glutamate N-methyl-D-aspartate receptors (NMDARs).
– “Inadequate endocannabinoid control may produce excess or insufficient dampening of NMDAR activity, thus promoting dopamine signaling, such as in schizophrenia, or diminishing serotonergic activity, as observed in depression”
– Problems in neurotransmission, neuroendocrine, and inflammatory processes
– Omega3s have a neuroprotective function and can modulate activity in the endocannabinoid system

Circadian Rhythms (Sleep!)
– Cortisol helps regulate our circadian rhythms, and circadian rhythms regulate cortisol levels.
– Circadian disruption is a stressor
– Perception of and response to internal and external stimuli shape how we interact with the world and the world interacts with us.
– Stimuli interpreted by the limbic system as threatening based on past experiences to similar situations
– Triggers ANS and HPA-Axis activation (stress response)
– Increased norepinephrine, glutamate, adrenaline
– Reduced GABA
– Alterations in the 5HT system (increased 5-HT2CR receptor activity & reduced 5HT 1A) and sex hormones
Recap What Causes Stress
– Physical pain (injury, inflammation, Intense exercise and overtraining)
– Physical illness or dysregulation (hormones, brain health, sickness)
– Nutrient availability & medications
– Gut Health (microbiome homeostasis)
– Nutrition
– Deficiencies due to lack of nutrient consumption or malabsorption
– Hypo/hyperglycemia/insulin resistance
– Lack of sleep
– Prior learning experiences (schemas/PTSD)
– Physical environment
– Social environment

Consequences of Chronic Stress
– In a state of chronic stress, the body does everything it can to survive leading to one of two situations:
– Hypercortisolism—The negative feedback mechanism doesn’t kick in to protect against ever present danger (Fight, Flee, Freeze)
– Hypocortisolism – The negative feedback mechanism kicks in too much to conserve energy for only the most severe emergencies (F-It)
– Base cortisol levels are reduced after exposure to chronic uncontrollable stressors.
– Chronic stress causes inflammatory cytokines to be released which interfere with H & P function
– H & P are responsible for producing precursors to thyroid hormones producing hypothyroid
– Suppress the sensitivity of thyroid hormone receptors to thyroid hormones.
Consequences cont…
– Emotional impact of a stressor is determined by our allostatic load
– Social Environment
– Physical Environment
– Physical Health
– Cognitive Perception of the Problem
– Behavioral Reactions

Consequences of HPA-Axis Activation
– Until the person feels safe…
– Irritability (physiological, behavioral emotional)*
– Perseveration*
– Hypervigilance*
– Sleep disruption*
– Increased pain (long term)
– Increased GI motility*
– Changes in gut microbiome*
– Reduced libido

– Hypothyroid
– Social withdrawal*
– Eating changes (ghrelin alterations)
– Inflammation*
– Decreased latency to immobility and increased duration of immobility after exposure to stressors*

– The mind helps the body interpret signals based on stimulus input and prior learning
– The body sends out messages in the form of hormones and neurochemicals which produce physiological reactions we label with “emotions”
– Positive emotions promote HPA-Axis downregulation which improves attachment and sleep, reduces cortisol, increases 5HT1A, GABA, dopamine and reduces pain
– The mind-body system is bidirectional and complex therefore it is essential to explore all causes of “symptoms” and enhance factors that promote positive changes.