Constipation, Dopamine, and a New Obsessive Research Topic

Despite keeping up with my 400mg of magnesium citrate in the evenings, and my two spoonfuls of flaxseed meal in the mornings, the constipation has returned. I am really bummed about that. But today, what I experienced was way beyond bummed. After three days without a respectable bowel movement (I know, I know, but it’s medically relevant), I woke up this morning feeling blue.

I stayed in bed while my husband got himself breakfast. I felt overwhelmed trying to come up with ideas on what to cook for dinner. By the time I got home from the grocery store, this had progressed to a complete fog of lethargy and hopelessness, with a side of foreboding. I took a nap, and it was difficult to get myself moving when it was time to put dinner together. As I cooked dinner, I felt like crying for no particular reason. And my guts were cramping up. Twice I had to leave the stove to pass an insignificant amount of poo (again, sorry), and as I served up the meal, I fought down a little wave of nausea that for once had nothing to do with food smells.

Somewhere in there, I was able to step outside the black cloud of bad feelings as an observer. I still felt it, and powerfully, but I could tell the feelings were not the result of anything that had happened. They were a singular entity, attaching themselves to any passing thought. This, I thought, is not just a blue mood. This is a crash in dopamine levels. Recognizing the problem didn’t make me feel any better, mind, but knowing it was a physical problem, not a personal problem, was helpful. It meant I could explain what was happening to my husband, and he’d have a better idea how to help/not help as needed, and also that it wasn’t his fault.

Now, recall the digestive situation: 3 days of constipation, dopamine crash on the third day, and at the height of the attack, some gut movement. Now, just an hour later, the black mood seems to have cleared. I know the two phenomena are connected, but I don’t know by what mechanism. I have experienced this, to a slightly lesser degree, before: inert guts, followed by lethargy and seriously depressed mood for no reason, which clears up when the guts start moving again. I have also observed it to an even more severe degree in my father. I accompanied him on a month-long trip in the developing world, and he developed terrible constipation and we had no access to laxatives. After five days of total gut inertia, he was explaining to me how/where he’d like to be buried, and how to get back home without him. He was morbid, hopeless, and overwhelmed with despair. I was scared for him. Finally, he tried the nuclear option: drank a glass of half Pepsi, half vegetable oil. I understand the next day, trapped in his motel room, was pretty miserable… but once his guts were clear, so was his mood (and while it’s a vile thing to drink, a carbonated beverage bubbling up through oil looks really cool).

I know there’s a connection, but I have not, so far, been able to tease it out. Basic physiology says dopamine regulates gut function, but the literature gives no mechanism for the gut affecting dopamine levels. There has to be one, and I want to know what it is, and if there is anything I can do to prevent/treat it effectively in the future. In the meantime, it’ll have to suffice that I can recognize it when it happens, and not simply be swept away by it.

Notes: This abstract suggests the regulation of the gut by dopamine, but not the other way around. However, from the discussion of rats, it looks like it might be possible to read the cause/effect train the other direction as well. Anxious rats develop more gut lesions. But what if the rats are anxious because their guts are dysfunctional?  In another direction, insulin apparently inhibits dopamine secretion, so the more insulin, the less dopamine? It might be something to keep tabs on, but it doesn’t quite fit the sequence of events I’m trying to decode here. This fascinating post points out that certain strains of gut bacteria actually produce dopamine, which is tantalizing. I don’t see how it hooks up directly to the phenomena I experienced, but it definitely gives a mechanism for the gut influencing dopamine levels, instead of the other way around.