KNOW YOUR BRAIN

Kelly Holyoake
Jul 27
12 min read

Updated: 6 days ago

As someone who has an interesting history with mental health I am committed to unraveling some of the unhelpful 'truths' that we automatically believe without too much critical thought, contemplation or rigorous research.

In my journey, I personally have found the medical system, the labels, the medical professionals and the medications wildly unhelpful. Rather than empowering me to learn, grow and heal, I have experienced misdiagnoses, gaslighting, and medications that not only didn't help me but that had unwanted side effects. The worst part may have been that this system kept me stuck. It made me believe I was sick and would always be sick. I was told that just managing or reducing the symptoms were my best possible outcomes but all in all, I would always have these battles. This is far from the truth and my reality. I wasn't actually 'sick', yes my body and brain weren't functioning optimally but with the right support and information, I was completely capable of eliminating the symptoms that led me to the doctors office, just as I was capable of living a life of joy and contentment with significantly higher energy levels than I ever thought possible.

There are many reasons why we as a society find ourselves in this predicament. Without unpacking the entirety of our society's history, culture and values that led us here I do want to emphasise that the woman's body and brain has been incredibly misunderstood, misrepresented and under researched, thanks to but not limited to scientific sexism, erasure of women and women being treated as smaller men which is far from the truth.

Only 7% of healthcare research focuses on conditions exclusively affecting women (1). This doesn't touch on the fact that women haven't been included in much of the research on conditions that aren't exclusive to women but affect women with our bodies responding differently to treatments. Ischemic heart disease (IHD) for example is known to be the leading cause of death in both men and women (2). It is also known that there are significant sex differences in cardiac structure, function, pathophysiology, presentation, treatment, and outcome of IHD(2).

Women however experience a delay in diagnosis, treatment, and worse outcomes compared to men. Women usually receive less evidence-based treatment and intervention, with less concern on preventive health care. Clinical trials primarily recruit male patients and women are underrepresented.(2)

We can not talk about women's health, the disparity in funding and representation without discussing Black Women, Indigenous Women and Women of Colour* who face unique challenges that affect their health (and that's putting it criminally mildly). When considering the enormous challenges that society* imposes on Indigenous Women, Black Women and Women of Colour as-well as the associated health outcomes that come with being exposed to and carrying these stressors, it is incredibly important that appropriate levels of funding are allocated to better understanding and remedying these systems and the consequential health outcomes affecting so many women.

Racism is a fundamental determinant of health: not only does it play an active role in shaping the systems, policies, and practices which affect health, but it also has a direct effect on physical and psychological well-being (5). Experiences of interpersonal racism for example have been shown to be associated with biological stress and disruption of the body’s immune, neuroendocrine, and autonomic systems. (3) In the BWHS, experiences of racism were also associated with increased risk of a wide variety of other adverse outcomes, including preterm birth, uterine leiomyomata, weight gain, adult-onset asthma, diabetes, insomnia, and reduced cognitive function(4). So the devastating impacts of harmful systems shouldn't be dismissed or underestimated but instead placed at the forefront of research and policy changes.

Not just this, Indigenous Women, Black Women and Women of Colour need to be included in and leading the research. The voices and experiences of Indigenous Women, Black Women and Women of Colour need to be amplified. Black, Indigenous and Women of Colour need to be in positions where they have decision making power so they can have an even greater impact on culture and disrupt these systems that are not only not serving us but are harming us. (There's a couple of really important things to note here: it is rarely productive to talk about people as groups, there are no homogenous groups within any given label or grouping. Women historically have had an enormous impact on culture and have led movements that have improved rights for everyone in society. Black women in particular have been leading change and leading movements that advocate for peoples rights for centuries. Black and Indigenous Women's influence on culture, their brilliance and contributions are often intentionally excluded from history and not acknowledged by white culture, but are instead appropriated which is another form of erasure).

When you are the person oppressed, you see, feel and understand the systems and actions of oppression significantly better than the oppressor. This is why women, Black Women, Indigenous Women and Women of Colour need to be in positions of power and leading the research so we can change these systems for everyone.

The reason to highlight that there is such a disparity in sex specific research and to acknowledge that harmful systems and racism (structural and interpersonal) have an impact on health isn't to paint a picture of inevitable hardship and exclusion but to empower us to have agency over our health; to trust ourselves; and to keep changing culture & systems and influence research so that we are included and represented.

Many women report being dismissed in the doctors office or of having their symptoms trivialised.(6) While I will always encourage you to seek medical advice for symptoms you may be experiencing, it is also beneficial to go into these consultations equipped with as much knowledge as possible and knowing that if the research hasn't been done on women's bodies then your doctor may not be equipped to provide you with the comprehensive, multifactorial and nuanced response you need. This is why your partnership with your doctor is really important.

Listening to your body, trusting yourself and your instincts as well as informing yourself with high quality information is paramount. Not all doctors are trained in the impacts of lifestyle choices such as nutrition, stress reduction, sleep and exercise even though lifestyle interventions can dramatically increase your life expectancy, reduce your likelihood of experiencing disease, even if you are genetically predisposed to a disease. Dementia provides us with an interesting framework in that there is no pharmacological treatment that dramatically slows or improves symptoms once a patient has dementia, however, there is Increasing evidence to suggest that diet, a major modifiable lifestyle factor, may play a significant role in preventing or delaying cognitive decline and risk for dementia(7). Women again have been left out of this research historically but there are now some leading female neuroscientists doing the clinical trials or fighting for the funding they need to do further investigations. This is exciting and is happening across other fields too.

Along my own journey what I have found to be incredibly helpful is high quality and nuanced information about the female body, the female brain and the systems we live in. This information has been nothing short of transformative for me and the people in my life. My diagnoses were devastating as were the feelings I carried in my body and the symptoms I thought I had to live with (just to be clear - I no longer have these symptoms). I therefore have an enormous amount of gratitude to the scientists and medical doctors who make this high quality information accessible. When I say high quality and nuanced, this is what I mean:

Information that is specific to the female body

Women are born with an incredible neuroendocrine system - our brain and nervous system which interacts with our endocrine (hormonal) system and the many corresponding systems in the body such as our metabolic and stress response systems. These dynamic and interactive systems need to be better understood and taken into consideration when diagnosing a range of symptoms from cognitive function to mood, sleep, to thermoregulation (this list could be enormous).

Previously it was believed that the role of estrogen was to regulate ovulation and female reproductive behaviour (11). We now know that 17β-estradiol (E2), (the most biologically active estrogen), exerts wide-ranging effects on neurological and cognitive functions (11) . It has been termed the "master regulator" of neurological function in the female brain due to its broad impact on multiple neural processes(11).

Knowing that estrogen is a major player in the regulation of our mood and cognitive function is hugely important. Just as it is key to know that E2 actions are mediated by specialised brain estrogen receptors (ERs) (11). The female brain is equipped with estrogen receptors that out number the receptors for other hormones such as testerone and for men it is the other way around - again emphasising that we are not the same and can't be treated as so(12). It’s also important to note that our gut plays a role in regulating our estrogen. There is a community of microbiome in our gut called estrobolone which helps metabolise estrogen and regulate how much estrogen we have in circulation (12). When we look after this colony of bacteria we are also taking care of our hormone health and therefore our brain health.

Considering the interacting nature of the systems in our body and the impact our hormones have on these systems, symptoms that may look like they reside in our head, skin, gut or joints may in fact have their solutions in our hormone health. While there is a lot to be understood, it is a great place to start to know that your hormones are not just predominantly part of your reproductive system but they play an integral role in brain health, cognitive function, memory, and the regulation of many other corresponding systems in your body.

It may be especially important to note that the way you eat impacts all these systems - your gut health, brain health and hormone health.

Information that takes the whole body into account - the interconnectedness of the all systems and treatments that are multi factorial in that they include lifestyle choices.

The gut, the brain, our nervous system and our hormones are inextricably linked and shouldn't be treated as stand alone systems. 70-80% of our immune system for example is located in our gut (13) with one side of our gut lined with immune cells and the other lined with our microbiome (13). These microbiome are also incredible 'decision makers' and so we want to look after them. They don't only decide if you need more estrogen in circulation or not, they also communicate with your immune cells helping them decide when and how big a reaction to have to the trillions of pieces of information passing through our guts. (13)

Depression or other mood disorders are now considered inflammatory conditions (13). What we eat affects the amount of inflammation in our gut. We have the choice to eats foods that are highly inflammatory or to eat foods that support us to produce short chain flatty acids (SCFAs) which help us to fight inflammation. SCFAs (some times called post biotics) are predominantly produced by our gut bacteria through the fermentation of fibre.

People with mood disorders often present with a microbiome that is missing some key microbes responsible for producing SCFAs. (13)

It can’t be underestimated how important the diversity of your gut microbiome is. Having high diversity can have powerful outcomes for your health, mood and ability to respond positively to treatments (13). One of the easiest and most effective ways to improve your gut microbiome is to increase your fibre and have a wide range of plants as part of your diet - this can include nuts, seeds, herbs, cacao, fruit, vegetables, legumes (preferably organic and as whole foods).

Information about the systems that we function in

Many of us (all of us if we are women, biological or not) have faced discrimination, exclusion, gaslighting, control and domination by the wider systems. If you are a Black Woman, a Women of Colour, an Indigenous Woman then the experience and impact is even greater.

Seeing how these systems unfold in our psyche, behaviours, relationships and interactions with the world is fascinating and for some people it is the key to understanding the grief, the rage, the dysregulation they feel in their bodies. Knowing these systems are real and that the harm is real can be deeply validating and a step towards liberation.

Knowing that our response to these systems is actually 'human and reasonable' can help us understand that we are not in fact sick but are experiencing a very 'human and reasonable' response to the harm that has been caused to us directly, to our ancestors, to our fellow humans and the earth.

The pathologising and medicating of these emotions causes further harm rather than looking to acknowledge, connect and where possible correct. These feelings need to be felt, for many of us they need to be heard, and we need to find connection both back to ourselves and to others as an essential part of our healing.

Acknowledging that structural violence and systems that cause harm such as racism, colonialism and the patriarchy needs to be included in treatment options . Again you may not find the answers you need for the health concerns that these system are causing in your 15 minute doctors consultation or in a session with a therapist if they are not systems informed, anti-racist and decolonizing. That doesn't mean it is not really important that we address the systemic causes of our health outcomes and this healing will look different for different people.

Information that is not oversimplified

I needed real information that did not skim on the impactful details to truly comprehend the impact of potential treatments and lifestyle choices.

While the simplification of really complex scientific information can serve to make that information more accessible, what I find is that the over-simplification actually removes the key pieces of information I need to understand what could be happening in my brain and body. This oversimplification also serves to significantly reduce the motivation I need to make the necessary changes. What I find is that we are more intelligent and capable than we give ourselves and others credit for. We can in fact understand quite complex scientific information relating to our health. In the case where we don't fully grasp all the details, having the details can still play the role of high-lightly how acutely important these choices, substances, transmitters, hormones, and nutrients are in our health and the optimal function of our incredible bodies and brains.

The more informed I am, the more equiped I feel to make the lifestyle choices I need to experience health and to be a partner with my health care professionals so that together we can come up with more specific solutions for my brain and body. Health and well-being like most things is wildly complex . You are beautifully complex, as are all the interacting systems in your body and the systems within which you live. The best response to your health needs is most likely to be multifactorial, as the causes and discomforts may be multifaceted, some medical, some not. I am excited by the new information that will continue to come to light as the woman's body is studied, as systems and their harm are acknowledged and as we turn to Indigenous Leaders for their knowledge.

Apart from informing ourselves so we can enter into a proper partnership with our healthcare professionals it is abundantly clear that we must eat more whole foods, increase our fibre in particular and stay connected. So if you are a woman who has read this article you have a unique opportunity to lead real change in the lives of women around you simply by staying connected, having meaningful relationships and during these catch ups choosing to eat whole foods, a diverse range of fruit and vegetables, seeds nuts and beans. Get a smoothie together and go for a walk or cook a curry from scratch with some of the incredible women in your life.

Let our connection and choices be an act of rebellion against systems and information that hasn’t served us but has in fact harmed us.

Disclaimer: I am not a doctor, I am not a scientist, this is my personal experience and opinion. What has not worked for me, may in fact be necessary for you. I am not discrediting medical advice, I am just highlighting my own need for more and better information to help me make informed decisions. If you are experiencing mental health struggles, I strongly recommend seeking the help of a medical professional alongside doing your own research, listening to your body and what you believe to be true for yourself. I am here only to present information and to share my experience in the hope that this will help you find the right solutions for you and that we as a society grow in our knowledge and application of multifactorial treatments.

In this article when I say 'women', I am referring to a woman's body that has two x chromosomes and ovaries. I fully acknowledge, love and support women who do not fit this definition of woman.

*This information is relating mostly to Black Women in the US, to Indigenous Women and Women of Colour who are living in societies that have been colonised.

*Colonial societies that still proliferate the values and harm connected with colonisation, wyt supremacy and patriarchy.