The Enteric Nervous System: How the Gut Shapes Mental and Emotional Health
You may have heard the gut referred to as the “second brain.” This isn’t just a metaphor—it’s rooted in neuroscience. The enteric nervous system (ENS) is a complex network of neurons embedded in the gastrointestinal tract, and it plays a powerful role in emotional regulation, stress responses, and mental health.
For many people struggling with anxiety, trauma, chronic stress, or emotional dysregulation, understanding the gut–brain connection can be both validating and transformative.
What Is the Enteric Nervous System?
The enteric nervous system is a vast network of more than 100 million neurons lining the digestive tract—from the esophagus to the colon. It operates semi-independently from the brain and spinal cord and is responsible for digestion, gut motility, and communication with the central nervous system.
Because of its complexity and autonomy, the ENS is often called the “second brain.”
The Gut–Brain Connection
The gut and brain are in constant communication through the gut–brain axis, a bidirectional system involving:
The vagus nerve
Neurotransmitters (including serotonin and dopamine)
Hormones
Immune signaling
The microbiome
In fact, about 90% of the body’s serotonin—a neurotransmitter essential for mood regulation—is produced in the gut.
This means emotional distress doesn’t just live in the mind. It often shows up in the body, particularly in the digestive system.
How Stress and Trauma Affect the Gut
Chronic stress and trauma can significantly impact the enteric nervous system. When the nervous system is repeatedly activated into fight, flight, freeze, or shutdown, the gut often responds.
Common gut-related symptoms include:
Nausea or stomach pain
IBS or digestive irregularities
Appetite changes
Bloating or cramping
A sense of “knots” or tightness in the stomach
From a trauma-informed perspective, these symptoms are not imagined or “all in your head.” They are nervous system responses shaped by lived experience.
Why the Gut Is So Sensitive to Emotional States
The enteric nervous system is deeply attuned to safety and threat. When the body perceives danger—whether physical or emotional—digestive processes often slow or shut down in order to prioritize survival.
Over time, repeated activation can cause the gut to remain in a heightened or dysregulated state, even when no immediate threat is present.
This helps explain why some people experience digestive symptoms alongside anxiety, panic, or emotional overwhelm.
The Role of Therapy in Supporting the Gut–Brain Axis
While nutrition and medical care are important, therapy can play a meaningful role in supporting gut health—especially when symptoms are connected to stress, trauma, or chronic emotional activation.
Therapy that focuses on the nervous system may help by:
Reducing chronic stress activation
Supporting vagal tone and regulation
Helping the body relearn safety
Addressing unresolved trauma held in the body
Increasing awareness of bodily signals without fear
Somatic, trauma-informed, and attachment-based therapies are often especially supportive for individuals experiencing gut-related stress responses.
Listening to the Body With Compassion
Many people learn to override or ignore gut sensations—especially if they’ve been told their symptoms are “just anxiety.” Over time, this can create further disconnection from the body.
Therapeutic work often involves gently rebuilding trust with bodily signals, including those that arise from the gut. This isn’t about controlling symptoms, but about understanding what the body is communicating.
A More Integrated View of Mental Health
The enteric nervous system reminds us that mental health is embodied. Emotions, stress, trauma, and safety all move through the body—not just through thoughts.