The Link Between IBD and Depression

Any chronic health condition can understandably cause a certain amount of stress and anxiety. Inflammatory bowel disease (IBD) not only causes pain but symptoms such as diarrhea and gas that are difficult to deal with in professional and social situations. Does all this lead to an increased risk of depression?

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Depression can be a difficult topic to discuss and understand. No one is immune from stress, and people with IBD certainly have their fair share. Managing stress is an important part of IBD management, to be sure, and some research has shown that stress management can help with symptoms. This is good news for people with IBD, but it does lead to misunderstandings about the role stress plays in IBD. IBD causes stress and related issues but it has not been shown that these factors lead to the development of IBD.

The Link

It's unclear if, and how, IBD is associated with depression. Some older studies have found a link between psychiatric conditions and IBD conditions like Crohn's disease and ulcerative colitis. But the exact nature of this association remains a controversy. Some researchers question the validity of these findings, while other researchers consider the link to be proven.

More recent research suggests that a depressed mood and an increased anxiety level have a negative effect on the course of IBD. Patients who exhibit symptoms of depression and anxiety report a lower quality of life and may be at increased risk for a relapse. One study showed that patients with Crohn’s disease who received some psychological treatment spent fewer days in the hospital and took fewer sick days.

What to Do If You Think You’re Depressed

While the jury is still out on exactly how mood affects IBD, and if IBD and depression are related, there is no question that identifying and treating depression and anxiety is important to overall health.

Diagnosing depression typically begins by ruling out any physical conditions that could cause the symptoms. The first step includes a check-up with a primary care physician or internist or a gastroenterologist. A complete history with a focus on the length and severity of any symptoms of depression (described below) will be included. A referral to a mental health specialist may be necessary for proper diagnosis and treatment.

Treatment is highly individualized and may include a combination of psychotherapy, medications and complementary treatments.

Symptoms of Depression

  • Persistent depressed, sad, or anxious mood
  • Decreased interest in previously enjoyable hobbies or other pursuits (including sex)
  • Changes in appetite or weight (overeating, weight gain, or weight loss)
  • Sleep disturbances such as insomnia or oversleeping
  • Irritability, agitation, or restlessness
  • Fatigue, decreased energy
  • Feelings of worthlessness, guilt, hopelessness, helplessness, or pessimism
  • Difficulty in making decisions, concentrating, and remembering ("brain fog")
  • Thoughts of death, suicide; or suicide attempts
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