Taking Care of Your Mental Health Is a Key Piece of the IBD Puzzle

When you have Crohn’s disease or ulcerative colitis, it’s not just your physical health that’s affected. The frequent pain, unpredictability and worrying that comes with inflammatory bowel disease can disrupt your emotional wellbeing, too.

And that stress, in turn, can make your IBD symptoms even worse.

“It’s pretty well understood that, while stress does not cause IBD, it definitely contributes to flares, and it can contribute to the first expression of IBD,” says Stephen Lupe, PsyD, a clinical health psychologist who specializes in digestive diseases.

That’s why taking care of your emotional wellbeing is a critical part of managing your IBD.

“A lot of patients get stuck in this cycle of putting their life on hold while they try to cope with the disease, and that tends to increase depression, increase anxiety and increase stress,” he explains.

“But we want them to know that they can have a life and the disease at the same time. There are things that we can do to help their bodies cope with these conditions.”

Mental health and IBD go hand-in-hand

Studies have found that people who have IBD are more likely to develop anxiety and depression than people who don’t have it.

“Sometimes, people who are frequently in pain start to become predictive with the pain way before it ever happens, and they’ll stop doing things in anticipation of the pain,” Dr. Lupe notes. “Maybe they’ll stop eating, or they’ll stop going out, and their lives get narrower and narrower, which a lot of times can influence the development of anxiety or depression.”

Sleep problems are also common in people who have IBD, especially during a flare, he adds.

It’s important to be aware of these risks. If you’ve lost interest in doing things you used to love, or are struggling with the day-to-day challenges of living with a chronic gut disorder, speak up and let your doctor know what’s going on. They are there to help.

“A lot of gastroenterologists know psychologists that they can refer patients to,” Dr. Lupe says.

Can a health psychologist help you?

If you’re already frequenting your doctor’s office, making yet another medical appointment might not be at the top of your “things I want to do” list.

But seeking help to cope with the mental and emotional aspects of the disease can be an important step in improving your quality of life and managing symptoms. Research suggests that the gut and the brain are connected through the gut-brain axis, and that stress may make symptoms worse.

“My job is to talk to patients about all of the things that come along with being diagnosed with a gut condition, whether that’s stress, anxiety or depression, or the lifestyle modifications that need to happen,” Dr. Lupe says.

“We also look at things like body image issues, the stress and fear that can sometimes come along with having to use the bathroom frequently, and even things like talking to our partners about sexual performance after being diagnosed.”

A psychologist may recommend one of these forms of therapy:

• Cognitive behavioral therapy, which focuses on changing thinking and behavioral patterns.
• Acceptance and commitment therapy, where people learn to accept the challenges that come with their condition and focus on being present and mindful in their situation.
• Hypnotherapy, which uses mind-body techniques to help people reach a relaxed state where they are more open to suggestions which may influence the quantity or intensity of symptoms.

Many people find additional support in the form of online or IRL support groups. “This can be very normalizing and validating to meet other people who have the same kinds of things going on in their life,” Dr. Lupe says.

But ongoing struggles with mood, stress, body image, sleep, anxiety or coping with the day-to-day challenges of living with IBD should be addressed by a mental health professional.

“I think there’s a lot of stigma, and a lot of patients have fear of talking about some of this other stuff that’s going on,” Dr. Lupe says. “People don’t always realize that there are things that we can do to help our bodies and minds cope so that we can have a life and keep moving forward. So make sure that you advocate for yourself and find a way to talk to someone.”