Being diagnosed, and living with IBD (inflammatory bowel disease) can be challenging. Not only do you now have an incurable and unpredictable chronic illness to deal with, you have pain, fatigue, bleeding, doctors, medications, and all the thoughts that come with chronic illness. Speaking from personal experience, when disease is active, your quality of life takes a big hit. Rightly so, your mental health takes a big hit too. It is understandable why IBD patients experience depression and anxiety with active disease. But did you know that those with IBD have an increased chance of being diagnosed with a mental illness?
In fact, a study from 2012 using patient records found that depression and anxiety appeared in patients “significantly more often than would be predicted by chance”, raising questions as to whether it has anything to do with disease. This same study then dug deeper researching 53 IBD patients and they found that patterns of anxiety and depression exist in the majority of patients. For patients with Crohn’s disease, depression and anxiety were more commonly diagnosed after their Crohn’s. Whereas, UC patients were more commonly diagnosed with depression before their IBD diagnosis, and anxiety after. They also found that people with CD had a higher rate of being diagnosed with a panic disorder, but at any point during their life.
This led researchers to consider if depression and anxiety could act as a catalyst for active disease. After gathering data, they have found that these mood disorders can increase production of proinflammatory cytokines, which will adversely affect IBD. Therefore, depression and anxiety no matter when originally diagnosed, can worsen active disease. This is why it’s imperative to speak to your mental health with your doctor or specialist. By getting your mental health under control you can help get your IBD under control and vice versa.
As a UC patient myself, I am familiar with anxiety and depression as a side effect of active disease. I was, however, diagnosed with depression in my teenage years almost six years before my UC diagnosis. With medication and therapy, I was able to get my depression under control and lead a normal life. I was then diagnosed with UC, and my anxiety came after. For me, my anxiety is generally related to the disease’s uncertainty and treatments itself (colonoscopies, infusions, etc.) although I have felt depression at the heights of my chronic illness due to a reduced quality of life and pain. I find it interesting that I fit the model derived from above for UC patients, and I genuinely hope to see more research done in this particular area of IBD, as it could help so many.
The brain gut connection is a powerful one, and while scientists may not fully understand its ins and outs it is an area of ever-growing interest. In the last two decades or so great strides have been taken in anti-depressant and anti-anxiety medications; as well as normalizing getting help for mental illness. There are however, some factors like predispositions in genetics and personality, that need much more research. What is clear, is that mental illness and IBD have a connection much greater than previously realized. Now that we know there is a correlation, the exact effects of mental illness on IBD will need a closer look. In the meantime, be sure to discuss your mental health with your provider to get the best overall care you can. And if you are in the middle of living with active disease, just know that will pass. Keep holding on!
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