Depression Is 9 Times More Likely for People with This Chronic Disease, Says New Study
A new study suggests depression often accompanies inflammatory bowel disorders. Here's the compelling possible explanation, with four expert-backed tactics to cope.
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An April 2022 study in the Journal of Gastroenterology and Hepatology may help shed light on the emotions Toronto-based content creator Renee Welch, 35, experienced as she spent a good part of her early life in and out of hospitals. Welch was being treated for Crohn’s disease—an inflammatory bowel disease marked by diarrhea, rectal bleeding, cramps, weight loss and fever.
These symptoms exacted a major toll on her mental health and dampened her quality of life during adolescence. “I went through a lot of dark times,” Welch tells The Healthy @Reader’s Digest. “I just wanted to feel normal, and I didn’t know anybody who … understood what I was going through.”
It turns out this is strikingly common for people living with inflammatory bowel diseases (IBD), like Welch. In fact, the new peer-reviewed gastroenterological study has demonstrated that people with Crohn’s disease or other types of inflammatory bowel diseases are nine times more likely to become depressed than people without these conditions. The link even extends to family—their siblings who didn’t have IBD are nearly two times more likely to develop depression.
Why Crohn’s and inflammatory bowel disorders are connected with depression
“There is overlap between IBD and depression, highlighting the role of the gut-microbiome-brain axis in diseases of both the gastrointestinal tract and the brain,” says study author Bing Zhang, MD, a gastroenterologist at the University of Southern California’s Keck School of Medicine in Los Angeles.
It’s a bi-directional relation, he says. Your gut is packed with nerve endings that communicate with the brain. That means inflammatory bowel disease increases the risk for depression, and depression also increases the risk for inflammatory bowel disease.
The study showed that people with depression were two times more likely to develop IBD. It also showed their siblings without depression were more than 1.5 times more likely to develop IBD.
So yes, the two conditions travel together. But these expert-approved steps will help you start to take your life back.
Recognize and treat depression
If you have Crohn’s disease or another type of inflammatory bowel disease and your doctor doesn’t ask about your mood, bring it up. Treating the depression will likely also help with your IBD symptoms. “Many chronic medical illnesses show improvement when symptoms of depression are treated,” says Shawna Newman, MD, a psychiatrist at Lenox Hill Hospital in New York City.
Drugs commonly used to treat depression or anxiety such as serotonin-enhancing medications have anti-inflammatory properties that help with chronic conditions, she says. She also suggests psychotherapy.
Stress makes everything worse, including your mood and IBD symptoms. “Adjuvant approaches such as mindfulness, meditation, yoga, stretching, music, art therapy and more can all contribute to the well-being of people with irritable bowel syndrome (IBS) and inflammatory bowel disease,” says Dr. Newman.
People with Crohn’s and other disorders of the bowel or digestive system may be at greater risk for dehydration, and Welch says becoming dehydrated can affect mood. (She’s even participating in a new campaign to raise awareness about the risks of dehydration among people with chronic diseases.)
This can be particularly important to keep an eye on for patients who have an ostomy—a surgical incision that allows stool to leave her body as induced by Crohn’s. “Two weeks after I had my ostomy surgery, I became dehydrated and ended up back in the hospital,” she recalls. Now, she’s careful to hydrate frequently.
Treat the underlying IBD
Crohn’s and other types of IBD predispose people to prolonged absence from school or work and social activities, explains Shivi Siva, MD, a gastroenterologist at Northwell Health in Great Neck, NY. “These factors could trigger anxiety and depression in affected patients, especially during prolonged illness and frequent flare-ups of the disease,” Dr. Siva says.
Dr. Siva says there are many new medications available that can help address the inflammation that causes Crohn’s and other types of IBD. If you experience any of these, Dr. she suggests you check in with your doctor to make sure you’re doing all you can to manage it.
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Renee Welch, Toronto, Ontario, Canada
Shawna Newman, MD, psychiatrist, Lenox Hill Hospital, New York City
Bing Zhang, MD, gastroenterologist, Keck School of Medicine, University of Southern California, Los AngelesJournal of Gastroenterology and Hepatology. "Bidirectional association between inflammatory bowel disease and depression among patients and their unaffected siblings"
Shivi Siva, MD, gastroenterologist, Northwell Health, Great Neck, NY