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Is IBD Associated With Depression?

If You Have IBD, Are You Predisposed To Developing A Mood Disorder?

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Updated October 12, 2013

Depression

Depression can be a part of IBD.

Photo © Marinka van Holten

Question: Is IBD Associated With 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 this lead to an increased risk of depression?

Answer:

It's unclear. 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.

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

Sources:

Andrews H, Barczak P, Allan RN. "Psychiatric illness in patients with inflammatory bowel disease." Gut 1987 28:1600–4. 25 Mar 2007.

Hans-Christian D, Keller W, Wietersheim J, Jantschek G, Duchmann R, Zeitz M. "Psychological treatment may reduce the need for healthcare in patients with Crohn's disease." Inflamm Bowel Dis. 2007 Jan 17. 25 Mar 2007.

Helzer JE, Chammas S, Norland CC, Stillings WA, Alpers DH. "A study of the association between Crohn's disease and psychiatric illness." Gastroenterology 1984 86:324-330. 25 Mar 2007.

Kurina LM, Goldacre MJ, Yeates D, Gill LE. "Depression and anxiety in people with inflammatory bowel disease." J Epidemiol Community Health 2001 55:716-720. 9 May 2013.

Mittermaier C, Dejaco C, Waldhoer T, Oefferlbauer-Ernst A, Miehsler W, Beier M, Tillinger W, Gangl A, Moser G. "Impact of depressive mood on relapse in patients with inflammatory bowel disease: a prospective 18-month follow-up study." Psychosom Med. 2004 Jan-Feb 66:79-84. 25 Mar 2007.

The National Institute of Mental Health. "Depression." National Institutes of Health 2006. 29 Aug 2012.

 

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