Question: Do Most People With IBD Have A Mental Disorder?
Is inflammatory bowel disease (IBD) caused by a psychological condition? Do people with IBD need treatment by a psychiatrist?
Answer: In years past, it was thought that people who had IBD also commonly had a mental condition. The idea was that people with IBD were making themselves sick, and that they should be treated for their mental condition as well as their physical one.
Knowing that the myth that IBD is "all in your head" still perpetuates today, I turned to UpToDate -- a respected medical resource -- to better understand the origins of this fallacy:
"Although early studies suggested a strong association between psychopathology and the development of IBD, more recent analyses conclude that there is no consistent type of psychopathology among patients with either Crohn's disease or ulcerative colitis. Stress does not appear to be related to the onset of IBD, but even if not causally related, it may have a role in the exacerbation of symptoms, possibly via activation of the enteric nervous system and the elaboration of proinflammatory cytokines."
Psychosocial Factors and IBD
Studies that were done decades ago indicated that people with Crohn's disease and ulcerative colitis often had a psychological condition along with their IBD. This is the basis for the persistent and incorrect assumption that people with IBD are making themselves sick.
More recent research shows that IBD is not always associated with a psychological condition. While some people with IBD may have conditions such as depression, it's not always the case. Some people with IBD, such as those who are struggling with a new diagnosis, may need help from a mental health professional, but not everyone with IBD needs a psychiatrist.
In that same vein, stress is also often thought of as a problem that goes hand-in-hand with IBD. People with IBD often say that their disease becomes worse during times of stress. However, stress does not cause IBD. It is thought that stress can worsen IBD symptoms because the brain and the digestive system seem to be linked. An example of this is how nervousness can cause some people to vomit or have diarrhea.
However, many people with IBD might still benefit from availing themselves of mental health services. IBD can cause a significant amount of stress, as well as problems at work and in the family. A mental health professional can help people with IBD to deal with these and other stressors in their lives.
Want to learn more? See UpToDate's topic, "Definition of and risk factors for inflammatory bowel disease," for additional in-depth medical information.
Peppercorn, Mark A. "Definition of and risk factors for inflammatory bowel disease." UpToDate. Accessed: Oct 2009.