New research highlights the importance of mental health support for patients with Crohn’s disease or ulcerative colitis.
Mental health conditions are prevalent in IBD patients, with roughly 43% reporting at least one mental health diagnosis over a 9-year period. Not only is there a strong correlation between IBD and mental health conditions, but it turns out the likelihood of a comorbid mental health disorder is closely tied to the severity of disease activity.
How Mental Health Impacts IBD
A number of studies have shown that comorbid mental health conditions can seriously impact not only the severity of Crohn’s disease and ulcerative colitis but also the course of treatment and recovery.
A 2021 analysis of healthcare services and patient spending found a link between higher costs of IBD-related hospitalizations and surgeries and the “presence of psychiatric comorbidities”. The findings reflect an earlier study showing that patients with more severe, active IBD suffered higher rates of depression.
IBD patients who suffer anxiety show higher rates of relapse, an increased risk for surgery, poorer quality of life, and less adherence to medication. And a multi-institution cohort study showed that comorbid depression or anxiety can increase the risk of surgery by 28% in patients with Crohn’s disease. Patients with depression also show a higher risk of relapse and respond relatively poorly to treatment.
According to researchers, patients with fewer mental health concerns tend to take better care of themselves physically, have healthier eating habits, better sleep quality, and are more likely to adhere to treatment regimes.
It appears that improving a patient’s mental health is crucial in helping them manage their condition. And with cases on the rise globally, it’s more important than ever to integrate and improve mental health support for IBD patients.
The Link Between Mental Health Conditions & IBD
Research shows that worsened mental health may be a symptom of IBD-related inflammation and gut dysbiosis, which can disturb the production and release of mood-regulating neurotransmitters through the gut-brain axis.
A new study recently found that the vascular barrier may play a large role in IBD-related mental health symptoms, through what researchers are calling a dysregulated gut-brain-vascular axis.
The study found that the inflammatory process can cause the vascular barrier in the choroid plexus to shut down. This barrier is an important gateway in the communication system that regulates the exchange of signals between our blood and cerebrospinal fluid (CSF). It shuts down to prevent the spread of inflammation to the brain, but researchers believe this may also impair communication between organs and impair some brain functions.
The study found that UC patients tend to have an impaired gut-vascular barrier. In animal models of UC, the shutdown of this barrier was linked to behavioral changes in mice. Researchers observed reduced movement and exploratory activity, as well as low performance in episodic memory lab tests. These behavioral changes suggest that the closure of the gut-vascular barrier caused by gut inflammation may trigger anxiety and depression in patients with IBD.
When to seek extra support
If you or a loved one experience several of these symptoms for a prolonged period, we recommend seeking support from your doctor or healthcare practitioner.
- Feelings of sadness and/or hopelessness
- Feelings of emptiness, worthlessness, or guilt
- Loss of interest in activities you generally enjoy
- Fatigue, irritability, and/or difficulty concentrating
- Loss of appetite and/or extreme weight loss
- Change in eating habits
- Social isolation or withdrawal
- Substance abuse
- Suicidal thoughts/ideation
If any suicidal thoughts occur, please speak to your doctor immediately.
Home Remedies & Lifestyle Support
If you’re suffering from anxiety or depression, medication and therapy can be extremely helpful. Whether or not you partake in conventional therapy, there are many additional ways to improve your general mood through simple healthy lifestyle changes.
Lifestyle tips for mental & physical health:
- Limit or avoid alcohol, hard drugs & processed foods
- Exercise, or engage in regular movement
- Prioritize rest & relaxation
- Know and articulate your limits (Just say no)
- Spend quality time with loved ones
- Focus on activities you really enjoy
- Check out local or online support groups
The future of mental health treatments
The emerging research on mental health and gut health may open new avenues of psychiatric treatment that will emphasize the restoration of healthy communication between the gut and the brain.
The field of nutritional psychiatry is already harnessing dietary treatment to improve mental health. This can only benefit IBD patients further as a low-inflammatory diet may also improve the IBD condition itself.
Tessa Eskin
