Studies show that anywhere from 50 to 90 percent of people who seek treatment for irritable bowel syndrome also have some psychiatric disorder like depression or anxiety. Research has shown that there are physical reasons for this even though much more research is needed. Watch my video to learn more.
Transcription of The Link Between IBS and Depression
Depression is an illness characterized by a persistent low mood or loss of interest and interferes with a person’s ability to function and enjoy life.
- Symptoms of depression may include:
- Changes in appetite and weight
- Difficulty concentrating
- Difficulty falling asleep and/or difficulty staying asleep
- Feelings of hopelessness, low self-esteem, excessive guilt, and pessimism
- Lack of energy and motivation
- Social isolation
- Even thoughts of suicide
Studies show that anywhere from 50 to 90 percent of people who seek treatment for irritable bowel syndrome also have some psychiatric disorder. This may include panic disorder, anxiety, and major depression. As far as scientists know, IBS does not cause depression, nor does depression cause IBS. In fact, we don’t really know whether anxiety and depression result from having IBS or whether they contribute to the development or maintenance of symptoms. In many patients, both possibilities may be true at the same time.
Scientists in Germany have found clear evidence that patients with IBS are less able to suppress pain signals in the brain coming from the bowel and that depression plays a role in it.
People who are stressed often are more aware of pain and discomfort. Of course, IBS symptoms are going to cause anxiety and that anxiety worsens symptoms. For example when you go out to eat, you are probably more anxious about what may happen and so you get more symptoms. This becomes a vicious circle.
In other words, concerns, worries, and fears can be due to the symptoms experienced by persons with IBS rather than due to a psychological disorder. This is where it is unclear and more research is needed.
Doctors may prescribe low doses of antidepressants to patients who don’t have depression because those particular drugs help block the brain’s perception of pain. It is thought that this helpful effect is due to the effect of the antidepressant on serotonin and other neurotransmitters.
In fact, a number of studies have found that antidepressants can help with some IBS symptoms. We are talking about tricyclic antidepressants like nortriptyline (Pamelor), amitriptyline (Elavil) or selective serotonin reuptake inhibitors like paroxetine (Paxil), or sertraline (Zoloft). But they are still unsure that antidepressants would be safe to use in the treatment of IBS. So, that leaves us nowhere.
Why tricyclic antidepressants work is that they slow down the intestinal tract, possibly making them the better choice for patients who have irritable bowel syndrome with diarrhea.
The others, the selective serotonin reuptake inhibitors are thought to only target serotonin, resulting in less unwanted side effects, including constipation. So, a person who has irritable bowel syndrome with constipation would be better off using these sorts of antidepressants.
Traditional psychotherapy and cognitive behavioural therapy may also help with depression. Traditional psychotherapy involves talking with a therapist to work out conflicts and understand your feelings. Cognitive behavioural therapy teaches you how to recognize negative and distorted thoughts, and replace them with positive, more realistic thoughts. This has been found to reduce IBS symptoms.
Along with drug therapy and psychotherapy, there are many other steps you can take to help ease depression if you have IBS like stress management techniques, regular exercise, a good diet for IBS, getting enough sleep, and taking time to do something enjoyable each day. For those who have done my coaching program, you will know that all these factors are included in the training for IBS and along the way help any anxiety or depression you may be suffering from.
There is obviously a long way to go with the research in this area but the connection is clear.