IBD is not caused by stress or mental health issues, but it is intrinsically linked to mental health.
Living with a chronic disease such as Crohn’s or ulcerative colitis is mentally challenging in itself. Unpleasant symptoms and constant management undeniably add extra stress to your daily life.
But stress, anxiety, and depression can increase and impact your IBD flare-ups. The potential for a vicious cycle where symptoms cause mental health problems and vice versa is very real.
In this blog, we’ll be delving deeper into how IBD nutrition and mental health are linked and advise on how to factor mental wellbeing into your IBD treatment and management plan.
The gut is inherently linked to the brain
First, it’s useful to understand that stress and anxiety can physically affect your gut.
The gut-brain axis is what we call the bidirectional bond between the central and the enteric nervous system. Your vagus nerve links the gut and brain and sends signals between both.
This means you’re not imagining those tummy flutters you feel before doing an important presentation at work, and it’s not unusual when you have an upset stomach before an exam.
As these signals run in both directions, your gut health can also have an impact on your brain health, meaning good IBD nutrition is key for both mental health and physical wellbeing.
How common are mental health issues in those with IBD?
Many studies have found that depression and anxiety are more prevalent in people with IBD.
It’s difficult to say whether this is caused by the stress and lifestyle implications that IBD symptoms can cause if it’s due to the gut-brain axis, a coincidence, or a combination of several factors. It will be a different scenario for each individual.
However, a study by Pennsylvania State University Hershey Medical Center found that those who had more x-rays, scans, and endoscopies, visits to the emergency room and stays in hospital, plus who were on corticosteroids more often and were taking a biologic, were more likely to have depression and anxiety.
This suggests that those with more active and aggressive IBD are at a higher risk of developing mental health issues. The vicious cycle of flare-ups causing stress, depression, and anxiety, and these in turn leading to more flare-ups, could be at play here.
Proper management of IBD and accessing support is of utmost importance for both your physical and mental health. Treatment for depression and anxiety can include cognitive behavioral therapy, counseling, and/or medication.
(If you experience thoughts of suicide, please contact 1-800-273-8255.)
Grief with IBD diagnosis
Whether you have depression and/or anxiety or not, the shock of being diagnosed with IBD can certainly influence your mental health in the short term. Coming to terms with the fact that you have a lifelong disease is not easy.
Luckily, there is plenty of support available and coping strategies that have been identified by The Crohn’s and Colitis Foundation to assist those struggling with their mental health.
It’s vital to take life one day at a time and to remember that getting the right support and finding the best management plan for you is a process.
How nutrition impacts mental health and IBD
As specialist Crohn’s and ulcerative colitis dietitians, the role that nutrition plays in IBD and mental health is our area of expertise within this management plan.
There are two main vitamins that come to mind when discussing IBD nutrition and mental wellbeing:
Supplementation of Vitamin D when low has been found to be effective for both improving mental health issues and treating symptoms of IBD.
Adequate levels of Vitamin D have been linked to being able to cope better with negative emotions and a boost in quality of life.
We actually get most of our Vitamin D from the sun, which isn’t an issue if you live in a sunny part of the world. But if you live somewhere darker and rainier, it’s a smart idea to eat foods rich in Vitamin D, such as fatty fish, or take a Vitamin D supplement.
We advise that you consult a doctor or IBD dietitian to find the best dose for you.
B12 has also been shown to impact depression. Various studies have told us that Vitamin B12, along with Vitamin B6 and folate, can delay the onset of depression and even help antidepressants work to their full potential.
Low levels of B12 can also cause Vitamin B12 deficiency anemia, which can make you feel breathless, weak, and exhausted. This can have an additional impact on your mental health.
IBD patients typically have low B12, so it’s one we prioritize within our nutrition programs and plans. Foods high in B12 include fish like salmon, trout, and sardines. Nutritional yeast is also a good source.
If on a vegan or mostly plant-based diet, it may be necessary to get this instead from a high-quality multivitamin.
What we eat and the supplements we take truly have a powerful impact on our overall health and wellbeing.
IBD and depression’s impact on eating habits
Depression and IBD nutrition can also relate to your relationship with food in general.
For example, low mood and anxiety can lead to a poor appetite, along with a lack of interest in food. This can mean you make poor quality choices and don’t get the nutrition you need.
Additionally, IBD patients often restrict their food intake due to triggers and symptoms, and the anxiety that surrounds them.
For example, if spinach or leafy greens gave you unpleasant symptoms on one occasion, you will naturally want to avoid them in the future. But this avoidance behavior can perpetuate unsustainable fears about foods in the long term, and mean you are not eating a varied and balanced diet.
Working with a specialist IBD dietitian can assist in addressing these issues and put you on the path to better IBD nutrition, fewer food restrictions, and reduced anxiety around food.
Get support with IBD nutrition and mental health
IBD and mental health is a huge topic – as you can see! The various factors involved can make you feel even more overwhelmed.
But one way to address IBD nutrition and mental wellbeing is to work with our dedicated Crohn’s and Colitis Dietitians, who know firsthand what living with IBD is like.
Our nutritional therapy can help both your body and mind and get you on the path to that all-important IBD remission.
Contact us today to access the IBD support you deserve.