Irritable Bowel Syndrome (IBS) and Depression

Stomach pain, bloating, diarrhea, or constipation can cause enough distress in a person's life. But often they are not the only problems. Studies show that up to 60% people with irritable bowel syndrome (IBS) also have a psychological disorder, most commonly depression or anxiety.

Of people who suffer from IBS symptoms and a psychological disorder, more than 60% have anxiety, and 20% have depression, according to Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany.

Although anxiety is a bigger problem for IBS patients, depression can also play a role in aggravating symptoms. As far as scientists know, IBS does not cause depression, nor does depression cause IBS. Together, though, they can wreak havoc on a person's life.

How IBS and Depression Work Together

Some people are so worried that their IBS symptoms will flare up that they avoid going to going to work, school, or social functions. This fear may make them physically withdraw from social life. They may lose interest in activities they once enjoyed. They may feel restless or irritable. All these are symptoms of depression.

Or, the feeling of despair caused by depression may influence the way people cope with their IBS. They may feel too tired or hopeless to bother changing their diet to ease IBS symptoms. In the dark cloud of depression, people may think they can't treat IBS-related constipation or diarrhea effectively.

People with IBS also seem to be more sensitive to emotional stress. And people who are stressed often are also more aware of pain and discomfort. IBS with depression can be a frustrating, often painful cycle.

Breaking the IBS, Depression Cycle With Treatment

Antidepressants are used to treat both depression and the symptoms of IBS. But they're used in different ways for each condition, so it's important talk with your doctor to learn if you're truly depressed.

For example, Beth Schorr-Lesnick, MD, FACG, a gastroenterologist at Montefiore Medical Center in Bronx, New York, prescribes low doses of antidepressants to some patients who don't have depression. The drugs help block the brain's perception of pain, she says.

A number of studies have found that antidepressants, given in low doses, can help with some IBS symptoms. Indeed, treatment guidelines published by the American College of Gastroenterology notes that low doses of tricyclic antidepressants like Pamelor, Elavil, or Norpramine can soothe stomachaches. The college did not have enough information to make a recommendation about other types of antidepressants.

But the low doses used in IBS studies could not effectively treat depression. That's why anyone with IBS and some signs of depression should be thoroughly evaluated. If you are clinically depressed, you may need higher doses of antidepressants than commonly prescribed for IBS.