IBS and Depression: What’s the Link?

As far as scientists know, irritable bowel syndrome doesn't cause depression, and depression doesn’t cause IBS. But for many people, the two go together. Sometimes, one condition can make the other one worse. It can be a frustrating cycle.

At the same time, treatments that usually relieve the mood disorder can help some people with their IBS symptoms, too. They can give you even more options to consider when you’re looking for relief.

How IBS and Depression Work Together

The symptoms of irritable bowel syndrome can cause a level of distress that looks like depression. Some people are so worried that their diarrhea, constipation, or other symptoms will flare up that they avoid going to work, school, or out with friends. They may focus less on their social lives and lose interest in activities they once enjoyed. They may feel restless or irritable. All of these are symptoms of depression.

On the other hand, the mood disorder may influence the way people handle IBS. They may feel too tired or hopeless to bother changing their diet to ease digestive symptoms or think they can't treat their constipation or diarrhea well enough. Also, emotional stress makes bowel symptoms worse.

Antidepressants for IBS

Some depression meds can treat the mood disorder and some of the symptoms of IBS. But they're used in different ways for each condition, so it's important to talk with your doctor to learn how you should take them.

Even people with irritable bowel syndrome who aren’t depressed can get relief from antidepressants. The drugs can help block how the brain processes pain.

The American College of Gastroenterology says two types of antidepressants can help IBS symptoms:

  • Tricyclic antidepressants, like amitriptyline (Elavil, Vanatrip), desipramine (Norpramin), or nortriptyline (Pamelor)
  • Selective serotonin reuptake inhibitors (SSRIs), like citalopram (Celexa), paroxetine (Paxil), or sertraline (Zoloft)

But experts say they need more research to fully understand how safe and effective the drugs are for people with IBS.

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Talk Therapy

Many people with depression get help by working with a therapist to figure out conflicts and understand feelings. One type of talk therapy, called cognitive behavioral therapy, can help with IBS symptoms and the mood disorder. 

Cognitive behavioral therapy teaches you how to recognize negative and distorted thoughts, and replace them with positive, more realistic ones.

The American College of Gastroenterology has found that behavioral therapy eased some IBS symptoms for most people. And when they felt physically better, they also had fewer symptoms of depression and anxiety.

Other Treatment Options

Along with medicine and talk therapy, other steps can help ease depression and irritable bowel syndrome. Some people find that stress management techniques, like meditation or deep breathing, help them feel better. Regular exercise also helps some people recover from depression. So does a good diet for IBS, the right amount of sleep, and taking time to do something you enjoy each day.

Support groups for people with IBS or the mood disorder can make a difference, too. When you talk with others who know what you’re going through, you might feel less alone.

To find support groups that meet in person or online, contact the International Foundation for Functional Gastrointestinal Disorders or tap into the IBS Self Help and Support Group.

Talk with your doctor about what’s right for you, too. Ask if meeting with a mental health professional will help.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on March 01, 2016

Sources

SOURCES: 

Lydiard RB. J. Clin Psychiatry, 2001. 

Philip Schoenfeld, MD, MSEd, MSc, co-author of American College of Gastroenterology's "Evidence-Based Position Statement on the Management of Irritable Bowel Syndrome in North America." 

Jeanine Blackman, MD, PhD, medical director of the University of Maryland Center for Integrative Medicine. 

Jonathan Gilbert, National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). 

The National Center for Complementary and Alternative Medicine. 

Mayo Clinic: "Highlights from Digestive Disease Week: An Expert Interview with Lawrence R. Schiller, MD." 

Fadgyas-Stanculete M., Journal of Molecular Psychiatry, 2014. 

Medline Plus: "Amitriptyline" and "Desipramine."

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