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Crohn’s Disease and Anxiety: What’s the Link?

Medically Reviewed by Sabrina Felson, MD on June 19, 2022

It’s normal to feel sad or worried about your Crohn’s disease at times. But if your feelings are more intense or frequent than usual, you might have anxiety. Anxiety is common among the general population, and even more common among people with Crohn’s disease. It can worsen Crohn’s symptoms, so it is important that you and your doctor work together to treat both conditions.

How Is Anxiety Related to Crohn’s Disease?

Crohn’s disease is a chronic (long-lasting) inflammatory bowel disease (IBD). Anxiety disorders cause feelings of worry or fear that you can’t control. People who have chronic conditions are more likely to have anxiety than those who don’t have them.

Crohn’s disease can affect your quality of life and impact your health outside of the disease itself. For example:

  • You might need a permanent ostomy, which could lead to body image issues.
  • If you’re pregnant, you might have a higher risk for miscarriage.
  • Crohn’s disease also can affect parts of your body outside of your intestines, such as your eyes, joints, or skin.

The condition’s uncomfortable symptoms can also interrupt your daily activities. You might have to shift your diet, reschedule events if you’re not feeling well, stay near a toilet if you’re having stomach trouble, or make other lifestyle changes.

Overall, these changes can impact your work, school, and home life. These changes can lead to anxiety, even when your Crohn’s isn’t flaring. During remission, you might still feel worried about the outlook of your disease. This anxiety could further affect your quality of life.

Anxiety also might make your Crohn’s symptoms worse. IBD patients who have anxiety are more likely to report symptoms (and rate those symptoms as more severe) than IBD patients who don’t have anxiety.

Is Anxiety a Risk Factor of Crohn’s Disease?

Anxiety disorders might also be a risk factor for Crohn’s disease. One study found high rates of anxiety among Crohn’s patients, including many who had anxiety disorders before they developed Crohn’s disease. This research suggests that anxiety might contribute to the development of Crohn’s disease, but more studies are needed before this idea can be proven.

What Are the Symptoms of Anxiety and Crohn’s Disease?

If you have an anxiety disorder, you might notice certain signs alongside your Crohn’s disease symptoms. They may be different for everyone. You could develop:

  • Hot flashes or chills
  • Numbness or tingling
  • Heart palpitations
  • Sweating
  • Shaking or trembling
  • Trouble breathing
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or stomach pain
  • Lightheadedness or dizziness
  • Feeling like things are distant or not real
  • A fear of losing control or dying
  • Tension or pain in your muscles
  • Restlessness
  • Feeling tense or stressed
  • Feeling like there’s a lump in your throat
  • Trouble swallowing
  • Intense reactions after you’ve been startled or surprised
  • Difficulty focusing
  • Irritability
  • Problems sleeping because of worry

If you aren’t sure whether your symptoms are because of anxiety, talk to your doctor. If they think you have anxiety, they might refer you to a psychiatrist who can formally diagnose and treat you.

What Are the Risk Factors for Anxiety and Crohn’s Disease?

Certain things can put you at higher risk for both anxiety and Crohn’s. These risk factors include:

Higher age. In one study, experts found that patients over 40 years old with both inactive IBD and mood disorders might have a lower quality of life than younger patients.

Psychological stress. Crohn’s symptoms are closely linked with stress and anxiety.

Severe and active disease. One study found that IBD patients with intense, ongoing symptoms were more likely to have anxiety than patients with mild symptoms. A different study of patients with ulcerative colitis (a condition that’s similar to Crohn’s disease) found a link between active inflammation and psychological stress.

Surgery and stoma. Some people with Crohn’s disease might need surgery. For example, doctors might need to take out your colon and place a permanent stoma on your body instead. A stoma is an opening that helps you release stool. This operation can be a huge change for many people. As a result, this surgery can cause anxiety and might affect your quality of life.

One study found that Crohn’s-related surgery and hospitalization were linked to a higher risk for anxiety. Anxiety might be related to symptoms, side effects of treatment, or the feeling of being in a hospital.

Your knowledge about Crohn’s disease. Some studies suggest that the more you know about Crohn’s disease, the more likely you are to have anxiety. But other studies didn’t find a link between disease knowledge and your mental health risk. Doctors need more information to understand if there’s a tie here.

Low socioeconomic status. Crohn’s patients with low incomes might be more likely to have anxiety than wealthier patients.

How Can You Treat Crohn’s-Related Anxiety?

It’s important that mental health specialists are a part of your Crohn’s disease care. Lowering stress and anxiety is important for both your physical and mental health.

To have the best quality of life possible, you might consider therapy for anxiety in addition to your Crohn’s disease treatment. Your doctor might suggest:

Cognitive behavioral therapy. This treatment teaches you to change your thinking and behavioral patterns.

Acceptance and commitment therapy. This form of treatment helps you to accept the challenges that come with Crohn’s disease. It might help you focus on staying present and mindful throughout your disease.

Hypnotherapy. This method uses mind and body techniques to help you achieve a relaxed state of mind. In this state, you might be more open to suggestions that can help improve your Crohn’s and anxiety symptoms.

You can also check out in-person support groups. These groups can help you meet other people who have Crohn’s and anxiety. You can share tips, make friends, and learn new coping strategies.

Show Sources

SOURCES:

Crohn’s and Colitis Foundation: “Depression and Anxiety.”

Clinical and Experimental Gastroenterology: “Inflammatory Bowel Disease and Anxiety: Links, Risks, and Challenges Faced.”

Inflammatory Bowel Diseases: “Influences and Impact of Anxiety and Depression in the Setting of Inflammatory Bowel Disease.”

Cleveland Clinic: “Taking Care of Your Mental Health Is a Key Piece of the IBD Puzzle.”

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