Patients with Crohn’s disease often do their best to cope with debilitating symptoms, such as diarrhea, abdominal pain, cramping, ulcers, reduced appetite, and weight loss, only to find themselves physically and emotionally drained. Over time, the struggle can take its toll on their mental and emotional well-being to the point where many fall into a severe depression.
And while there may be several reasons why people with Crohn’s disease experience depression, understanding the connection between the two conditions is the first step toward effectively dealing with the problem.
Here’s what people with Crohn’s disease should know:
Chronic illnesses affect mental health. People suffering from both a chronic illness and depression may find that one condition often makes the other worse. “Individuals with Crohn’s disease are dealing with a chronic illness that is out of their control,” says Frank J. Sileo, PhD, a licensed psychologist and the founder and executive director of the Center for Psychological Enhancement in Ridgewood, New Jersey. “There is no cure, and it impacts work, social, academic, family, and other areas of one’s life.”
The understanding that there’s “no cure” can give way to a sense of hopelessness and can ultimately lead to a more pessimistic view on life. Prolonged periods of feeling hopeless, helpless, and pessimistic are all symptoms of depression. Conversely, there’s now evidence that suggests falling into a depression can exacerbate Crohn’s flare-ups. A study published in June 2016 in the American Journal of Gastroenterology followed more than 2,100 volunteers and found that, over the course of a year, patients who experienced a worsening of depression symptoms reported having more frequent diarrhea and pain. They were also more likely to be hospitalized due to the condition.
The physical challenges are hard to manage. Crohn’s disease tends to breed a sense of helplessness and confusion, and can be particularly challenging because it’s so unpredictable. “There is always the threat of symptoms flaring up,” Dr. Sileo says. With this kind of uncertainty always hanging over you, it can be extremely stressful when you’re trying to live a normal life.
Crohn’s can hinder your personal life. Besides the physical challenges, patients sometimes find themselves having to make difficult lifestyle changes. If symptoms flare up, they may be forced to cancel plans with friends and end up spending more time alone. Additionally, people with Crohn’s disease may feel guilty about burdening family and loved ones with their problems, so they’ll isolate themselves even more. The symptoms may also prevent them from working as quickly and efficiently as they once did. Eventually their job performance starts to suffer, leading to a loss of self-worth.
Fortunately, depression is a treatable condition, though it usually requires professional help. Sileo feels that treating depression in people with Crohn’s disease can be especially important. “Depression wreaks havoc on our immune system,” he says. “Because Crohn’s is an immune system disease, treatment of depression is very important to avoid overtaxing an already compromised immune system.”
Tips for Handling Depression When You Have Crohn’s
So if you have Crohn’s disease and think you might be exhibiting signs of depression, here are steps you can take to get back on the right path:
Find a therapist. Your family physician can help you find a mental health counselor or a psychologist. Mental health professionals work with patients to develop strategies to combat symptoms of depression by helping them set realistic goals and identify negative patterns of thinking.
Try doing something positive for yourself. According to a study published in February 2016 in Translational Psychiatry, combining a moderate exercise plan with meditation techniques can reduce depression and improve one’s overall well being. You might also want to start a new hobby or visit a place that you’ve always wanted to. Setting aside time to do the things you find enjoyable will remind you of all the positives in life.
For some people, antidepressants may boost mood. Beyond therapy and other lifestyle changes, your doctor may prescribe an antidepressant, such as Zoloft (sertraline) or Prozac (fluoxetine). Patients who opt for antidepressants should make sure to discuss them with their gastroenterologist to avoid any negative interactions with any prescribed medication for Crohn’s.
Staying mentally and emotionally healthy are crucial elements of managing Crohn’s disease, so take the steps necessary to take care of your emotional well-being, just as you do your body.