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Depression and IBS

IBS or irritable bowel syndrome is a complex disorder characterised by constipation, diarrhoea or both, along with abdominal pain and bloating. Other symptoms can include mucous in the stools, indigestion, bad breath, fatigue, and mild depression.

No one knows exactly what causes IBS as it would appear that there are many different triggers including intolerance to certain types of food and imbalances in the delicate microflora of the gut. What is known is that stress and anxiety can make the symptoms of IBS much worse and that many people with IBS can also have other conditions including depression.

One study by Cole et al that was published in 2006 looked at the prevalence of Migraine, Fibromyalgia and Depression in IBS sufferers. They found that there was around a 40% higher chance of depression in people with IBS. Although this is quite a high percentage and does highlight that there is some sort of link between IBS and depression, depression does not cause IBS and just because you have IBS it doesn’t mean you will become depressed.

The link between IBS and depression

IBS can be a distressing condition, particularly if your symptoms are so severe that they inhibit you from attending social functions, affect your performance at work and impact negatively on your relationships with your loved ones. Over time this can lead to feelings of isolation and possibly predispose you towards depression, particularly if you lose all interest in carrying out the activities you used to enjoy and feel alone, irritable and sad.

People with IBS have been found to be more sensitive to pain and to any kind of emotional anxiety or stress. Interestingly, low dose anti-depressants, particularly selective serotonin reuptake inhibitors or SSRIs have proved to be effective in treating some people with IBS. Although the dose is too low to alleviate depression, it is enough to make a difference to the symptoms of IBS. This is thought to be because of the influence that anti-depressants have on levels of serotonin in the body.

Serotonin is an important neurotransmitter responsible for mood as well as for many functions in the digestive tract. Indeed, most of the serotonin in your body is located in the gut and not in the brain. This goes to show the close link between the brain and the gut and indeed, IBS is believed to be some sort of malfunction in the communication signals between the brain and the gut. Consequently, it stands to reason that any changes in serotonin levels will affect both your mood and your digestive functioning.

Treating IBS and depression

Treatment for IBS currently involves finding ways of dealing with the symptoms that are causing the most concern. For example, anti-diarrhoeal agents for diarrhoea, laxatives for constipation and pain killers and antispasmodics for painful stomach cramps. The link between IBS and depression means that for any kind of treatment plan to by effective, it must involve a holistic approach whereby any underlying worries and anxieties are also dealt with. Indeed talking therapies have proved to be effective for IBS and depression and as such should be considered as a possible treatment option for both.