Irritable Bowel Syndrome (IBS) is an extremely common gastrointestinal disorder affecting 1 in 5 adults in the United States alone.
Currently, there is no known cause of IBS but it’s characterized by constipation, gas, bloating, cramping, abdominal pain and diarrhea, and the disorder is very different to live with.
According to a survey conducted in 2017 by the American Gastroenterological Association, 47% of patients would give up their cell phone in exchange for just 1 month of relief from their symptoms.
As if the physical symptoms were not difficult enough 90% of patients suffering from IBS also suffer from mental health conditions, specifically anxiety and depression.
With a 90% correlation rate, the question is could your IBS be linked to anxiety and depression and what options are available for relief without causing worsening of IBS symptoms?
Researchers Find Serotonin as the Missing Link
IBS researches are exploring the role of serotonin, a valuable neurotransmitter that regulates mood and the ability to handle stress, and its relation to IBS. While serotonin fulfills an important role in mood regulation, it’s equally involved in many functions of the digestive system.
This important neurotransmitter performs the key role in communication between our guts and our brains.
Researches wonder if low levels of serotonin may be the cause behind both IBS and depression, as the symptoms behind both disorders seem to overlap with serotonin deficiency.
Are Depression and Anxiety Causing IBS?
Similarly, researches wonder if anxiety and depression lead to IBS.
According to an extensive 12-year study, almost all participants with IBS at the beginning of the study had ended up with higher levels of both anxiety and depression by the end of the study.
Likewise, participants with depression and anxiety at the beginning of the study were at a considerably greater risk of developing IBS at the end of the study.
Researchers concluded that IBS, depression, and anxiety can occur in either direction, i.e. from the gut to the brain or from the brain to the gut and they firmly believe serotonin regulation may provide some if not complete relief.
Can IBS Cause Anxiety and Depression?
Another limited study looked at the possibility of IBS solely causing the symptoms or anxiety and depression.
There’s an intense level of distress seen in patients with IBS, as their symptoms frequently make living a normal lifestyle difficult. When a flare-up occurs it can make daily living seem next too impossible, affecting work, family and social life.
The constant worries about a flare-up occurring can cause stress to arise in IBS patients. The worry produces symptoms of anxiety, and the anxiety itself can cause IBS flare-ups more often, leading to depression symptoms.
It’s a vicious cycle, resulting in irritability that seems to never end.
The Missing Link in IBS
While the exact cause of the link between IBS, depression, and anxiety is still unknown, researchers agree that there is an absolute link between the three.
When experiencing depression symptoms it can lead to more difficulties in managing symptoms of IBS, as depression often causes feelings of hopelessness and despair.
Without proper management of symptoms, IBS can spiral out of control, causing a round-about effect of anxiety, depression and chronic flare-ups.
The good news is that help is available. Those living with IBS have various options to manage their anxiety and depression symptoms, and these treatment options can also help IBS symptoms and lower the frequency of flare-ups.
Treatment Options for IBS Related Depression and Anxiety
As mentioned, living with IBS often causes symptoms of anxiety and depression to arise, and the severity of symptoms is much higher in those whose IBS symptoms aren’t properly treated.
What many patients with IBS don’t realize is there are actually 3 different types of IBS.
While they all fall under the same diagnosis of Irritable Bowel Syndrome, determining the form of IBS helps determine the most efficient route of treatment for managing symptoms.
The 3 forms of Irritable Bowel Syndrome include:
- (D-IBS) diarrhea-predominant
- (C-IBS) constipation-predominant
- (A-IBS) alternating constipation and diarrhea.
Those who aren’t aware of the differences in the three forms of IBS may expect their doctor to easily identify their symptoms, assuming they are universal among IBS patients.
The key to finding the best treatment is first determining what category you fall under.
There are many forms of treatment for IBS patients to help relieve symptoms and finding the right one can help improve anxiety and depression symptoms.
The worry and isolation leading to depression worsen feelings of both emotional difficulties, but the right medication or alternative treatment option can reduce flare-ups and improve the patients overall quality of life.
Cognitive Behavioural Therapy for IBS
Cognitive behavior therapy (CBT) remains a popular option for patients suffering from IBS, anxiety, and depression. While this treatment module takes longer for the benefits to show, it’s without side effects and can provide a lifetime of healing. Strong research supports the use of CBT in relieving the symptoms of depression and IBS. Not only that, but a significant among of research indicates that CBT is effective for reducing IBS symptoms of pain, constipation, and diarrhea.
CBT involves teaching the patient different strategies for coping with unpleasant symptoms, calming the body and mind, and learning to face difficult situations.
When using CBT for IBS treatment, any one of these three techniques may be used, depending on the patient’s specific treatment needs.
Unlike other forms of treatment using medication, the symptom improvement that occurs following a course of cognitive behavior therapy can be expected to continue long after treatment has ended.
In fact, the American College of Gastroenterology recently recommended CBT as a first-line treatment option for IBS patients.
Antidepressants for IBS Treatment
One of the most common treatments for IBS co-occurring with anxiety and depression are SSRIs (Selective Serotonin Reup-Inhibitors)
According to statistics SSRIs are currently prescribed 60 times more than 10 years ago. SSRIs are often used off-label (for conditions other than what they are prescribed) for various medical issues and IBS is one of the more typical ones.
SSRIs not only help relieve anxiety and depression, but they are also sometimes effective for reducing pain and gut functioning. Experts believe this occurs because the antidepressant works on serotonin and other neurotransmitters that are linked to IBS, anxiety, and depression.
By using SSRIs to regulate serotonin, some medical professionals state they may improve IBS symptoms while also managing mental health.
However, SSRIs aren’t without their own side effects.
Actually, most of the side effects related to SSRIs are gastrointestinal related and they are notorious for causing gastrointestinal problems, which seems like a catch 20.
A Solution Without The Side Effects
Dr. Lindsay Israel, chief medical officer and medical director at Success TMS, responded with an effective treatment option without the side-effects common to SSRIs.
Dr. Lindsay stated “Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain, cramping, bloating, gas, constipation, and diarrhea, and affects approximately 1 in 5 adults in the United States. There is no known cause for IBS, however, it is a well-known fact that up to 90% of patients with IBS also suffer from psychiatric conditions, specifically Depression and Anxiety. Therefore, digestive disease specialists often prescribe antidepressants to help mitigate the symptoms of IBS. The rub is that many of these antidepressants, specifically the SSRI’s, are notorious for causing gastrointestinal side effects. Now, with the option of non-medication treatments for depression, such as Repetitive Transcranial Magnetic Stimulation (rTMS), patients with comorbid IBS can very likely get much-needed relief from their daily symptoms without any confounding side effects.”
What Exactly is Repetitive Transcranial Magnetic Stimulation?
Repetitive Transcranial Magnetic Stimulation (rTMS) may be a new term for many, but this form of brain stimulation therapy has been in use since 1985.
rTMS involves the use of a magnet that targets and stimulates specific areas within the brain. While there isn’t much data on its success related to depression symptoms, many people have praised rTMS for providing long-term relief of their symptoms.
According to a study published in March of 2014, researchers found that rTMS can be effective in reducing anxiety and depression associated with IBS, pressure pain threshold, and rectal sensitivity.
According to the study patients with IBS experienced a significant improvement in pain using rTMS. Patients with rectal hypersensitivity experienced the most improvement in IBS symptoms.
The results of the study showed enough improvement in symptoms at the end that there are plans to continue more powered studies in the future aimed towards IBS alone.
However, a more recent study published in November of 2018 showed an improvement in intestinal, bladder and neuropathic pain, along with urinary disturbances and depressive symptoms.
These results alone show that rTMS can be effective for IBS and the mental health symptoms of depression and anxiety. The research is exciting because patients may experience much-needed relief from their symptoms without the side-effects common to SSRIs.
It’s clear that the link between IBS, anxiety, and depression is strong.
While dealing with these three disorders together can feel like a never ending journey, with the right help you can experience symptom relief and improve the quality of your life.
By exploring the different treatment options available to you, you can find the one that’s best suited for your needs and create a long-term treatment plan that provides you with the relief you are seeking.