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THE IBS DIETITIAN

Kirsten Jackson Consultant BSc Hons PG Cert RD

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Stress, Anxiety, Depression and IBS: Managing Mental Health to Help IBS

by Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert 3 Comments

Research has shown that 54-95% of people with IBS suffer with psychiatric conditions such as generalised anxiety disorder (1, 2, 3).

The link between IBS and psychiatric conditions is only partly understood. BUT the good news is there are multiple ways to help manage them.

In this article I will explain the link between generalised anxiety disorder and IBS, as well as other mental health conditions.

Please note, this article is designed as an education tool only and not medical advice. If you are in anyway concerned over your mental health you should see your doctor for advice.

generalised anxiety disorder and IBS

Table of Contents

  • The gut-brain axis
      • The Gut-Brain Axis in IBS
  • Depression and IBS
  • Generalised anxiety disorder and IBS
  • Video explaining generalised anxiety disorder
  • The impact of stress on IBS
  • How to manage generalised anxiety disorder and other mental health conditions linked with IBS
  • Summary
  • References

The gut-brain axis

The gut-brain axis consists of bidirectional communication between the gut and the brain. This means that your brain can communicate with your gut and vice versa.

Ultimately, your mood can impact your gut AND your gut can impact your brain function.

The gut and brain ‘speak’ to each other through your nervous system, hormones and even microbiota interactions.

It is not entirely understood how the gut-brain axis works just yet. But there are some very interesting findings facts about the gut-brain axis in IBS which I have listed below.

The Gut-Brain Axis in IBS

  1. When your body becomes ‘stressed’ it releases stress hormones as part of the fight or flight pathway. This element is normal, but if you have IBS then your brain may have a hyperactive response to these hormones.
  2. The level of stress hormones in someone with IBS can be higher than in someone who does not have IBS (4, 5 ,6).
  3. In people who have IBS, the vagus nerve and sympathetic nervous system appear to react differently (compared to those who do not have IBS) which can impact gut motility and sensitivity (6).

Depression and IBS

Around 37% of people with IBS are also thought to have depression but the exact link is unknown (7).

Interestingly, those with depression appear to have a difference in gut microbiome, so this could be one of the causes and there is research underway to see if probiotics could help in this area (8).

Generalised anxiety disorder and IBS

The term ‘anxiety disorder’ refers to specific psychiatric disorders that involve extreme fear for worry (9).

Some examples of anxiety disorders are;

  • Generalised anxiety disorder
  • Panic disorder and panic attacks
  • Social anxiety disorder

Digestive symptoms have been shown to occur when you suffer with fear, anxiety or stress.

This is because your body has an inbuilt survival mechanism called a ‘fight or flight’ response which creates a number of changes in your body if it comes into contact with danger. These changes would allow you to ‘fight’ the danger or ‘flight’ away from it.

This is great if you are being attacked but when you have an anxiety disorder you can regularly experience anxiety for no ‘logical’ reason. If you suffer with an anxiety disorder, your body will often be in a fight or flight response which can impact your gut.

Unsurprisingly, up to 32% of people with IBS suffer with generalised anxiety disorder (10).

It is also common to experience anxiety in relation to the IBS symptoms which can in tern worsen the situation further. Research has shown that those who suffer with this type of anxiety have more depressive symptoms (11).

Video explaining generalised anxiety disorder

The impact of stress on IBS

The term ‘stress’ is thrown around very casually and some stress in life is pretty normal at times.  But if you are finding that stress is an every day occurrence then it is time to take action.

In IBS, stress has been shown to increase gut sensitivity and motility (1, 2, 3). This can be one reason why you may find that the low FODMAP diet process was unable to resolve your symptoms.

Top Tip: sometimes you become used to running high stress levels and maybe unaware of your own mental state. Try asking someone close to you if they feel you are stressed, it can be a real eyeopener. 

How to manage generalised anxiety disorder and other mental health conditions linked with IBS

Firstly, if you feel you are suffering in ANY way with your mental health, it is vital to speak to your doctor.

There are a wide range of therapies and medications that can help. We are all different and there is no one size fits all approach. 

The below is a list of pharmaceutical or therapeutic management techniques that have been scientifically proven to help in IBS specifically. 

  • Cognitive Behavioural Therapy – is a form of psychotherapy where  the  therapist  helps  patients  to  actively question their their  irrational  beliefs  and instead to form more rational  beliefs, with a positive impact on their emotional, cognitive, and  behavioural  response (10).
  • Hypnotherapy – you can read more about hypnotherapy and IBS in this blog post.
  • Mindfulness – this has been shown to reduce symptom severity and anxiety related to symptoms (11).
  • Antidepressant medications – this has been advised by NICE when other ‘first line’ medications such as laxatives do not work.

Summary

Mental health conditions are directly linked to IBS via the gut-brain axis. In order for you to manage this part of IBS it is vital to speak to your doctor as there are a range of treatments that can help to manage these issues.

References

10. Beck JS. Cognitive Behavior Therapy. Basics and Beyond. 2nd ed. New York: The Guilford Press, 2011

Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

Filed Under: Mental health Tagged With: generalised anxiety disorder, mental health therapy

About Kirsten Jackson Consultant Dietitian BSc Hons, RD, PG Cert

Kirsten Jackson is a UK registered Consultant Gastroenterology Dietitian and founder of The Food Treatment Clinic. She has undergone many qualifications to get where she is today, including a UK BSc Honours Degree in Dietetics and Post-Graduate Certificate in Advanced Dietetics. In addition to this, she has FODMAP Training from Kings College London University. Kirsten set up The Food Treatment Clinic in 2015 after first experiencing digestive problems herself. She felt that the NHS was unable to provide the support individuals needed and went on to specialise in this area before opening a bespoke IBS service. Kirsten also participates in charity work as an Expert Advisor for the IBS Network. In addition, she can be seen in publications such as Cosmopolitan and The Telegraph discussing IBS as an Official Media Spokesperson to the IBS Network.

Previous Post: « Does Colonic Irrigation Help IBS?
Next Post: The Low Fermentation Diet for SIBO »

Reader Interactions

Comments

  1. Rachel says

    at

    A very interesting read. I wonder what the statistics of the number of women suffering from ibs and anxiety are compared to those of men?

    Reply
    • Kirsten Jackson Specialist Dietitian says

      at

      Hi! Likely high but the data would be skewed as more women seek medical input so it is hard to get figures for mens health.

      Reply
      • jj says

        at

        Another excellent article. 2 questions: ” which came first the anxiety or IBS,IBD, Leaky GUT, SIBO,SIFO,LIBO diagnosis< and so on" and Secondly, I would like to see more generalized Information if causation could be Viral-

        I see little talk about this in Gastro circles much less psychological publications.

        Epstein Barr getting much more attention these days and hopefully w PCR technology we will learn of other important viral players possibly.

        Again great article.

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😥 We spend a lot our lives at work and if you have IBS, this routine can be quite stressful. You may feel frustrated at the difficulties you face trying to thrive in the workplace and you may lack energy to achieve your absolute best. ​​​​​​​​
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😊  Instead of accepting that work needs be this anxiety triggering thing in your life - adopt the Take Control approach of making small, sustainable changes over time like 10 minutes of meditation per day or going for a walk in your lunch break. Small changes over time add up to = big results!​​​​​​​​
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😪 Constipation is a common symptom of IBS (IBS-C). Some of the symptoms include straining on the toilet, loose or hard stools, and abdominal pain (these are just a few!😪) Constipation can leave my clients feeling bloated, fatigued, suffering from lack of appetite and overall totally fed up!! ​​​​​​​​​​​​​​​​
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😬 Do you have a food intolerance? Comment below 😬 Do you have a food intolerance? Comment below.

😳 Despite the multiple tests out there claiming to diagnose food intolerances, you can't actually test for an intolerance 😅. This means many people are wasting 💰💰 and following restrictive diets unnecessarily.

🙏 If you have symptoms of an intolerance then 1/ go to your GP to have some routine tests to ensure the symptoms aren't coming from other conditions and then if these all come back negative adopt our Take Control approach of using the scientifically backed low FODMAP diet approach to identify your actual intolerances with a registered dietitian support.

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😓 IBS feels like a continuous emotional rollercoaster. Yes there are physical IBS symptoms, but there are also many unseen struggles of IBS including social anxiety and loneliness. This can leave us feeling exhausted and not knowing where to turn to next. ​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​
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😊️ Instead of going through this alone, adopt the Take Control approach of community..​this could look like taking a step to reach out to a loved one that will you trust or joining an online group of other people with IBS who 'get it'. Doing this will make you feel seen when your IBS takes you for a ride. 
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Having IBS can really take a toll on your mental​​​​​​​​​​​​​​​​
health. There is a higher prevalence of mental health related symptoms and disorders in IBS compared to those without IBS😔. ​​​​​​​​​​​​​​​​
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The good news is that there are multiple treatments​​​​​​​​​​​​​​​​
including medications, CBT, clinical hypnotherapy and​​​​​​​​ mindfulness that have been shown to be of benefit to​​​​​​​​ those with IBS! The Take Control Approach 2.0  focuses on every aspect of lifestyle - including mindfulness and meditation!​​​​​​​​
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For anyone struggling out there with either gastrointestinal symptoms or psychological symptoms check in with a health professional. Whether it be your regular psychologist, dietitian or doctor, there is support available for you. ​​​​​​​​​​​​​​​​
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😢 The question I often get asked by many of my 😢 The question I often get asked by many of my clients is ‘where do I start’. Misinformation about IBS is rampant on social media and can often leave us feeling confused and overwhelmed about what is actually best to help manage our IBS and where we should start making changes.​​​​​​​​​​​​​​​​
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😬 Anyone relate? 💩 Many people I talkt to a 😬 Anyone relate?

💩 Many people I talkt to are trying to manage their IBS through restriction. The irony being that even with avoiding multiple foods, they still have symptoms.

🙏 Whilst you may have some food intolerances, it shouldn't be multiple. A restrictive diet will worsen your gut health. Instead of avoiding multiple foods and Still having symptoms adopt the Take Control approach of following the low FODMAP diet to identify specific food triggers and tolerance levels.

❤️ Don't forget to download your free IBS morning routine -  link in bio.

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🧅🍹🍎 Whilst this article points out 10 common IBS triggers, it's important to note that everyone will have different tolerance levels and there is no 1 cookie cutter diet for people with IBS.

🙏 To find out your intolerances it is important to work through the low FODMAP process which will give you specific answers.

👀 Read the full article https://www.cosmopolitan.com/uk/body/diet-nutrition/a13057878/foods-to-avoid-ibs/

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👉Anyone else feel like they just can't catch a break from IBS for just one minute? IBS is a debilitating condition that can impact so many aspects of your life, the big and the small things - they can all be a struggle when you have IBS!​​​​​​​​
⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
👍 But what if you could fully understand your IBS so you were able to identify your triggers AND improve your gut health so it was less sensitive? This would allow you to get on with tasks big or small without feeling overwhelmed. The Take Control 2.0 approach allows you to look at all aspects of your life to give you back control of your life!​​​​​​​​
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🎉 🎉 I am giving away a FREE IBS morning routine guide which you can download via the link in my bio. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​​​​​​​​​​
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😪 When following a low FODMAP diet, consuming enough fibre may be challenging as often high fibre foods are restricted. However, eating enough fibre is essential for helping bulk and soften stools! ​​​​​​​​​​​​​​​​
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🤩 Life should not have to be this challenging! ​​​​​​​​Using the Take Control 2.0 approach can allow you to discover foods and drinks which you can tolerate to improve your fibre intake - which is so important for gut health!​​​​​​​​
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🥳 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide! Link in bio.​​​​​​​​​​​​​​​​
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🙋🏼‍♀️ I am a huge advocate of the Mediterranean diet because it is repeatedly shown to be the best option for our health regardless of what is studied. AND especially in gut health.

💩 Including wholegrain, oily fish, plenty of veggies, fruits, nuts and olive oil is easy with a few tweaks to any diet!

✅ Swap your white carbs to brown
✅ Add 2 portions of fish per week - one should be oily like mackerel or salmon
✅ Eat the rainbow with fruit and veg
✅ Snack on nuts
✅ Switch your oil to olive oil

💩💩 What could you do this week to make your diet more in line with the Mediterranean diet? comment below 👇
DO YOU MOVE FOR YOUR GUT HEALTH? Comment below 👇​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​
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🥵 We get told that the more intense we exercise, the better. But exercising intensely can trigger our IBS, making us feel confused about the best way to stay healthy and control our symptoms. ​​​​​​​​
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🤔 In reality, people like to over complicate exercise. This is why we use the term 'movement' in the Take Control method. Avoid the confusion and keep it simple by going for a daily 30 min gentle walk and you will see the benefits!​​​​​​​​
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🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide! Link in bio.​​​​​​​​​​​​​​​​​​​​​​​​
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#ibs #walking #movement #irritablebowelsyndrome #ibsexpert #ibs diet #ibs #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealthiskey #healthylife #bloating #irritablebowelsyndrome #fodmapfree  #healthygut #goodguthealth #gutfood #fermentedfoods #trustyourgut #chronichealth
🤔 Can you relate to any of these comments? Let 🤔 Can you relate to any of these comments? Let me know below 👇 ​​​​​​​​
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😔 When you have IBS, you may feel that how you come across appears rude at times. IBS impacts every area of your life and you can feel you are constantly having to cover it up. Over time, this style of 'coping' can leave you feeling pretty isolated.​​​​​​​​
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🙏 Instead of treading water with your symptoms, use research proven methods such as the low FODMAP diet process and mindfulness (part of the Take Control approach) to move forward with your symptoms and regain confidence in yourself and your social life!​​​​​​​​
⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​
🎉 🎉 I am giving away a FREE IBS morning routine guide which you can download via the link in my bio.​​​​​​​​
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#ibs #ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #ibsd #ibd #chronichealth
⏩ Do you suffer from bloating? Comment below 👇​​​​​​​​
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🤰 Bloating is a common symptom for those suffering with uncontrolled IBS. Having bloating which is unpredictable and there everyday will make you feel tired, impact your relationship with your body and give you real anxiety about eating food.​​​​​​​​
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⏩ Instead of suffering with unpredictable bloating try the Take Control 2.0 approach of using the low FODMAP diet to identify your dietary triggers. By doing this, you can avoid foods which cause you bloating and start to feel more confident in your body.​​​​​​​​
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🎉 Would you like to start the day in a way which would benefit your gut? Download my FREE IBS morning guide! Link in bio.​​​​​​​​​​​​​​​​
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#ibsbloattips #ibsbloat #ibs #ibsdiet #ibsmanagement #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree #gutinstinct #healthygut #ibsd #ibsmanagement #ibssymptomrelief #ibshelp
WHAT WOULD YOU ADD? Comment below 👇 ​​​​​​​​​​​​​​​​
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😣 IBS is a condition that others cannot see. As humans, we struggle to understand or truly believe in things that we can't touch, hold or see. As a result, IBS sufferers often feel quite alone.⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​​
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😇 IBS is estimated to affect 5-10% of the worldwide population - so you really aren’t alone! Follow the Take Control process of finding a community to support you - there are lots of online forums where you can chat and share your worries with other people who completely understand. ​​​​​​​​
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning routine guide! Link in bio.⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​​
⠀⠀⠀⠀⠀⠀⠀⠀⠀​​​​​​​​​​​​​​​​
#ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #mumlife #dubaimom #constipation #chronicpain #chronicallyunwell #women'shealth #ibswishes
⁉️ Have you heard of these symptoms before?

😳 Both of these symptoms can be caused by a few things and one of them is bowel cancer. But we don't know based on symptoms alone so please go and get checked.

🩸Blood can appear on a toilet tissue, in the toilet bowl or it can look like part or all of your stool is black.

⚖️ Unexplained weight loss means that you have lost weight despite eating adequate calories and not really changing your exercise routine. It can be common in IBS to lose weight but this is due to eating less food and so it is explainable.

🙏🙏 If you have either of these symptoms please see your doctor to get checked, don't take the chance.

#bowelcancer #cancer #theibsdietitian
😭 Can you relate? Comment below👇👇​​​​​​​​​​​​​​​​​​
😫 Suffering from IBS can be difficult and burdensome especially when trying to go about your daily life. IBS is a condition that cannot be seen which makes it even more difficult for others to understand and can often feel very isolating😢. 

👉 Instead of keeping this condition to yourself, adopt the Take Control principle of community and get support from people who also have this condition. You can do this by opening up to friends (1 in 10 people have this!) or joining  online FB groups - this way you won't feel so alone in your fight! 
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide - link in bio.​​​​​​​​

#ibs diet #ibsbehindthescene ibs #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #bloating #irritablebowelsyndrome #fodmapfree  #healthygut #goodguthealth #gutfood #fermentedfoods #trustyourgut #chronichealth #microbiome #dubaidietitian #londondietitian #dubailife #dairyfree #prebiotics
🤔 WHICH ONES DID YOU KNOW? Comment below 👇 ​​​​​​​​​​​​​​​​
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😞 IBS is a very complex disorder to navigate by yourself. It’s more than just altering your diet, a lot of factors are at play with your IBS. Trying to work out what triggers your IBS is an absolute mind field.​​​​​​​​​​​​​​​​
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Adopting the Take Control Method, where the 4 pillars of IBS relief are all addressed (diet, movement, mental health and sleep), has helped so many of my clients to achieve that ultimate symptom relief because it considers EVERYTHING, not just what you out in your mouth.​​​​​​​​​​​​​​​​
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🎉 🎉 Fed up of trying everything you can but nothing seems to be working? Download my FREE IBS morning guide - link in bio.​​​​​​​​​​​​​​​​
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#ibsdiet #guthealth #ibsfood #guthealth #lowfodmapdiet #guthealthy #guthealing #guthealthdiet #guthealthiskey #bloating #gutmicrobes #gutscience #healthylife #lowfodmapdiet #bloating #irritablebowelsyndrome #fodmapfree  #gutinstinct #healthygut #ibsd #ibd #tea #5steps #chronichealth #multifactorial. #chronicallyunwell #endo #ibstype #ibstyping #ibsc
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