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

Table of ContentsView AllTable of ContentsConnectionRisk FactorSigns and SymptomsThose Most Likely to Have BothHow to Find Relief

Table of ContentsView All

View All

Table of Contents

Connection

Risk Factor

Signs and Symptoms

Those Most Likely to Have Both

How to Find Relief

Having Crohn’s disease, a type of inflammatory bowel disease (IBD), can increase your risk ofanxiety. Research shows that people with IBD are twice as likely to have anxiety or depression as the general population.

While the link between these conditions is unclear, anxiety occurs more often in people with IBD than in the general population. Without treatment, anxiety can cause complications in Crohn’s disease.

Kseniya Ovchinnikova / Getty Images

How Is Anxiety Related to Crohn’s Disease?

Research shows that abnormal anxiety levels occur in up to 40% of people with IBD. When it happens, anxiety can contribute to the onset of symptoms and impact the course of the disease.

People with Crohn’s disease may experience anxiety as a result of worrying about unpredictable symptoms. Experiencing a return of symptoms or more active symptoms is called a flare-up.

These episodes affect everyone differently and can last from a few days to several months. While anxiety symptoms are often related to flare-ups of Crohn’s disease, they may persist even during remission (periods without symptoms).

Having anxiety is linked with worse outcomes for people with Crohn’s disease. This is because poor mental health can make it harder to manage your Crohn’s. It can interfere with your motivation to take care of yourself and follow through on your treatment plan and medication schedule. As a result, anxiety and other mental health problems may lead to more hospital admissions and a higher risk of severe disease, more complications, or the need for surgery.

Anxiety and other mental health conditions can also interfere with the brain-gut connection of people with Crohn’s disease.

Your brain and gut are connected through thevagus nerve, which sends signals in both directions between your brain and gut. Through this connection, mental health disorders that affect your brain can also impact your digestive health. This can create a cycle in which stress worsens your symptoms of Crohn’s disease, which then causes more stress. This chronic stress can make you more sensitive to pain signals from your gut and increase your discomfort.

Is Anxiety a Risk Factor for Crohn’s?

While anxiety can impact Crohn’s disease, there is no conclusive evidence that it is a risk factor for the onset of Crohn’s disease or another type of IBD. Separate risk factors can increase your chances of getting either one of these diseases.

There are several types of anxiety disorders, including the following:

While the risk factors for each type can differ, the following genetic and environmental factors can increase your chances of having any anxiety disorder:

The genetic and environmental risk factors for Crohn’s disease include:

Possible Signs and Symptoms

Since anxiety and Crohn’s disease are two different conditions, each disease has distinct symptoms that can occur differently for everyone.

Symptoms of Crohn’s disease occur when the disease is active. Crohn’s usually affects your small intestine and the beginning of your large intestine. The symptoms that you experience during a flare-up can change over time. They can also vary based on the location and severity ofinflammation, they can include:

Research shows that people with IBD who have anxiety and/or depression tend to have more severe symptoms compared to people who have IBD without anxiety and/or depression. Symptoms such as fatigue, abdominal pain, fecal urgency, excess gas, andbloody stoolswere more commonly reported.

Crohn’s Disease And Flare Symptoms

Who Is More Likely to Experience Both?

Research indicates that people with Crohn’s disease who have certain characteristics are more likely to experience anxiety and/or depression. Risk factors can include:

Complications of Crohn’s can include what are called extraintestinal manifestations —Crohn’s disease-related conditions that occur outside the gastrointestinal tract—such as:

Research indicates that people with IBD who have anxiety and/or depression also have the following characteristics when compared to people with IBD who don’t have mental health concerns:

How to Deal With Anxiety: 13 Ways to Cope

You will need more than traditionalCrohn’s disease treatment optionsif you experience anxiety with your disease. It’s important to discuss your symptoms with your healthcare provider so they can develop a treatment plan that addresses your physical and mental health needs.

There are many ways to reduce anxiety while managing Crohn’s disease, such as:

If your symptoms of anxiety do not improve, talk to your healthcare provider about getting professional treatments to reduce anxiety, decrease your risk of relapse, and improve your overall quality of life. These treatments include medications and psychological treatments.

Medications

The most commonmedications for anxietyand depression areselective serotonin reuptake inhibitors (SSRIs)andserotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs include:

SNRIs include:

Psychological Treatment

Can the Gluten-Free Diet Help Treat Your Crohn’s Disease or Colitis?

Summary

If you have an IBD like Crohn’s disease, you have a higher risk of anxiety compared to people who don’t have Crohn’s disease. Factors such as the unpredictable nature of symptoms and the stress of managing the disease can contribute to the onset of anxiety.

While the link between anxiety and Crohn’s disease is unclear, anxiety can worsen symptoms and make it harder to manage your disease. Anxiety is linked with more severe symptoms and worse disease outcomes.

Contact your healthcare provider if you have symptoms of anxiety with Crohn’s disease. They can adjust your treatment plan and advise ways to improve your mental health. Leaving anxiety untreated raises your chances of being hospitalized and possibly needing surgery.

13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gao, X., Tang, Y., Lei, N.et al.Symptoms of anxiety/depression is associated with more aggressive inflammatory bowel disease.Sci Rep.2021;11:1440. doi:10.1038/s41598-021-81213-8Bannaga AS, Selinger CP.Inflammatory bowel disease and anxiety: links, risks, and challenges faced.Clin Exp Gastroenterol. 2015;8:111-117. Published 2015 Mar 23. doi:10.2147/CEG.S57982Narula N, Pinto-Sanchez MI, Calo NC, et al.Anxiety But Not Depression Predicts Poor Outcomes in Inflammatory Bowel Disease.Inflamm Bowel Dis. 2019;25(7):1255-1261. doi:10.1093/ibd/izy385Crohn’s & Colitis UK.Mental health and wellbeing.Crohn’s & Colitis Foundation.Stress and IBD: breaking the vicious cycle.MedlinePlus.Anxiety.MedliePlus.Crohn’s Disease.MedlinePlus.Crohn’s disease.Crohn’s & Colitis Foundation.The impact of anxiety and depression on patients with inflammatory bowel diseases.Navabi S, Venkata GS, Yadav S, et al.Influences and impact of anxiety and depression in the setting of inflammatory bowel disease.Inflammatory Bowel Diseases.2018;24(11):2303–2308, doi:10.1093/ibd/izy143Crohn’s & Colitis Foundation.Depression and anxiety.Crohn’s & Colitis Foundation.Coping strategies to improve mental health.Parish AL, Gillis B, Anthamatten A.Pharmacotherapy for depression and anxiety in the primary care setting.J Nurse Pract. 2023;19(4):104556. doi:10.1016/j.nurpra.2023.104556

13 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Gao, X., Tang, Y., Lei, N.et al.Symptoms of anxiety/depression is associated with more aggressive inflammatory bowel disease.Sci Rep.2021;11:1440. doi:10.1038/s41598-021-81213-8Bannaga AS, Selinger CP.Inflammatory bowel disease and anxiety: links, risks, and challenges faced.Clin Exp Gastroenterol. 2015;8:111-117. Published 2015 Mar 23. doi:10.2147/CEG.S57982Narula N, Pinto-Sanchez MI, Calo NC, et al.Anxiety But Not Depression Predicts Poor Outcomes in Inflammatory Bowel Disease.Inflamm Bowel Dis. 2019;25(7):1255-1261. doi:10.1093/ibd/izy385Crohn’s & Colitis UK.Mental health and wellbeing.Crohn’s & Colitis Foundation.Stress and IBD: breaking the vicious cycle.MedlinePlus.Anxiety.MedliePlus.Crohn’s Disease.MedlinePlus.Crohn’s disease.Crohn’s & Colitis Foundation.The impact of anxiety and depression on patients with inflammatory bowel diseases.Navabi S, Venkata GS, Yadav S, et al.Influences and impact of anxiety and depression in the setting of inflammatory bowel disease.Inflammatory Bowel Diseases.2018;24(11):2303–2308, doi:10.1093/ibd/izy143Crohn’s & Colitis Foundation.Depression and anxiety.Crohn’s & Colitis Foundation.Coping strategies to improve mental health.Parish AL, Gillis B, Anthamatten A.Pharmacotherapy for depression and anxiety in the primary care setting.J Nurse Pract. 2023;19(4):104556. doi:10.1016/j.nurpra.2023.104556

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Gao, X., Tang, Y., Lei, N.et al.Symptoms of anxiety/depression is associated with more aggressive inflammatory bowel disease.Sci Rep.2021;11:1440. doi:10.1038/s41598-021-81213-8Bannaga AS, Selinger CP.Inflammatory bowel disease and anxiety: links, risks, and challenges faced.Clin Exp Gastroenterol. 2015;8:111-117. Published 2015 Mar 23. doi:10.2147/CEG.S57982Narula N, Pinto-Sanchez MI, Calo NC, et al.Anxiety But Not Depression Predicts Poor Outcomes in Inflammatory Bowel Disease.Inflamm Bowel Dis. 2019;25(7):1255-1261. doi:10.1093/ibd/izy385Crohn’s & Colitis UK.Mental health and wellbeing.Crohn’s & Colitis Foundation.Stress and IBD: breaking the vicious cycle.MedlinePlus.Anxiety.MedliePlus.Crohn’s Disease.MedlinePlus.Crohn’s disease.Crohn’s & Colitis Foundation.The impact of anxiety and depression on patients with inflammatory bowel diseases.Navabi S, Venkata GS, Yadav S, et al.Influences and impact of anxiety and depression in the setting of inflammatory bowel disease.Inflammatory Bowel Diseases.2018;24(11):2303–2308, doi:10.1093/ibd/izy143Crohn’s & Colitis Foundation.Depression and anxiety.Crohn’s & Colitis Foundation.Coping strategies to improve mental health.Parish AL, Gillis B, Anthamatten A.Pharmacotherapy for depression and anxiety in the primary care setting.J Nurse Pract. 2023;19(4):104556. doi:10.1016/j.nurpra.2023.104556

Gao, X., Tang, Y., Lei, N.et al.Symptoms of anxiety/depression is associated with more aggressive inflammatory bowel disease.Sci Rep.2021;11:1440. doi:10.1038/s41598-021-81213-8

Bannaga AS, Selinger CP.Inflammatory bowel disease and anxiety: links, risks, and challenges faced.Clin Exp Gastroenterol. 2015;8:111-117. Published 2015 Mar 23. doi:10.2147/CEG.S57982

Narula N, Pinto-Sanchez MI, Calo NC, et al.Anxiety But Not Depression Predicts Poor Outcomes in Inflammatory Bowel Disease.Inflamm Bowel Dis. 2019;25(7):1255-1261. doi:10.1093/ibd/izy385

Crohn’s & Colitis UK.Mental health and wellbeing.

Crohn’s & Colitis Foundation.Stress and IBD: breaking the vicious cycle.

MedlinePlus.Anxiety.

MedliePlus.Crohn’s Disease.

MedlinePlus.Crohn’s disease.

Crohn’s & Colitis Foundation.The impact of anxiety and depression on patients with inflammatory bowel diseases.

Navabi S, Venkata GS, Yadav S, et al.Influences and impact of anxiety and depression in the setting of inflammatory bowel disease.Inflammatory Bowel Diseases.2018;24(11):2303–2308, doi:10.1093/ibd/izy143

Crohn’s & Colitis Foundation.Depression and anxiety.

Crohn’s & Colitis Foundation.Coping strategies to improve mental health.

Parish AL, Gillis B, Anthamatten A.Pharmacotherapy for depression and anxiety in the primary care setting.J Nurse Pract. 2023;19(4):104556. doi:10.1016/j.nurpra.2023.104556

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