Feeling sad

IBD is a psychosocially challenging disease.  In general, individuals with IBD are at a greater risk for behavioral and emotional difficulties including episodes of anxiety, depression, and low self-esteem.  The uncertainty of living with IBD, especially during a flare, has led some adolescents to describe their life as a roller coaster ride of emotions, from frustrations to waiting and hoping for a good response to a new treatment.[2]


Adolescents and young adults with IBD have high rates of depression and a higher risk of developing depression compared to patients with other chronic diseases (i.e., cystic fibrosis, diabetes, cancer).  While depressive symptoms can vary widely from one individual to another, distinct clusters of symptoms have been identified including (1) diverse milder depressive symptoms with little to no symptoms of inflammation; (2) high levels of depressive symptoms in the presence of inflammation; and (3) high levels of cognitive despair, including suicidal thoughts, with relatively low levels of inflammation.  In individuals with IBD, abdominal pain and sleep disturbances commonly co-occur with depressive symptoms.[1]


Other potentially under-recognized contributors to depressive symptoms are the side effects of treatment. For example, corticosteroids have been linked to irritability, inattention, and reduced sleep time.1


Therefore, individuals with IBD need to be open when communicating with their gastroenterologist about how they are feeling and not just discussing their IBD symptoms.  Your gastroenterologist is your first-line when it comes to identifying and treating depressive symptoms and/or anxiety.  Your gastroenterologist and their support staff can provide you with empathy, education, and appropriate treatment for your symptoms of depression and/or anxiety, if needed.[1]


Reach out, you are not alone. It is fine to ask for some help. Just so you know: 1) At least 40% of patients with IBD will exhibit abnormal anxiety levels. 2) Anything you share with a doctor is confidential. Reach out and talk to someone, doesn’t matter if it is your best friend, your parent, your doctor or a professional counselor.



[1] Keethy D, et al. Pediatric IBD and depression treatment implications. Curr Opin Pediatr 2014;26:561-567.


[2] Lynch, T., & Spence, D. A qualitative study of youth living with Crohn’s Disease. Gastroenterology Nursing 2007; 31: 203-231