The relationship between ulcerative colitis and mental health disorders is complex. The National Institute of Mental Health suggests that any chronic illness can increase a person’s risk of depression and that those with both chronic illness and depression often have more severe symptoms of both conditions.
People who have anxiety and depression alongside UC may view and manage their symptoms differently from those who do not have mental illness.
Factors that lead to depression and anxiety in people with IBD may include:
- Financial difficulties
- Social isolation
- Not having effective enough tools to cope with the effects of IBD
- Social stigma
- The effects of IBD on intimate relationships
Other people may be worried about specific aspects of the condition, such as the embarrassment of regular toilet breaks in social situations or concerns about certain foods triggering symptoms.
The pain, fatigue, and discomfort of UC symptoms might also be linked to the development of mental health conditions.
Importantly, depression might also affect the severity of IBD symptoms during flares and how often a person with IBD needs evaluation in the hospital.
Taking steroids to treat symptoms of ulcerative colitis can also increase a person’s risk of mental illness as a side effect, including depression, anxiety, and psychosis.
No strong evidence shows that stress, tension, or anxiety actually causes ulcerative colitis in the first place.
But studies have shown that psychological stress may increase the intestines’ permeability.
This might reduce how well the mucosal lining of the intestines can keep out various harmful substances, researchers have suggested.
A review published in 2023 also suggests that stress can change the activity of cytokines.
These are molecules in the immune system that may play a role in the onset of ulcerative colitis and its associated inflammation.
Inflammatory cytokines may also play a role in the onset of depression and anxiety, contributing to anxiety when their levels go up due to intestinal inflammation, according to a review published in 2024.
A study of online posts from people with UC also suggested that those living with the condition see stress and anxiety as common flare triggers.
Because UC both caused stress or anxiety and resulted from it, the online users found it challenging to identify whether mental health symptoms caused or resulted from UC symptoms.