Today I want to talk about another area of IBD and that is mental health support. I’ve been vocal about why I feel so many people with IBD should be given counselling, something I’ve had myself. Many of us with IBD find we might need medication-such as antidepressants-to help with this side of things too. Today I wanted to talk about my experiences of taking antidepressants and crohn’s disease-as well as sharing some comments I got from you all too!
Why might someone with Crohn’s disease need antidepressants?
We already know that having Crohn’s Disease and Ulcerative Colitis means you’re more likely to struggle with your mental health-you’re twice as likely to have anxiety, which is something I deal with myself. There are lots of reasons for this-whether it’s due to medication (such as steroids) or the worry of living with a chronic condition, having IBD can be really anxiety-inducing. Depression is another common part of living with IBD; this may be due to the role of serotonin (which is made in our gut): those with Crohn’s were found to potentially have reduced effectiveness of the serotonin reuptake transporter which could impact our serotonin levels- which is otherwise called the happy hormone!
Around 30% of patients with IBD take antidepressants so do know that you’re not alone with this! You would happily take medication to help your Crohn’s so why not your mental health too? Research has found that anxiety and depression were improved in patients with IBD who took antidepressants.
Some doctors also diagnose antidepressants to help with specific gut issues-like pain or loss of appetite-although this tends to be more in the case of IBS.
My experience of antidepressants and IBD
So now I wanted to share my experience of taking antidepressants and IBD. After having my son Jude in 2019, I was referred for CBT as my anxiety massively increased postpartum. I found CBT really helpful (find out about my journey here) but I was frustrated: I felt as if I was constantly having to manage and rethink anxious thoughts and asked my therapist if there was something that could make it easier for m
Although I had struggled with my mental health for many years, this was the first time I had considered taking antidepressants but with a newborn to look after, I felt it was time to try to get better. The first one I tried was Sertraline, which is commonly given to those with postnatal mental health issues. Unfortunately, this made me have really bad fatigue and diarrhea.
The fatigue (not great when you also live with a newborn and a chronic illness) faded after a few weeks but I could not shift the constant diarrhea-it was so bad it stopped me going out in public. I was then put on a different drug, citalopram, but had similar issues; it was really having a big effect on me and two months later, I felt no better and my gut was worse.
My experience with Mirtazapine and IBD
After my negative experience with antidepressants and IBD, I felt like just giving up altogether. However, my doctor suggested I try one last drug which was Mirtazapine. Mirtazapine works differently than the two I mentioned and is more likely to cause constipation rather than diarrhea. This drug really worked for me-there was much less fatigue and no diarrhea. I did however gain quite a bit of weight on Mirtazapine but this is also something steroids didn’t help with either.
Two years on and I’m happy I tried Mirtazapine and IBD. I still worry but find I am able to park my worries and they don’t feel like they overpower me-I am able to book a doctor’s appointment for a week later rather than an emergency or chat with someone before going into catastrophe mode. I don’t think I’m ever going to be worry-free but the feeling of panic and overwhelm seems to be less and less. I am now thinking of potentially coming off the drug at some point but am happy enough with it for now.
What other IBD patients say about trying antidepressants and IBD.
I asked other IBD patients what they had to say about how trying antidepressants affected their IBD and received a lot of insightful and varied responses.
Ellie, who has ulcerative colitis (UC), said that Valdoxan did not cause her any issues, but she had to stop taking this antidepressant due to liver side effects.
Shoshanna also tried Sertraline, like I did, and she said: ‘I started taking Sertraline, my diarrhoea got WAY worse, took ages to make the connection’. Sarah’s experience was similar to mine with Sertraline but noted that she has seemed okay over the last few years. Stacey, who takes Sertraline for her anxiety, notes that it seems to work for her, although she has tried to come off them but struggled every time.
Faye takes Venlafaxine, which ‘definitely helps with the health anxiety that comes with IBD’ but that ‘the night sweats are awful, and [she] gets them from [her] Crohn’s too.’
Laurie uses Paxil, but doesn’t think there has been any IBD side effects.
I’d love to know your experiences: have you ever tried antidepressants for your IBD?
