The death of Robin Williams has sent shock waves through social media.  If you had to name one actor who fits the word “funny” or “happy”, it would probably be him. But what most people don’t realize is that Robin had struggled with bipolar disorder for a very long time.  Mental illness, like IBD, is an invisible illness for many – what you see on the outside is almost never an indicator of what’s going on inside.  If you’ve struggled with IBD, then you’ve likely also had to struggle with depression.  There is hope.

I’d be lying if I said that Crohn’s disease hasn’t challenged my will to live at one point or another.  When you’re faced with a chronic illness, the disruption to your home, your career, your school and social life can be incredibly hard. And when you add non-stop pain for months or years at a time, it’s inevitable that suicide becomes a “treatment option”. The loneliness, despair and desperation tend to follow you, often kicking you down when you’re at your worst. Depression sets in and suicide is often thought of as a means to end your own suffering.  There are studies which show that depression and IBD often go hand in hand, with major depression being double of that in people with IBD vs the general public (27.2% vs. 12.3%) [SOURCE].  So it’s not a subject that we should take lightly.  It can affect us and often does.

When you have IBD, you tend to also be in the hospital more often than the rest of the population.  I’ve been admitted four times over the past year alone from everything ranging from a post-op infection to surgery. Hospital visits are tough for most of us, and being admitted to one can also increase the risk of depression.

An IBD-related hospitalization itself was associated with a significant risk of depression. Even excluding those who subsequently underwent surgery, the risk of depression 5 years after a CD-related hospitalization was 17% with a corresponding risk of anxiety of 12%. [SOURCE]

Even some of the medication we take can drastically shift our mood or thought patterns (fuck you, Prednisone), so it’s important to let your support system know about these possible side-effects and to keep an eye on you for any of the signs that might call for a follow-up with your doctor. What are those signs? There are a lot, and many of them come naturally with having a chronic digestive illness: lack of appetite, tiredness, sleep problems or anxiety can be experienced even if you don’t have depression.

The Mayo Clinic lists the following signs of depression [SOURCE]:

  • Feelings of sadness, emptiness or unhappiness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in normal activities, such as sex
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so that even small tasks take extra effort
  • Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  • Anxiety, agitation or restlessness — for example, excessive worrying, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

If you notice any new symptoms that are out of the ordinary for your illness, you need to speak up and get help.  Often, things can escalate quickly if they aren’t taken care of right away.

Where to find help

There are so many ways to reach out to get help for depression. Many people have a close friend or family member that they can talk to.  If you don’t, you can always find people who are willing to listen through support groups and online forums.  Many of the IBD related forums that I’m part of have a mental health section where you can talk openly about your concerns and get feedback from others who’ve been in similar circumstances. There are help lines, which can be of use in times of distress, and you can also check into your hospital emergency room.  People will help. 

It’s also important to speak with your GI if you have any concerns. They’ll be able to refer you to a medical professional who specializes in depression and anxiety disorders. For some people with IBD, getting counseling may not only help improve quality of life, but also may alter the course of the disease in a positive way [SOURCE].

For more information about depression, please visit any of the following websites, or find one that helps people in your country.

Depressionhurts.ca (Canada)

Mental Health Helpline (Canada) 1-866-531-2600

Suicide Prevention Lifeline (USA) 1-800-273-8255

Samaritans (UK) 08457 90 90 90

If you have Crohn’s Disease or Ulcerative Colitis, please remember that you are not alone and there is help available when you feel down. Things will get better.

SOURCES:

  1. Similar risk of Depression and Anxiety following surgery or hospitalization for Crohn’s disease and Ulcerative colitis
  2. The Manitoba IBD cohort study: a population-based study of the prevalence of lifetime and 12-month anxiety and mood disorders.
  3. Depression symptoms. Mayo Clinic
  4. Does psychological counseling alter the natural history of inflammatory bowel disease?