Dr. Erin Hendriks

What are the possible mental health risks of IBS?

With IBS, it’s not uncommon for mental health challenges such as anxiety or depression to occur, as Salvo Health Clinical Advisory Board member Dr. Emeran Mayer has extensively researched.


November 23, 2022

Written by:

Medically Reviewed by:

Dr. Erin Hendriks

Board-Certified Physician


November 20, 2023

Mental Health
Mental Health

We tend to think of irritable bowel syndrome (IBS) as something that delivers a hit straight to the gut, but have you noticed it affecting your mood as well? Your mind and GI tract are intricately linked. With IBS, it’s not uncommon for mental health challenges such as anxiety or depression to occur, as Salvo Health Clinical Advisory Board member Dr. Emeran Mayer has extensively researched. Here’s why:

You have two brains in your body

Researchers are increasingly seeing the body as having two brains, so to speak. Or at least two clusters of nerves and tissue that both affect and process emotions, send signals about various stimuli, and impact cognition. One of those clusters is, of course, the brain in your skull. The other is what’s called the enteric nervous system (ENS), a matrix of neurons woven throughout your gastrointestinal tract. The ENS:

  • Contains at least as many neurons as your spinal cord does
  • Is partially on “auto-pilot,” following directions from the brain, and partially autonomous, with a mind of its own, so to speak
  • Can respond to a huge range of stimuli 

In short, the ENS is a complicated network involved in directing the muscles of your digestive system while also feeding information back and forth between your brain and your bowels. That neuronal conversation can impact or even change your mood and your mental health, due to the tiny organisms called microbiota that colonize your gut and send signals to both your brain and ENS as well. This is often called the gut-brain axis, or, as Dr. Mayer prefers, the mind-gut connection

A 2019 review of IBS described how:

  • Microbiota influence serotonin production and signaling, which is important for both mood and IBS regulation
  • Chemical imbalances in the brain appear to cause some forms of mental illness, while others may be influenced by gut microbiota
  • Your microbiome and what you eat can dramatically impact your mental health

Why you might be having both IBS and mental health problems 

We need to talk about the elephant in the room. The big, popping-up-everywhere elephant that’s probably stepped on nearly every aspect of your life by now. Yes, we mean the COVID-19 pandemic. The pandemic matters because, during the time you were isolated, you may have lost some microbial diversity, and consequently might feel worse. 

Antibiotic use, handwashing, and differences in eating patterns could affect your microbiota and your mood, too. One study involving 46 people administered a mood questionnaire and took blood and stool samples during the pandemic. The researchers found that bacterial colonies shifted as subjects’ anxiety and depression changed, implying a connection. Another recent study determined that it’s possible for healthy mice to become depressed when they get a microbiota transplant from depressed mice (which could apply to humans, too).

Then there’s stress. Chronic stress and burnout can chip away at your immune system and kill off beneficial gut microbes, leaving you more vulnerable to mental illness and to IBS. It can also heighten your intestinal sensitivity, meaning your gut may be more volatile and may hurt more. Stress can also accelerate your heart rate and push your body into a near-constant state of emergency. If that happens, your brain and body funnel blood away from your stomach and intestines. Blood full of “danger” chemicals surges through your muscles so you can run or fight if you need to. Your cortisol spikes, inflammation sets in, and so do more signs of IBS and mental illness. 

Additionally, IBS-specific stress like worrying about diarrhea, constipation, bloating, pain, or certain foods, can make you feel more depressed and want to stay home more, increasing isolation and gut microbiome changes. Plus, having IBS is linked to higher risks of developing anxiety, depression, and bipolar disorder, often within a year, according to a study that followed 4,500 people with IBS for six years.

Finally, research indicates that at least six genetic loci underlie both mental illness and IBS. That dual vulnerability could explain why up to 94% of people with IBS who seek treatment also report mental illnesses. Past periods of abuse or trauma can also make people more likely to experience both IBS and mental illness.

Three ways to offset both IBS and mental health challenges 

This has been sounding a bit grim so far, no? It could help to take a deep breath. (Do you know about 4x4 or “box” breathing, by the way?) 

To cope, first assess your strengths. We all face unique challenges and all have unique strategies for dealing with those challenges. Maybe you’re extremely persistent, which helps you find the health answers that work for you? Or maybe your diligence ensures you manage your IBS better than most? Whatever your resiliency superpower is, acknowledge and celebrate it. How could you use that to deal with combined IBS and mental health challenges? 

Next, come up with a custom plan that has a good chance of working for both your mind and your ENS. These approaches could help: 

Feed your gut to alter your mood

What you feed your stomach feeds your mind, too. Your goal should be a balanced gut microbiome, meaning a digestive system that contains at least 85% helpful bacteria and no more than 15% harmful ones. Too many harmful bacteria colonies establish what’s called dysbiosis, which can contribute to IBS, inflammation, mental illness, obesity, and more. 

  1. If your IBS symptoms are giving you a lot of trouble, you may benefit from completing the low FODMAP process. During the FODMAP process, you can discover what foods are best for you and design a personal long-term eating plan
  2. Probiotic supplements contain beneficial bacteria colonies that help balance your digestion and reduce IBS symptoms. Fermented foods like sauerkraut or kimchi or specially formulated supplements could give your gut health a hand.
  3. A particular type of probiotic, psychobiotics are live microorganisms that benefit your brain, including your mental wellbeing. Specifically, psychobiotics reduce stress response hormones, spur your gut to crank out more serotonin and dopamine, help lift depression, and communicate with the vagus nerve so you feel calmer. 

Make your mental health a priority

Your mental health matters, and can help soothe your gastrointestinal system

  1. Train your mind to deal with stress through mindfulness practices like meditation, visual imagery, or prayer. 
  2. Seek professional support in the form of therapy. Cognitive behavioral therapy (CBT) for IBS, for example, teaches positive behavioral change and how to reframe unhelpful thoughts. 
  3. For some, certain medications may help improve mental health conditions. 

Consider a whole body approach

If you take care of your entire mind and body, you’re more likely to feel better, sooner. That’s the approach Salvo Health advocates. It involves building a strong foundation for well-being, including: 

  • Getting regular, IBS-friendly exercise 
  • Aiming for seven to eight hours of restful sleep a night 
  • Spending time with positive friends 
  • Taking everything that’s going on for you into account
  • Getting support from a whole team, including a doctor and a health coach

That’s how to nurture a healthy gut-brain connection, in a nutshell.  

Get more support from Salvo Health, no matter the season

At Salvo Health, our digital healthcare platform and virtual clinic provides you with continuous text-based support and care for your chronic condition. Imagine being able to text a board-certified Physician or Behavioral Health Coach to avoid flare-ups or manage your pain. Alongside messaging-based communication, members receive a customized Care Plan that can take account of how their symptoms can be managed. 

Get immediate access to a coordinated Salvo Health care team, including a certified gastro specialist and board-certified health coach when you join Salvo Health today.  


Share this article

Written by: