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Ulcerative Colitis and Mental Health: What’s the Link?

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On July 3, 2025
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Ulcerative Colitis and Mental Health: What’s the Link?

The relationship between UC and mental health disorders is complex. Research shows that living with any chronic illness can increase a person’s risk of depression and that those with both a chronic illness and depression often have more severe symptoms of both conditions.

When it comes to mental health and UC, the two appear to be more interconnected due to what’s called the gut-brain axis, a bidirectional communication system between the digestive tract and nervous system. In short, what’s going on in your brain can influence digestive systems and vice versa.

Factors that can contribute to depression and anxiety in people with IBD may include social isolation, financial difficulties, and not having effective enough tools to cope with the effects of IBD.

 Social stigma and the effects of IBD on intimacy can also play a role.

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, research has found symptoms of depression and anxiety are associated with a greater risk of flares, more severe symptoms during these flares, and more frequent hospitalizations.

Taking steroids, a common treatment for symptoms of UC, may also increase a person’s risk of mental health issues, including depression, anxiety, and psychosis, as a side effect.

There is no evidence that stress, tension, or anxiety directly causes UC in the first place.

 But studies have shown that psychological stress may increase the intestines’ permeability which may reduce how well the mucosal lining of the intestines can keep out various harmful substances; however, this mechanism is not linked directly to the development of IBD.

A research review also suggests that stress can change the activity of cytokines, proteins in the immune system that may play a role in the onset of UC.

Other studies have linked circulating levels of cytokines — as well as elevated levels of other inflammatory biomarkers — to higher depressive and anxiety symptoms.

A study of online posts from people with UC suggests 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.

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