Which Came First - IBS or Anxiety and Depression?

Your irritable bowel syndrome (IBS) has been a mystery since you first experienced symptoms. Beyond the discomfort of the symptoms, dealing with the condition is frustrating. Much of the frustration comes from a lack of certainty surrounding the condition.

What causes IBS? No one knows. What cures IBS? There is no cure.

There is much uncertainty, but we do know the majority of people receiving treatment for IBS also have a mental health condition like depression or anxiety. Depression is a condition marked by:

  • Low mood or irritability
  • Low energy and motivation
  • Poor appetite and sleep
  • Lower concentration and attention
  • Excessive guilt and thoughts of death

Anxiety refers to a large group of anxiety disorders with symptoms like:

  • Excessive worry
  • Problems with eating and sleeping
  • Feeling tense or rigid
  • Feeling fatigued

At this point, no one can say for sure that these mental health conditions cause IBS or that IBS causes these mental health conditions. Currently, people can only say they are associated with each other.

Think about your own situation. Which symptoms presented first for you?

Did IBS emerge before your feelings of worry and nervousness? Was your depression well established before your first indications of IBS? Do you have all three conditions or only a combination of two?

Because there are three variables to consider, there are many combinations of the conditions and how they progress. Working to understand your unique status can help gain valuable information to better treat your condition.

Treating the Medical

Since IBS has a direct impact on your physical health, it makes sense for you to explore medical interventions to improve your symptoms. Taking supplements to manage constipation and diarrhea can be helpful, just as taking using medications to control spasms in the colon will reduce other discomfort.

Some of the biggest improvements can be had when working to adjust your diet. To begin:

  • Eat foods lower in fat and slightly higher in carbohydrates.
  • Slowly add more fiber to your diet — eating too much could create more discomfort, so search for the best balance.
  • Set a list of IBS food triggers to avoid.
  • Focus on eating small meals more regularly rather than fewer, larger meals that are highly related to cramping and diarrhea.

Treating the Mental

With luck, taking a few of these practical steps will make a significantly positive impact on your IBS.

For many people, the physical health changes are not enough. If you are one of these people, you will benefit from finding ways to address the condition through mental health treatment.

One highly recommended style of therapy is called cognitive behavioral therapy (CBT). CBT is well known, widely used treatment that can improve symptoms related to many mental health diagnoses as well as physical health symptoms.

In fact, CBT is so helpful that professional gastroenterological associations endorse the treatment as an initial method to reduce the symptoms of IBS.

To get the maximum benefit from CBT, you should seek out professional treatment from an experienced, licensed psychologist, counselor, social worker, or another mental health clinician. The therapist trained in CBT will come from an approach that places an emphasis on the interconnected nature of thoughts, feelings, and behaviors.

CBT is based on the principle that unwanted feelings stem from irrational thoughts and unhelpful behaviors. To improve your state, your therapist will guide you through ways to change these damaging aspects.

CBT Techniques Your Therapist May Use

Changing Self-Talk

In CBT, the way you speak to yourself has a drastic impact on how you feel and how your symptoms present. If you make negative statements about yourself, you are bound to feel worse.

By observing and improving the things you say to yourself about your life and your condition, you might find symptoms begin to improve.

One specific way to improve your self-talk is through ending cognitive distortions. Cognitive distortions are flawed ways of thinking that affect all people, but are especially present in those with depression and anxiety.

A common cognitive distortion is “black or white thinking,” which means you see your life or events in your life as either all good or all bad. Without shades of gray, you will feel let down and disappointed. Your therapist will help you see your situations with more objectivity to lessen your symptoms.

Behavioral Activation/Activity Tracking

How do you spend your day? What type of schedule do you have? Does your schedule contribute or reduce your stress?

By going to therapy, your clinician can work with you to assess and discuss your routines to identify problematic patterns. Sometimes people actually make situations worse in an attempt to make their symptoms better. Your therapist can provide interventions and offer strategies to help you change your behaviors to change your symptoms.


Increased stress usually triggers additional IBS symptoms. In a show of the strong connection between the mind and the body, IBS symptoms also trigger increased stress.

One of the best stress reduction tools is relaxation. During CBT, your therapist can teach helpful relaxation techniques to you and guide you towards the most beneficial options for your current status.

IBS and mental health symptoms related to depression and anxiety coexist frequently. If your steps to improve your physical health directly do not show results, you should consider shifting your focus to your mental health.

By addressing your mental health symptoms with CBT, you can improve your physical health along with your mental health to arrive at a point of wellbeing.