Sad? Stressed? How to Deal with the Emotional Toll of UC
If you’ve been diagnosed with ulcerative colitis (UC), you’re probably familiar with its uncomfortable physical symptoms, like cramping, pain, and fatigue. But you might not have anticipated the heavy psychological toll these troubles can take. You may be grappling with heavy emotions, from increased stress to debilitating depression, which can make the physical pain even worse. But you don’t have to accept this big-downer cycle as your new normal. We’ll equip you with coping strategies for the psychological effects of UC so you can gradually feel better, body and mind.
Understanding the UC/Stress Link
So what’s it all about? “Stress isn’t great for any of us, but it can be especially damaging for someone with a chronic digestive disease,” says Megan Riehl, Psy.D., a clinical health psychologist and an assistant professor in the Division of Gastroenterology at the University of Michigan in Ann Arbor. “The brain and gut are constantly communicating, and when stress is high, that can ramp up digestive distress and even negatively impact our immune system.” Stress, particularly the chronic kind, can also increase your risk of depression.
Confide in Your Support Team
Ever hear the saying “You’re only as sick as your secrets?” Keep the lines of communication clear with your medical team—which may include your primary care physician, gastroenterologist, psychologist, and dietitian—and be sure to discuss your flares and symptoms openly. “Your doctors may have a wealth of resources,” says Jacqueline Jossen, M.D., an assistant professor of pediatric gastroenterology at the Icahn School of Medicine at Mount Sinai in New York City. Don’t let embarrassment prevent you from enlisting your pros to help you navigate the daily physical and emotional hurdles.
Manage Your Meds
Part of your discussions with your doctor should be making sure you’re on the best possible medication to manage your condition. “Having an improved physical state will also improve any related stress, anxiety, or depression you might be experiencing,” says Dr. Jossen. It may take a bit of trial-and-error to identify the treatment plan that works for you, but it’s definitely worth it.
Reconsider Your Diet
Our emotional and physical health are intertwined, and eating better can elevate both. Talk with your doc before you start any new diet, of course, but one eating plan that can be helpful for people with inflammatory bowel diseases is the Mediterranean diet. Focused on fruits, veggies, and healthy fats from fish, nuts, and olive oil, it was shown to lessen inflammation in a 2018 review of research from Italy. (Keep in mind, though, the Mediterranean mode of eating might not be great during a flare, as it involves lots of fiber, the study authors note.)
Keep a Log of Your Symptoms
There’s a universe of information out there on UC, but quietly tuning into your own body and mind is just as valuable as reading up on your condition. The easier you make this kind of self-observation, the more likely you’ll be to stick with it. Try keeping a short-and-simple daily log of what you ate, what you did, and how you felt. It can help your doctor pinpoint foods and activities related to your flares and accompanying issues like IBS or lactose intolerance. “Additionally, if you’re having ongoing symptoms, your doctor can help determine if food problems are related to another condition,” says Dr. Jossen.
“Regular, moderate aerobic exercise is helpful for anyone, but especially people dealing with chronic disease,” says Dr. Jossen, who notes that activity could potentially have an anti-inflammatory effect. But the benefits of a workout are far from just physical: Exercise is an ace stress reliever. “Run, bike, hike, walk, or do yoga, barre, whatever gets you excited or makes you feel good,” says Dr. Riehl. “But understand that if you’re flaring, you may need to take a break or scale back a session. Some days, rest may be the best choice for your body.”
Talk It Out
Your physician or gastroenterologist should be able to offer advice for coping with your emotions. But if your stress, anxiety, or depression seems constant or overwhelming, don’t be shy about turning to a mental health pro. You’re not being overly sensitive; people with UC are more likely to suffer from depression, anxiety, and bipolar disorder, according to recent research. “Therapy allows you a safe place to talk about your illness,” says Dr. Riehl. “It’s also a way to learn stress management skills, relaxation interventions, and coping skills to better manage all aspects of life.”
Rally Your People
Even if you’re seeing a therapist weekly, you’ll want a team of friends and family members you can turn to for continual emotional support. “Ulcerative colitis tends to run in families, so sometimes there’s a built-in support group,” notes Dr. Jossen. If no one in your inner circle really understands what you’re going through, look elsewhere—a state or national organization, such as the Crohn’s and Colitis Foundation, or one on a nearby college campus are solid places to turn.
Hop on Social
If you’re having trouble finding either a local group that can help you deal with your condition or the time to connect face to face, social media can be a supportive environment, says Dr. Riehl. Many nationwide organizations have active Twitter handles, which can be a tool to track down resources near you and link up with other patients. Check out the Crohn’s and Colitis Foundation (@CrohnsColitisFn) and Girls With Guts (@IBDGirls).
Remember Your Strength
No matter how often you check in with your doctor and therapist, you can’t sidestep every flare. “People often have fear or anxiety about the next time they’ll get sick,” says Dr. Jossen. But when flares happen, give yourself credit: You’ve been through the valleys of this disease before, and come out on the other side every time. “There is only so much we can plan for, so reminding yourself that you have managed flares in the past and you are capable of managing the unknowns of the future can be helpful,” says Dr. Riehl.
Do Your Thing
Occasionally, ulcerative colitis might prevent you from taking part in certain activities, and “you may need to grieve over things that may be impacted in your life due to having a chronic disease,” says Dr. Riehl. But living with UC doesn’t mean you have to give up hobbies, travel, or mostly anything you love to do. “If your disease is well controlled, you can go on to live your fullest life.”
- Mediterranean Diet and Inflammatory Bowel Diseases: Acta Biomedica. (2018). “The role of diet in the prevention and treatment of inflammatory bowel diseases.” mattioli1885journals.com/index.php/actabiomedica/article/view/7952
- Psychiatric Illness and Ulcerative Colitis: University Hospitals Cleveland Medical Center and Cleveland Clinic Foundation. (2019). “Epidemiology of Major Depressive Disorder, Anxiety Disorder, and Bipolar Disorder in Ulcerative Colitis in the United States Between 2014 and 2019: A Population-Based National Study.” eventscribe.com/2019/acg/fsPopup.asp?Mode=presInfo&PresentationID=591935&sponsor=1