How Therapy Can Help You Manage the Mental Health Side of IBS-C
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How Talk Therapy Can Help You Manage the Mental Health Side of IBS With Constipation

How Talk Therapy Can Help You Manage the Mental Health Side of IBS With Constipation
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Updated on July 17, 2025
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Abdominal pain. Bloating. Irregular, painful bowel movements. The symptoms of irritable bowel syndrome with constipation (IBS-C) can be overwhelming. So overwhelming, in fact, that many people with the condition struggle with one or more mental health disorders — particularly, depression and generalized anxiety disorder, according to Laurie Keefer, PhD, a professor of medicine and psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.

Help is available, though. Thanks to an increasing awareness and understanding of the toll that all types of IBS can take on emotional and mental well-being, there are several proven psychological therapies to explore.

The Mental Challenges of IBS-C

With IBS-C symptoms, it’s not only the complications that people have to manage, but also the unpredictability of when they might occur.

Living with this chronic, unpredictable condition can make navigating daily life all the more difficult, and for some, it becomes too much to handle. “People often give up their engagement in pleasurable events, which can lead to low mood and feelings of hopelessness,” says Dr. Keefer.

Worrying about symptoms and situations in which they may occur can make it hard to feel fully engaged in life. “I describe IBS as a background app tracking your location: It’s always there and drains your battery,” she says.

What’s more, the primary driver of IBS-C and mental health challenges is the gut-brain connection, says Keefer.

The brain-gut pathways are thought to be a contributing factor to IBS. Because stress and anxiety from worrying about the condition can cause the brain to misinterpret signals of pain coming from the gut, symptoms can actually worsen.

It’s important to remember that it’s a two-way street, though. IBS-C symptoms can negatively affect mental health, but alternately, tending to mental health and well-being can calm that brain-gut connection and help improve the condition.

Mental Health Therapies and Additional Treatments for IBS-C

Brain-Gut Therapy

Self-management training, gut-directed cognitive behavior therapy (CBT), and gut-directed hypnotherapy are all part of brain-gut therapy. According to Keefer, in some trials the majority of participants experienced a reduction in pain and related symptoms.

“There’s evidence that CBT may have an effect on the gut microbiome, which could help reduce IBS-C symptoms even further,” says Supriya Rao, MD, a board-certified physician in gastroenterology and lifestyle medicine and managing partner at Integrated Gastroenterology Consultants in Lowell, Massachusetts.

She points to research that found after 12 weeks of CBT treatment, participants had increased levels of beneficial gut bacteria in their microbiome, compared with those who didn’t receive CBT treatment.

Mind-Body Practices

Meditation, music therapy, and yoga have little science behind them to show they can help ease IBS-C. But, says Keefer, “Anything you can do to reduce the physical impact of stress on the body, increase moment-to-moment awareness of your body, and experience movement” could help.

Stress management in particular can help boost gut health. “Research shows that chronic stress can worsen or even cause digestive conditions,” says Dr. Rao. Mental stress has a direct impact on the digestive system, activating the fight-or-flight response. “This causes hormones to be released, which can trigger a cascade of physiological responses, such as an increase in blood pressure, heart rate, and respiration, all of which are linked to the onset or worsening of IBS-C,” she says.

Antidepressants

Medications that increase the availability of serotonin — a chemical in the body that helps relay messages between the gut and brain — can be highly effective in treating depression brought on by IBS-C.

“Ninety-five percent of your body’s serotonin is in your gut,” Keefer explains.

Why is it important to increase serotonin when talking about gut health? The chemical can help reduce the perception of pain and help regulate gastrointestinal (GI) motility — the muscle contractions and relaxations in the GI tract.

Three classes of antidepressants affect serotonin levels: selective serotonin reuptake inhibitors (escitalopram, sertraline); serotonin and norepinephrine reuptake inhibitors (duloxetine, venlafaxine); and tricyclic antidepressants (desipramine, imipramine). Taking these medications can improve psychological and emotional symptoms of IBS.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Staudacher HM et al. Irritable Bowel Syndrome and Mental Health Comorbidity — Approach to Multidisciplinary Management. Nature Reviews Gastroenterology & Hepatology. September 2023.
  2. Mayer EA et al. The Neurobiology of Irritable Bowel Syndrome. Molecular Psychiatry. April 2023.
  3. Jacobs JP et al. Cognitive Behavioral Therapy for Irritable Bowel Syndrome Induces Bidirectional Alterations in the Brain-Gut-Microbiome Axis Associated With Gastrointestinal Symptom Improvement. Microbiome. November 30, 2021.
  4. Update on IBS Treatments: Examining the Efficacy of Antidepressants, Psychological Therapies, Prebiotics, Probiotics, Synbiotics and Antibiotics. Mayo Clinic. June 11, 2019.
  5. Riehl M. Antidepressants for the Treatment of Functional Gastrointestinal Disorders [PDF]. University of Michigan Medicine.
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Last modified on June 27, 2025 at 7:37 PM by Andy Orin First published on June 27, 2025 at 7:37 PM by Andy Orin Thomas Rutledge

Thomas Rutledge, PhD

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Dr. Thomas Rutledge is a staff psychologist at the VA San Diego Healthcare System. He provides clinical services to help patients manage chronic health conditions such as chronic pain, diabetes, and obesity.

Dr. Rutledge is also a professor and research scientist with the UC San Diego Department of Psychiatry, where he's studying treatments to improve mental and physical health conditions.

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