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

Ulcerative Colitis and Mental Health: What to Know
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Updated on July 1, 2025
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Ulcerative colitis (UC) can have a wide range of symptoms and complications, from rectal pain and bleeding to weight loss, frequent diarrhea, skin issues, joint pain, and even liver problems.

While mental health problems commonly overlap with UC, it’s not clear that they develop as a direct result of the disease. Living with UC can certainly lead to mood changes, which can exacerbate symptoms of depression or anxiety in people with these conditions. Depression and anxiety may also make IBD symptoms worse.

How Many People With Ulcerative Colitis Have Mental Health Conditions?

It can be challenging to know exactly how common mental health issues are for people with UC. For one, research often combines information on UC and Crohn’s disease, another type of inflammatory bowel disease (IBD). Additionally, research in a general population of people (not just those with UC or Crohn’s) suggests that anxiety disorders are underdiagnosed.

According to a research review, people with IBD are 3 to 5 times more likely to develop anxiety and 2 to 4 times more likely to develop depression compared to the general population.

Another review of data from 77 studies including more than 30,000 individuals with IBD found 25 percent experienced depression symptoms while 32 percent had symptoms of anxiety.

Older adults with IBD may be more likely to have mental health conditions.

 Teens and young adults may also be particularly susceptible to mental health issues related to IBD. One study of 14- to 25-year-olds with IBD found that feelings of embarrassment about the condition increased the individual’s risk of depression, anxiety, and loneliness.

5 Complications of Ulcerative Colitis

Ulcerative colitis is an autoimmune disease and a form of IBD. Complications from UC affect more than just the digestive track. Here are some things to watch out for.
5 Complications of Ulcerative Colitis

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How Ulcerative Colitis and Mental Health Are Linked

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.

Anxiety and Depression Symptoms: How to Know if You Need Help

The following symptoms can indicate symptoms of an anxiety disorder:

  • Feelings of panic, fear, or dread
  • Feeling on edge
  • Feeling irritable
  • Uncontrollable and obsessive thoughts
  • An increased heart rate
  • Shortness of breath
  • Tense muscles
  • Dry mouth
  • Nausea
  • Concentration difficulties
  • Sleeping difficulties
If you have symptoms of depression, you can talk to a healthcare provider about the potential treatment options. Signs and symptoms of depression include:

  • Sadness, emptiness, hopelessness, or feeling tearful
  • Losing interest in hobbies or activities that used to bring joy
  • Outbursts of anger that may be out of proportion to the trigger
  • Sleep problems, such as insomnia or sleeping for too long
  • Fatigue
  • Weight changes, such as unexpected or unwanted weight gain or loss
  • Feelings of anxiety
  • Slower thought processes or body movements
  • Feelings of guilt and worthlessness
  • Thoughts of or attempts at suicide
If you experience any of these symptoms, it’s important to discuss them with your primary care doctor or gastroenterologist.

How to Get Mental Health Help

Healthcare professionals who already help you manage UC may be able to provide the emotional support you need.

If you’re experiencing severe emotional difficulties or feel like you need to try new ways to cope with the disease, you may benefit from seeing a psychologist or psychiatrist. Your gastroenterologist or primary care doctor can help you find the right therapist based on your symptoms and the type of treatment you’re looking for.

Treatments you might consider include:

  • Psychotherapy (talk therapy): Psychotherapy can help people with UC work through their emotions around life with the condition and reduce harmful thought patterns. For example, cognitive behavioral therapy (CBT) may help people learn behavioral skills that help with stress management, regulating emotions, and coming to terms with living with a chronic illness.

     Look for a therapist who is familiar with UC since it’s helpful to know about the disease’s symptoms, complications, and drug treatments when deciding how to address mental health issues.
  • Relaxation training: Mindfulness practices like meditation and yoga can help people focus on the present and reduce stress. One study of 43 people living with UC found that those who participated in an 8-week mindfulness course involving yoga, meditation, and other mindfulness practices experienced greater reductions in stress levels and depressive symptoms, as well as improved sleep, compared to those who did not take the course.

  • Medication: For some people, anti-anxiety medications may help for a short period of time. Antidepressants can also help treat severe emotional symptoms and chronic pain due to UC. The medications that help depression and anxiety disorder generally won’t interact with those that reduce UC flares.

Online and in-person community support may also help to reduce feelings of isolation that stem from UC symptoms. The Crohn’s & Colitis Foundation offers a directory of different tools and resources. With support and treatment, people with UC can live full, active lives despite the challenges of living with a chronic health problem.

Doctors control UC flares by prescribing medications that calm the immune response and reduce inflammation in the large intestine. This may help to control UC’s impact on daily life and mental health and well-being. Make sure you follow your treatment plan exactly as prescribed, as this is the best way to help manage symptoms. If you’re doing so and not seeing improvements, talk to your doctor who might prescribe a different dosage or medication.

The Takeaway

  • Ulcerative colitis can be challenging to live with, and it has a complex relationship with mental health problems like depression and anxiety.
  • Mental health issues can worsen UC symptoms or trigger flares, and flares can lead to extreme worry, hopelessness, guilt, or shame in some people, making depression or anxiety worse.
  • If you’re finding it hard to cope with mental health issues, speak to the physician managing your UC or look for a mental health professional who specializes in treating IBD-related psychological difficulties.

Common Questions & Answers

What are some common symptoms and complications of ulcerative colitis?
Symptoms of ulcerative colitis can include rectal pain and bleeding, weight loss, joint pain, and liver problems. Mental health issues, such as depression or anxiety, may also be associated with ulcerative colitis.
The exact prevalence of mental health issues in people with ulcerative colitis is difficult to determine. But studies have estimated that anxiety and depression rates in people with IBD may be as high as 32 percent and 25 percent, respectively.
Mental health disorders and ulcerative colitis can have a complex and bidirectional relationship. People with IBD are more likely to develop depression and anxiety than the general population.
Psychological stress can increase the permeability of the intestines and change the activity of cytokines in the immune system, potentially contributing to the onset of ulcerative colitis and mental health issues. Steroid treatment can also have psychological effects, contributing to anxiety.
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
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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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