Beyond Depression and Anxiety in Inflammatory Bowel Diseases: Forging a Path Toward Emotional Healing

Inflammatory bowel diseases (IBDs) are chronic, often debilitating diseases characterized by inflammation of the digestive tract. IBDs affect up to 1% of the world's population and tend to be diagnosed in the second and third decades of life. In addition to physical burdens, IBDs have significant psychological manifestations stemming from bidirectional inflammatory and coping pathways and thus, are best understood from a biopsychosocial perspective. Though previous IBD literature has predominantly focused on traditional psychological comorbidities, such as anxiety and depression, recent studies have uncovered adjustment disorders, post-traumatic stress, and disordered eating as prevalent manifestations of the disease. This review will summarize the rates and postulated biopsychosocial mechanisms underlying these conditions to frame how cultivating resilience can protect against IBD symptoms and help forge a path toward emotional healing. We will also provide guidance to aid clinicians in screening for these conditions and creating a trauma-informed healthcare environment.