Inflammatory bowel disease (IBD) can affect many parts of your child's life including school, friendships and activity. The physical symptoms associated with Crohn's disease and ulcerative colitis are just one aspect. Your child may also experience mental health effects such as stress, depression and anxiety.
"There is a well-established link between chronic illness and higher rates of psychiatric illness," explains Brittany Gresl, Ph.D., a GI psychologist with Children's Health℠ and Assistant Professor at UT Southwestern. In fact, research shows that patients diagnosed with childhood-onset IBD are approximately two times more likely to experience a psychiatric illness than their healthy peers. "This is why it is critical to teach children positive ways to cope and to screen for mental health issues in patients over the long-term."
How can IBD affect mental health?
While a diagnosis of any chronic disease can be emotionally difficult to accept, children with IBD may experience unique challenges related to their disease, for instance:
- Physical functioning and quality of life – Children with IBD may need to go to the bathroom frequently, have blood in their stool, or experience chronic abdominal or joint pain. These can affect their physical functioning and quality of life, especially during flare ups.
- Emotional challenges – Children may feel there is something wrong with themselves or have feelings of sadness about the loss of normalcy. They may believe that they're seen as the sick kid at school or not feel open about talking about IBD because of the nature of the disease.
- Behavioral changes – Sleep disturbances are common in kids with IBD. This, along with changes in appetite and decreases in activity levels, all affects quality of life.
There is also a connection between the brain and the gut, meaning GI health may be uniquely tied to mental health. The "brain in your gut," what scientists call the enteric nervous system, communicates back and forth between the gut and the brain and sends signals that can influence mood.
Lastly, it's important to recognize family factors when caring for a child with a chronic disease. "Family support is critical in caring for IBD," says Dr. Gresl. "For some parents, it can be a challenge to balance the needs of one child with a chronic condition with the needs of healthy siblings."
How to help your child positively cope with IBD
Children diagnosed with IBD may cope with physical symptoms on a daily basis, but their mental and emotional well-being is equally important. Just as there are effective physical treatments available, there are ways to address these mental health effects of IBD.
"I encourage parents to help their child find positive ways to cope and to set goals for healthy habits," says Dr. Gresl. "These are the foundation, and a good foundation stands strong even in times of stress."
Healthy goals for children with IBD include:
- Have positive involvement in activities
- Participate in social groups
- Maintain consistent school attendance as able
- Engage in normal eating habits
- Ensure good sleep hygiene
- Have a predictable daily schedule
Dr. Gresl also recommends talking to your child’s doctor if any emotional or behavioral concerns arise. They can refer your child to a mental health provider to help manage anxiety and stress, increase energy levels and improve self-confidence. You may discuss some of the following options:
- Relaxation techniques – Ideally, kids should take 10 to 20 minutes a day to engage in belly breathing – also called diaphragmatic breathing. Mobile apps can help guide the visual practice of deep breathing. Mindfulness and meditation can also improve coping skills, quality of life and help ease symptoms.
- Visualization and guided imagery – Children can use their minds to focus their attention away from worrisome thoughts by imagining a calm and peaceful place.
- Gut-directed hypnotherapy – With the help of a provider, patients can enter a state in which they can more easily focus on verbal suggestions to help reduce pain and stress.
- Biofeedback – Can be used to teach kids to identify and regulate their physiological responses such as breathing, heart rate, temperature and muscle tension. This can help them better manage stress.
- Cognitive behavioral therapy (CBT) – A gold standard therapy for depression and anxiety that uses specific techniques such as calming self-talk and thought-stopping to help manage symptoms and change thinking patterns. It can help with their perception, reduce pain, improve functioning and can help increase their resilience.
- Positive family communication – For parents, it's important to seek social support and connect with other parents in similar situations. Parents can also continually recognize and validate a child's feelings, no matter where they're at in the disease process.
- Find a peer support group for your child – Support groups and condition-specific camps can help your child feel less isolated and give them a chance to connect with other kids who experience similar feelings. Search for a support group near you.
If your child is having difficulty coping with symptoms associated with IBD, talk to your child's doctor about ways to intervene. When given the tools they need to help cope with a chronic diagnosis, children can feel more in control to manage their physical and emotional symptoms.
"Children are incredibly resilient, and there are great treatment options available that give hope to both kids and parents," says Dr. Gresl.
Ranked among the 10 best in the nation by U.S. News & World Report, the Gastroenterology Division at Children's Health is home to the Southwestern Pediatric Inflammatory Bowel Disease (IBD) Program, a leading multidisciplinary program of excellence in the care of children with IBD. Learn more about our IBD program and services.
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