IBS and Mental Health: How Gut Health Can Affect Overall Well-Being

Physical well-being depends on all your bodily systems working in harmony. Your gut is a central player in well-being,¹ and is constantly communicating with the brain.²

Irritable bowel syndrome (IBS) is caused by a long-term miscommunication between the gut and the brain.³ It affects as many as 20% of people,⁴ and is more common in women than men.⁵ People with IBS regularly experience stomach pain, bloating, and discomfort.⁴ For this reason, unsurprisingly, it can restrict working and socializing.⁶ 

As if these symptoms weren’t bad enough, people with IBS also tend to have higher rates of some mental health conditions.⁷ As many as one in three people with the condition also deal with anxiety or depression.³

This blog will explore why IBS might lead to mental health problems, the vicious cycle of IBS and anxiety, and current care approaches.

The Gut-Brain Axis: The Phone Line Between the Gut And the Brain

The communication line between the gut and the brain is known as the “gut-brain axis”. It influences physical and mental health. The axis is like a phone line directly between your gut and brain, as the gut communicates with the brain via the vagus nerve,^1,2 which runs from the brain stem to the abdomen.⁸ It uses hormones and neurotransmitters to send messages to the brain. 

As well as containing more than 500 million neurons, the gut also houses trillions of microorganisms (including bacteria, viruses, and fungi). But don’t panic; these microorganisms are essential for our health – they help digest food, produce vitamins, boost the immune system, and produce neurotransmitters (including serotonin).² Neurotransmitters are essential not only to maintain the communication between the gut and brain, but also for normal brain functioning.

What Is IBS?

IBS is split into four main types, each with a different cause. These are:⁵

• Constipation-predominant (IBS-C): Affecting about 35% of people with IBS. It’s caused by slow motility, pelvic floor problems, gut-brain axis miscommunication, and/or low serotonin levels in the gut.
• Diarrhea-predominant (IBS-D): Affecting about 40% of people with IBS. It’s caused by fast motility, excess bile acid, hypersensitive nerves in the gut, and changes in the microbiome because of food poisoning.
• Mixed type (IBS-M): Affecting about 23% of people with IBS. It’s caused by irregular gut motility, several different triggers, and an imbalance of the gut microbiome.
• Unclassified type (IBS-U): Affecting about 2% of people with IBS. The symptoms of this type don’t quite fit into the other IBS types.

If you can pinpoint your type, don’t get too comfortable – your IBS type can change! Age, hormones, diet, and that old favorite, stress, all contribute to IBS and can change the type you have. And probably just when you think you’ve figured out how to manage the condition. 

A diagnosis should be made by a healthcare professional, who will usually refer to the ROME criteria.⁹ You can find some self-assessment quizzes online to see if you might have IBS. However, they should be used to help document symptoms to prepare for a discussion with a professional to get a proper diagnosis.

What Does IBS Have to Do With Anxiety?

People with IBS are more likely to deal with anxiety or depression than someone without IBS.⁷ But, usually, in the case of IBS and mental health, IBS comes before anxiety or depression.¹⁰ Let’s explore some possible reasons why.

Chronic Stress

Stress affects your digestive system, for instance, by increasing bowel spasms, changing motility (slowing or stopping digestion), increasing gut sensation, and changing your gut microbiome.¹¹ If you are under stress for a long time, your body might struggle to return to its previous state.¹¹ Plus, people with IBS generally report worse symptoms when they’re stressed.

But IBS is, in itself, stressful. It’s not just big events that become a stressor. It’s the every day. Imagine worrying about the very real possibility of having an IBS flare-up on a long journey. Holidays, which should be a relaxing time, might then become a stressor. Leaving the house could ultimately become stressful. Living with that kind of regular stress inevitably worsens IBS symptoms, making a flare-up more likely. In fact, panic attacks and IBS are not uncommon for this reason. 

You can see how easy it is for IBS and stress to become partners in crime, intent on ruining your life. The blog, “Nausea from Stress and Anxiety” on our website, gives extra insight into the link between stress and IBS.

Changes to the Gut

A change in the microbiome (which could be the result of stress or food poisoning, for instance) can cause the gut to send inflammatory signals up the vagus nerve to the brain. This can lead to feelings of anxiety.⁸ The gut produces about 90% of the body’s serotonin (which helps regulate mood, appetite, and sleep). So changes to the microbiome can reduce the amount of serotonin produced, leading to changes in neurochemistry that can affect brain chemistry and mood.⁸

Genetics

If someone in your family has IBS, you’re two to three times more likely to develop it than if you didn’t have a relative with the condition.¹⁰ A 2021 analysis of more than 250,000 people with IBS showed that IBS, depression, and anxiety share some common genetic similarities. This means they probably have a similar route cause, rather than directly causing one another.

What About Depression and IBS?

The worry caused by IBS might lead people to avoid social situations and lose interest in things they used to enjoy. This might ultimately lead to depression.¹²

Depression can cause the brain to send signals to the gut that can make IBS symptoms worse.³ As described above, changes to the gut microbiome can affect some neurotransmitters produced in the gut, such as serotonin, which plays a key role in regulating mood. So, for people with IBS and depression, reducing depressive symptoms can help their IBS.¹² 

As a result of issues like anxiety and depression, many wonder how to break the IBS anxiety cycle. We explore some options that can provide relief next.

Treatment Approaches for People With IBS and Mental Health Problems

A question many people ask is, “Can therapy help IBS symptoms?” The answer to this is a resounding “yes.”

In general, common medicinal treatments for IBS don’t work very well (for instance, diet changes and medication),¹⁰ probably because the cause of IBS is largely unknown. Behavioral therapies, especially ones that try to relax the digestive system,³ tend to be more effective.¹⁰ 

Additionally, techniques to manage stress (meditation or breathing exercises, for instance) can help some people to feel better.¹² Regular (but not too intensive) exercise can also be helpful,¹³ as can general good self-care (an appropriate IBS diet depending on your type, good sleep hygiene, and taking time for yourself every day).¹²

Below, we take a closer look at some of the psychological treatment for IBS options that could help ease symptoms.

Cognitive Behavioral Therapy

In CBT, a professional helps you recognize thoughts that are negative or distorted, and instead choose more positive or realistic thoughts.^3,12 Interestingly, this kind of therapy has been shown to ease IBS symptoms, and then, when people start feeling better, they have fewer anxiety and depression symptoms.¹²

Relaxation Therapy

Visualization and muscle relaxation are used along with CBT to temper your body’s reaction to stress and make you more comfortable.^3,13 For this reason, it is useful for managing anxiety with IBS.

Mindfulness

Mindfulness approaches encourage people to be in the present moment rather than thinking about previous experiences or what might happen in the future.¹¹ It teaches people to perceive physical feelings without moving into panic.⁸ For instance, deep breathing exercises can lower cortisol (a stress hormone) levels and encourage the body into a more restful state.¹³

Gut-Directed Hypnotherapy

This aims to calm your gut by using deep relaxation and managing habits that might not be helpful.^3,11

Mission Connection: Professional Support for Depression, Anxiety and IBS

IBS is a complex disorder that causes a great deal of gastrointestinal discomfort. People with the condition are more likely to deal with anxiety and depression – but maybe not entirely as a result of the condition. It is this complex interplay of symptoms, often feeding into and worsening one another, that can make life difficult to navigate.

Medical treatments for IBS are not known to be that effective for most people. Instead, treatment tends to have a more behavioral focus. These treatments, including relaxation and cognitive behavioral techniques, can help people with IBS to focus on being present in the moment rather than fixating on their next flare.

If IBS and mental health are issues for you, Mission Connection is here to help. We offer a variety of evidence-based therapies that can support the mind and body, allowing you to turn the page on gastrointestinal pain. 

If you’re ready to explore our treatment options, reach out to our team today. Relief often starts with a simple phonecall. 

References

1. Van Oord, G. (2024, August 28). The gut-brain axis explained in plain English. Dietvsdisease.org. https://www.dietvsdisease.org/gut-brain-axis/
2. Tuhin, M. (n.d.). The link between gut health and mental health. Science News Today. https://www.sciencenewstoday.org/the-link-between-gut-health-and-mental-health
3. IrritableBowelSyndrome.net. (n.d.). The connection between IBS and mental health. https://irritablebowelsyndrome.net/other-health-conditions/mental-health
4. Zhang, Q.-E., Wang, F., Qin, G., et al. (2018). Depressive symptoms in patients with irritable bowel syndrome: A meta-analysis of comparative studies. International Journal of Biological Sciences, 14(11), 1504–1512.
5. IBS Therapeutics. (n.d.). Types of IBS: Understanding IBS-C, IBS-D, IBS-M, and IBS-U. Complete guide. https://ibstherapeutics.com/symptoms-and-subtypes/types-of-ibs-complete-guide/
6. NHS Inform. (n.d.). IBS and your mental health. https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs/ibs-and-your-mental-health
7. Lee, C., Doo, E., Choi, J. M., et al. (2017). The increased level of depression and anxiety in irritable bowel syndrome patients compared with healthy controls: Systematic review and meta-analysis. Journal of Neurogastroenterology and Motility, 23(3), 349–362.
8. Biology Insights. (2025, November). Can stomach problems cause panic attacks? https://biologyinsights.com/can-stomach-problems-cause-panic-attacks/
9. The Rome Foundation. (n.d.). Rome IV criteria. https://theromefoundation.org/rome-iv/rome-iv-criteria/
10. Eijsbouts, C., Zheng, T., Kennedy, N. A., et al. (2021). Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders. Nature Genetics, 53, 1543–1552.
11. Healthline. (2026, January). Can stress and anxiety worsen IBS symptoms? https://www.healthline.com/health/irritable-bowel-syndrome/stress-and-anxiety
12. WebMD. (2024, December). IBS and depression: What’s the link? https://www.webmd.com/ibs/irritable-bowel-syndrome-ibs-depression
13. Biology Insights. (2025, July). Stress-induced IBS: Why it happens and how to manage it. https://biologyinsights.com/stress-induced-ibs-why-it-happens-and-how-to-manage-it/