Tips for Managing Anxiety When You Have Ulcerative Colitis

Sam Cleasby was 23 years old when she was diagnosed with ulcerative colitis (UC), an inflammatory bowel disease (IBD) that causes chronic inflammation and sores in the gut. Medication kept her flare-ups under control for nearly a decade, until 2013, when she needed to have surgery.

“Though I had times when life was tough and I was sad, frustrated, or angry, I didn’t actually struggle with anxiety and my mental health until after surgery,” says Cleasby, who is the founder of the blog SoBadAss and says she also has post-traumatic stress disorder. “It wasn’t the surgeries themselves but the loss of control that was the source of my panic attacks and anxiety,” she says.

Ulcerative Colitis and Anxiety

In addition to coping with the illness, people with UC have to manage doctor’s appointments, medication, and changes to lifestyle and eating habits, says Mira Zein, MD, a psychiatrist with Stanford Medicine in California. Flares can also put a damper on socializing.

“When you lose control of your bowels, one of the most basic bodily functions, the feeling of losing control [over] the rest of your life is huge,” says Cleasby. “I was so scared of having an accident in public that I would avoid going out, and I became very isolated. And, when you hide away in your home, alone, it’s easy to allow fear and anxiety to take over.”

• Difficulty controlling thoughts of worry
• Weakness or tiredness
• Increased heart rate
• Rapid breathing (hyperventilation)
• Difficulty sleeping
• Nervousness, restlessness, or tension
• A sense of impending danger, panic, or doom
• Sweating
• Shaking or trembling
• An upset stomach or other digestive issues
• Avoidance of things that trigger worry

“People think a panic attack is all in your head, but it’s such a powerful physical thing. My hands would cramp until I couldn’t move them, my chest felt like it was being crushed, I couldn’t breathe, my vision would blur. It’s terrifying,” says Cleasby.

Tips for Managing Anxiety With UC

To help you manage anxiety while living with UC, follow these tips.

Talk to a Professional

“I think the most important way to deal with anxiety and depression is to speak out about it,” Cleasby says. “It’s easy to feel so alone and that no one will understand you, but actually, just voicing your fears takes away some of their power.”

Petrik says to ask your doctor if there is a mental health provider on staff or if they can recommend a therapist that specializes in chronic illness or IBD. Psychology Today also maintains a searchable database of verified mental health providers across the United States. And a psychiatrist can help determine whether anxiety medication is a good fit for you.

Identify Stress Triggers and Explore Relaxation Techniques

“Recognizing the initial symptoms and heading them off with deep breathing and meditation works for me. But, it’s about finding what works for you,” says Cleasby. “Speak to your doctor about how you are feeling and to your loved ones. There is no shame in needing support.”

Dr. Zein recommends eliminating everyday stressors that could trigger anxiety with a few simple rules of thumb:

• Set realistic goals for yourself each day, and break big tasks into smaller ones.
• Do some prep work at night, such as packing a lunch or laying out your clothes, to decrease stress the following day.
• Build structure into your days, whether you’re in a flare or in remission. Using a calendar or daily planner to keep track of your activities and appointments can help.

Zein says that relaxation techniques can reduce anxiety after it’s set in. These include breathing exercises, muscle relaxation, and meditation. “Apps like Calm and Headspace can be really useful to guide people through these techniques when they’re feeling more anxious,” she says.

“One technique is to combine slow, deep breathing with muscle tensing and relaxing,” Zein says. “Try balling your fists while inhaling, holding, and then releasing them slowly while exhaling. [Doing this] is enough to relieve anxiety.”

Another technique is to inhale slowly while raising your arms overhead and exhale slowly while lowering them back to your sides.

Cultivate a Support System

To help you learn more about your disease and form a network of people who are living a shared experience, it can help to join an online or a local support group.

“Having good support is an important part of managing physical and mental health in IBD. Asking for and accepting help from family and friends is important,” says Zein.

And whatever your ritual, “It’s really important to develop coping skills that work for you,” says Zein.