Coping Strategies to Improve Mental Health

Managing your mental health and emotional well-being is just as important as treating the physical symptoms of Crohn’s disease and ulcerative colitis.

Struggling with mental health issues can make it more difficult to stay on top of managing your disease, going to work or school, or participating in relationships with your family and friends. The stress of feeling bad emotionally can also take a toll on your physical health.

We want to help you feel better. There are several coping strategies that can help you feel more in control and optimistic about your ability to manage your IBD.

Tackling IBD One Day at a Time

It can be hard to even get out of bed when you are feeling down about living with a chronic illness. Facing the day may feel exhausting and overwhelming.

  • Plan something special to look forward to, even if it’s something small like watching your favorite TV show, eating your favorite breakfast, calling a friend, or taking a long walk on your lunch break.

  • Prepare the night before for the day ahead to eliminate as much stress as you can in the morning. This can include laying out your clothes or packing your lunch for the next day.

  • Take the time to put on your favorite outfit, shave, or put on makeup. Making the effort to look your best will help you feel more positive about yourself and it will encourage others to respond positively to you.

  • Make your plans for the day ahead of time. It is important to build structure into your day, no matter if you are in a flare or in remission. Make sure to allow plenty of time for your medical care.

  • Schedule time to rest. It is easier to get going and keep going if you know you have a built-in break.

  • Allow yourself a little extra time to get going in the morning. Reading or listening to music may make it easier to get your day started.

If you are still having trouble getting out of bed after several weeks, you may need to seek professional help to treat your depression.



Psychology Treatment

There is no one-size-fits-all approach to mental health treatment for inflammatory bowel disease (IBD) patients. Various forms of treatment are helpful to patients with inflammatory bowel disease, and are supported by ongoing scientific research.

When to seek a mental health professional

Video Length 2:57

When to seek a mental health professional When you are newly diagnosed with Crohn's disease or ulcerative colitis, it can be hard to understand how these diseases can change your life. Seeing a clinical psychologist can be a helpful no matter if you are newly diagnosed, or have had the disease for years. Learn more!



when you first get diagnosed it's really


really stressful so you are sick you may


have had surgery there's so many new


things you're establishing care with a


doctor there's so many unknowns and so


that first being diagnosed sometimes


patients get into my door and we have


some time to just process all of the


changes that are going on in their life


and that that's fine that can be a


really adaptive and therapeutic time for


patients but then there's also this


period kind of a year later where you're


out from surgery you're doing pretty


well or you may be doing well and you


kind of have this sit back moment where


you recognize oh wow I have a chronic


disease this is not going away


now what and that's when I really like


to work with patients to discuss


different management strategies from


both Crohn's and Colitis perspective a


stress management perspective different


coping strategies to recognize when mood


may be shifting and so that can also be


a really important time and then both


women talked about sometimes it just not


feeling like the right fit with a


therapist and so I have some tips in


terms of locating a provider and you


really want to find somebody that has


expertise in the management of anxiety


because we know that stress doesn't help


anything and it's a bonus if you can


find somebody that specializes in


gastroenterology or chronic health


issues so you really want to find people


that are a good fit for what you're


looking for and some of the treatment


modalities that they offer should


include cognitive behavioral therapy as


its evidence-based for this patient


population and then there's also this


stigma that can go along with seeking


out mental health care so I like to


destigmatize that by highlighting that a


lot of the people that I work with are


very high function


folks and they may never work with a


psychologist if they didn't have a


chronic disease and and so they're


really looking for tools and strategies


to just help improve their management


their quality of life overall how they


feel about how they manage stress and so


really highlighting that you don't have


to be psychiatrically ill to seek out


mental health care it really can be when


you're doing pretty well and you're just


looking to strengthen your skills


highlight your resiliency and set


yourself up to manage different


complexities that are going to happen in


your future

English (auto-generated)

Cognitive Behavioral Therapy

During cognitive behavioral therapy (CBT), patients work with a therapist to identify and change negative thought patterns and behaviors that contribute to depression and anxiety. This evidence-based treatment has been shown to improve patients’ quality of life.

Gut-Directed Hypnotherapy

This treatment uses deep relaxation exercises, such as meditation and guided imagery, to teach patients how to feel more in control of their symptoms. IBD patients using gut-directed hypnotherapy have shown positive results in research studies, such as a longer remission periods and reduced inflammation throughout the body.

Mindfulness Based Therapy

This evidence-based intervention, which includes meditation, has been shown to help improve depression, anxiety, and overall quality of life.


Medications may be used in some patients who experience severe symptoms of depression and for the management of chronic pain. Your doctor may recommend medications, such as an anti-depressant or anti-anxiety medication. These medications may also be prescribed in addition to other forms of mental health treatment. Your gastroenterologist may feel comfortable prescribing this medication, or you may be referred for a consultation with a psychiatrist for treatment. As you would with any medication to treat your disease, you should always discuss risks and side effects with your doctor and mental health professional. 

Taking medications for your IBD and anxiety

Video Length 00:02:49

Taking medications for your IBD and anxiety There are medications available to help you cope with anxiety and other emotions you may feel as an IBD patient. Learn more about these medications.

IBD and stress can affect sleep

Video Length 1:25

IBD and stress can affect sleep Stress and anxiety can impact a person's sleep patterns, and when you have IBD, that can be a difficult thing to manage. Learn how consulting an expert can be helpful in understanding what is affecting your sleep as an IBD patient.



so we certainly want to have all of our


resources in a line and if we find that


we're not sleeping and chronic fatigue


can be a very common symptom of IBD


if you feel as though your fatigue is


worsening and maybe you've tried certain


remedies such as exercise and getting


enough sleep at night but you're still


having difficulty falling asleep staying


asleep stress can certainly play a role


in that so if you feel as though your


mind is racing or you're struggling with


other aspects of your life because maybe


you're in a flair or you're feeling as


though it's been difficult to cope with


the disease again reaching out for


support from a mental health provider or


even a sleep specialist can be helpful


but from the clinical psychology


perspective I would be working with a


patient to see what are the thoughts


that they're having before night or


before sleep and can we use some CBT to


target some relaxation strategies before


bed maybe some meditation or gut


directed hypnosis but really honing in


on some strategies and interventions


that have been known to help with


whether it's disease related insomnia or


anxiety and stress provoked sleep



English (auto-generated)

Stress Reduction Techniques

Stress and anxiety do not cause Crohn’s disease or ulcerative colitis, but they can negatively impact your physical health and cause further gastric distress. These mindfulness techniques can help you learn to relax.

Diaphragmatic Breathing

The ability to relax and clear your mind is a helpful coping skill for managing stress. Living with a chronic illness can make it difficult to know how to relax or even where to begin. Diaphragmatic breathing, which is also known as deep breathing or belly breathing, offers many physical and emotional benefits, making it a great place to start.

  • Lowers heart rate and blood pressure

  • Decreases muscle tension

  • Oxygenates your blood

  • Brings warmth to your hands and feet

  • Increases energy and motivation

  • Improves concentration

  • Strengthens the immune system

  • Reduces stress hormones

The activation of the diaphragm through diaphragmatic breathing also allows for a gentle massage of the internal organs, including the intestines and stomach, which can help with abdominal pain, urgency, bloating,  and constipation.

How to Diaphragmatic Breathe

Diaphragmatic breathing is a skill that requires practice. It will become easier over time. When you are first learning to diaphragmatic breathe, you may feel some uneasiness or lightheadedness, which is perfectly normal. Allow yourself time to acclimate after your session and take care not to stand up too quickly.

  1. Sit or lie in a comfortable place. Close your eyes.

  2. Place one hand on your chest and one hand on your abdomen. Your bottom hand should do the moving. Top hand should remain still or only move as the bottom hand moves.

  3. Inhale through your nose for about 4 seconds and feel your abdomen expand. You may feel slight tension during these initial inhalations.

  4. Hold your breath for 2 seconds.

  5. Exhale through your mouth very slowly for about 6 seconds. Your mouth should be relaxed with a steady, slow exhalation.

  6. Repeat for 5 to 15 minutes.

Progressive Muscle Relaxation

This technique, also called PMR, involves tensing and relaxing various muscle groups to relieve your body of added tension that can make stress and pain worse. It is easy to learn and it will help you become more aware of muscle relaxation after you release the tension in each group of muscles. This technique can also be done in consultation with a mental health professional. 

With each movement, focus on the sensations of relaxation coming into your body. You may feel warmth and a sense of well-being and peace. Hold each position for 7 to 10 seconds, then relax your muscles for about 20 seconds. Tense and relax each muscle group twice before moving on to the next part of the body.

  1. Begin by sitting or lying in a comfortable position. You may want to close your eyes.

  2. Start with the muscles in both hands. Make fists and hold them tightly for 7 to 10 seconds. Then let go and relax your muscles for about 20 seconds. Notice how your hands feel as they release tension. You may begin to notice a warm sensation. Repeat this one more time.

  3. Next, tense the muscles of your upper and lower arms by bending the arms at the elbow and tensing as you bend. Then relax those muscles.

  4. Next, focus on the muscles in your shoulders and neck. Shrug your shoulders up toward your ears. Notice the warmth, heaviness and relaxation coming into the muscles of your shoulders and neck. Then let go.

  5. Now, push your head against whatever is supporting it. Gently tense the muscles of your neck, then let go.

  6. Next, gently pull your chin toward your chest. Notice the feeling of tension. Let go.

  7. Now you will focus on the muscles in your face. Wrinkle the muscles of your forehead and the area around your eyes. Notice the feeling of tension in these muscles, then let go.

  8. Now, move to your chest. Arch your back slowly and easily as you inhale and tense the muscles around your ribcage. Hold the tension, and then let go.

  9. Tense the muscles of your lower back and stomach by pressing your buttocks down into your chair, floor or bed. Feel the tension and notice the tightness in the low back, stomach, and buttocks. Then relax.

  10. Now, lift the right leg and point the toes upward and slightly inward. Notice the tension running from the top of your leg, down through the knee, calf, and toes. Then release.

  11. Lift the left leg and point the toes upward and slightly inward. Feel the tension run through the leg muscles all the way to the toes. Notice the warmth that has flowed into these muscles then relax your leg.

  12. Finally, scan your entire body from head to toes. Notice the relaxation that has come into your body. Which muscles have relaxed? Simply notice the difference between how your body feels now and how it felt before you started.

Feel free to revisit certain areas of the body, or simply enjoy the relaxation and feel proud of yourself for doing something good for your body and mind.


Related Resources

Fact sheet

Emotional Factors (.pdf)...

Fact sheet on emotional factors


Mental Health and IBD Infographic...

Mental health and IBD infographic