Living with inflammatory bowel disease (IBD) is a complex journey that extends beyond physical symptoms. IBD affects us as whole people, not just digestive systems.
On The Mind-Body Connection in IBS and IBD Featuring Ali Navidi, PsyD – About IBD Podcast Episode 178, Dr. Ali Navidi, a gastropsychologist and co-founder of GI Psychology, discusses the often-overlooked mental health challenges that come with an IBD diagnosis. Patients, caregivers, and healthcare professionals will all come away with a deeper understanding of the gut-brain connection and practical strategies for holistic care.
This blog post covers some of the themes and expert advice from the episode, offering in-depth guidance and actionable tips for managing the mental health aspects of IBD.
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Understanding the Gut-Brain Connection
Dr. Navidi points out that there has been a change in how the medical community understands GI disorders. The term “functional disorders” is replaced by “disorders of gut-brain interaction.” This is a more nuanced approach to the two-way communication between the gut and the brain.
Key Points:
- Symptoms are Real. IBD and IBS symptoms are not “all in your head.” They are genuine, physiological experiences that are affected by physical and mental factors.
- Mind-Body Connection. Stress, anxiety, and depression can worsen GI symptoms, while chronic GI issues can, in turn, impact mental health.
Actionable Advice:
- Acknowledge Both Sides. A plan to manage IBD requires attention to both physical and mental health. Neither one should be minimized over the other.
- Education. Learning about the gut-brain axis can help people with IBD better understand their symptoms and advocate for themselves within the healthcare system.
Breaking Down Stigma and Internalized Shame
Dr. Navidi calls out the persistent stigma surrounding mental health, especially for those with digestive diseases. Patients may take that message into themselves, internalizing the message that their symptoms are psychological. This can lead feelings of shame and reluctance in seeking help.
Key Points:
- Stigma is Harmful. Dismissing symptoms as psychological (“in your head”) can delay treatment and worsen outcomes.
- Internalized Stigma. Patients often feel isolated and might blame themselves or their lifestyle for their illness.
Actionable Advice:
- Challenging Stigma. Sharing your story can normalize mental health struggles in the IBD community and beyond.
- Find Allies. Building a support network of friends, family, and professionals who support you through your ups and downs can help.
Learn more about the IBD Therapy Group with GI Psychology and The Crohn’s and Colitis Foundation
Specialized Mental Health Care for IBD
Not every mental health professional is trained in the most effective ways to address the unique challenges of IBD. Dr. Navidi talks about how IBD patients need therapists trained in GI-specific protocols, such as gut-directed cognitive behavioral therapy (CBT) and clinical hypnosis.
Key Points:
- General CBT vs. GI-Specific CBT. Standard CBT may not get to the source of the anxiety and though processes of someone living with IBD.
- Clinical Hypnosis. Hypnosis can help patients manage pain, anxiety, and other symptoms. This type of therapy is valid and supported by research to help people change their response to discomfort or stress.
Actionable Advice:
- Finding the Right Provider. Look for therapists with experience in GI psychology or gut-brain therapies. Ask about their training and approach to learn more about how they work with people with IBD.
- Telehealth Options. National practices like GI Psychology offer remote access to specialized care, which can help people who don’t have a local GI therapist.
Demystifying Hypnosis for GI Disorders
Dr. Navidi explains that clinical hypnosis is not mind control, like we see in movies and on TV. Instead, it’s a learnable skill that can help people manage pain and anxiety. He introduces the concept of “hypnotic talent,” saying that some people are naturally more responsive, but most people can benefit with some practice.
Key Points:
- Conditioned Relaxation. Hypnosis can create a learned response, helping patients relax or manage their symptoms on command.
- Skill Development. Like any skill, hypnosis improves with practice and guidance.
Actionable Advice:
- Keep an Open Mind. If traditional therapies haven’t worked, think about trying clinical hypnosis.
- Practice Regularly. Working with a trained professional helps develop and reinforce hypnotic skills.
Why Sticking with Therapy Matters
Research shows that while some patients feel better after a few sessions, completing the full course of therapy (typically 8–10 sessions) leads to more long-lasting improvements.
Key Points:
- Building New Habits. Consistency is key to rewiring thought patterns and learning new coping mechanisms.
- Long-Term Benefits. Giving therapy some real effort increases the chance of long-term changes.
Actionable Advice:
- Committing to the Process. It’s important to know how to set realistic expectations and make a plan to complete the full course of therapy.
- Tracking Progress. Keeping a journal to monitor changes in symptoms and mental health is helpful.
Navigating Insurance and Provider Shortages
Access to specialized mental health care for people with GI disorders is challenging. There aren’t enough providers to serve the patient community. Dr. Navidi tells us about a “gap exception.” This is a strategy for patients to seek reimbursement from their insurance company for an out-of-network provider because no in-network specialists are available.
Key Points:
- Provider Shortage. There are few therapists trained in gut-brain therapies, making access difficult.
- Insurance Solutions. Gap exceptions can help bridge the access gap.
Actionable Advice:
- Advocating for Yourself. Ask your insurance company about gap exceptions and document your efforts to find in-network care with a GI psychologist.
- Explore Group Therapy. Therapeutic groups, such as those offered in partnership with the Crohn’s and Colitis Foundation, can be more affordable and accessible.
The Power of Therapeutic Groups
Therapeutic groups for IBD patients are a type of group therapy that might be less expensive and more accessible. These groups may combine CBT and clinical hypnosis in a supportive, peer-driven environment. They are also often covered by insurance.
Key Points:
- Shared Experiences. Group members benefit from the understanding that comes with living with a chronic condition and also offers some collective problem-solving.
- Cost-Effective. Group therapy is typically less expensive than individual sessions.
Actionable Advice:
- Join a Group. Ask your healthcare providers, your mental health professional, or an IBD patient organizations about group therapy options.
- Engage Actively. To get the most benefit, it’s important to fully participate and attend most or all of the sessions.
Looking Ahead: Expanding Access and Awareness
GI Psychology and other groups are working to bridge the gap between research and practice. This includes finding a way to expand access to specialized mental health care for GI patients.
Key Points:
- Ongoing Innovation. New programs and telehealth options are making care more accessible.
- Patient Empowerment. Education and advocacy are essential for driving change. Patients asking for more mental health care and trained providers can help with expanding access.
Actionable Advice:
- Stay Up-to_date. Follow organizations like GI Psychology and the Crohn’s and Colitis Foundation for updates on new resources.
- Advocate for Change. Share your experiences to help shape better care for all IBD patients. Support the patient activists who are pushing for better access to mental health care.
Conclusion
The intersection of mental health and IBD is complex. It can also be difficult to manage the medical trauma that many patients cope with every day. But we have to remember that patients can make real change by challenging stigma and the systems that keep us from accessing the care we need and deserve.