While no one can stave off stress forever, people with Crohn’s disease can be especially at risk for mental health conditions. According to the Crohn’s & Colitis Foundation, depression rates are higher among people living with inflammatory bowel disease (IBD) than in people without IBD. Anxiety is also common. A review of 77 studies published in The Lancet Gastroenterology & Hepatology found that about 32 percent of people with IBD had anxiety and 25 percent experienced symptoms of depression. Struggling with anxiety and depression can make it more difficult to manage the disease and go about daily life — so much so that the authors of the The Lancet review note that routinely screening people with IBD for these mental health issues may improve symptom treatment and management. Here are some ways to manage the emotional effects of Crohn’s disease.

Ways to Manage Your Emotions if You Have Crohn’s Disease

These practical strategies can help you cope with the emotional toll of managing Crohn’s disease. Remember that you’re not alone. According to the most recent estimates, 1.6 to 3.1 million people in the United States are living with IBD — either Crohn’s disease or ulcerative colitis — according to the Crohn’s & Colitis Foundation. Learn about your illness. Knowing the facts about your disease, including possible complications and how to manage flares and treat symptoms, can help you feel more in control of your illness. “The more knowledge you have about your disease, the more it can reduce your stress,” says Jacquelyn Spencer, the manager of educational resources at the Crohn’s & Colitis Foundation. Don’t stop your treatment. “Many people stop taking their meds when they feel well,” Spencer notes. “That’s when you can experience a relapse.” Plan ahead. Being prepared, by having an emergency change of clothes, carrying a slim pack of wipes, and knowing where bathrooms are when you travel somewhere new, can go a long way toward easing anxiety. Expect emotional turbulence. “It’s not uncommon for people with Crohn’s to feel stress,” Spencer says. “There can be some depression and mood swings. In some cases, some of the meds can be the cause.” The important thing is not to let your stress get out of control. Prepare for the unexpected and try to take it in stride. Practicing a stress-management technique like meditation or deep breathing may help you regain control. Treat the depression. Being proactive can help you handle any depression symptoms, which the Crohn’s & Colitis Foundation says can include:

Ongoing sadnessHopelessnessLoss of interest in people or activities you once enjoyedChanges in appetite and sleep habits

Lifestyle changes such as exercise may help, but don’t hesitate to talk to your doctor about professional counseling, such as psychotherapy, or antidepressant medication. Find a Crohn’s support group. “Many people tend to isolate themselves when they have Crohn’s disease,” Spencer says. “It’s better to share and to realize that it’s not uncommon to feel stress.” While it’s important to depend on your friends and family, there may be times when you want to talk to other people living with the condition. That’s when joining a Crohn’s support group can be very useful. They can provide information and support, as well as an outlet to vent your feelings. You can attend support groups in person or join an online group through organizations such as the Crohn’s & Colitis Foundation. “Online communities can be very important,” Spencer notes. “It’s a place where people can post personal stories.” Start a journal. Take time — once a day, once a week, or whenever you have a spare moment — to write down your thoughts. “Letting out your feelings in a notebook or journal can be very helpful,” Spencer says. You can also use this journal to recognize how different stressors in your life affect your Crohn’s symptoms. While managing stress won’t guarantee that you’re flare free, it can help you better manage the emotional burdens of your condition.