Will antidepressants mess with my gut and cause me more issues?

[PlatinumEdition]

I know that no-one can really answer this as we are all individual with our reactions to meds but I am really at a dead end with my mental health.

Despite struggling with anxiety most of my adult life it has really been the last 6 years that things have become out of control. This has been due to my natural tendency towards anxiety but also having a lot of stressful situations thrown my way over these last 6 years. The longest stress factor and most pressing is helping to care for my mum who has (now) advanced dementia, I am just about done in. I wake every day in a state of high anxiety and spend the day exhausted from panic, ocd and continued anxiety. Only evenings give me some respite before it starts all over again the following day.

The problem that I have is that I also suffer from IBS (mixed but more diarrhoea than constipation). Despite trying all the strategies which have helped so much in the past nothing is touching it now. No amount of changing my diet, watching what I eat (could live off dust and still have symptoms every day), relaxation, exercises etc etc helps at all. I am stressed due to my circumstances which aren't changing (even if mum goes into a home it will still stress me to see her the way she now is), I am sure this is the reason for my awful gut health.

I feel SSRI's could be my only chance to gain back some control within my mental health. I have been advised by my GP not to take TCA's like Amitriptyline due to the dementia risk from these meds so have been offered Escitalopram, Sertaline or Fluoxetine (my rescue dog is on these and doing great!).

All the reviews for these meds though state that diarrhoea is a very common side effect, often lasting for weeks. As someone who battles with this on a daily basis and is one if the other biggest trigger to my vicious anxiety cycle I am very concerned taking an SSRI will cause me even further gut issues and therefore more anguish but I am also desperate to feel better mentally which may in turn eventually ease my gut issues? It really does feel like a horrible vicious cycle.

I am at a loss. Can anyone help and advise me how these meds affected you in the beginning?

PS Imodium does not help my gut at all, in fact it makes things worse so taking those alongside the SSRI would probably not help.

I've been on Sertraline for nearly ten years and had no upset stomach with it at all. I felt a bit spacey for a couple of days and that was all.

Honestly it's been life saving for me, and I'm not exaggerating.

I’ve never had diarrhoea from antidepressants and I’ve taken four different ones! I had mild nausea for about two or three weeks with Sertraline but zero side effects after that.

I can definitely live with feeling spacey. I really need them to save me too, I'm.at breaking point right now.

That's really good to know. I can handle most milder symptoms but just couldn't tolerate a worsening of my ibs-d, think that would just about throw me over the edge.

Just to check you’ve had a full blood work up done. My ibs became similar to yours. I did also have undiagnosed mental health issues which would have been in the background, but when I got tested my iron was really low. Once iron back up the bowels setttled down to their more usual pattern again. I’m not saying it’s iron for you but there are lots of other possible causes and a full blood work up and stool check should be done if they haven’t already been.

I’m on mood stabiliser rather than antidepressant but it’s not impacted my bowels and it has positively impacted my emotions. I no longer wake up wishing it was bedtime.

All the best.

SSRIs completely messed my gut up.

I was on them for 4 years and, at the same time, was being investigated for the gut issues. I didn't realise it was the SSRI until I stopped taking them.

I now use beta blockers for my anxiety and they help a lot, my gut symptoms cleared up as soon as I stopped the SSRI.

I had very low iron stores for years and years but following iron infusions and then a uterine ablation back in 2022, I no longer have issues with my iron, they are all at normal levels now. Same with my full blood panel, all appear to be normal.

That's my fear, I've read so much that SSRI's can mess with the gut, mine is already messed right up, I just can not risk making it worse.

My sister has been offered Propranolol but it's something that's never been offered to me. Was your digestive system fine with beta blockers?

If it helps, everything went back to normal almost as soon as I stopped taking them. So you could try them and, if things flare up, stop taking them. Many others on here haven't had any problems, so it might be that these kinds of side effects are rare but do happen!

I wasn't offered Propranolol either, I had to ask for them (they were a little hesitant because I'm asthmatic, but came round after a discussion). I've had no side effects from the beta blockers.

Sertraline did not affect my guts in anyway, but it did not help my mental health enough . Venfalaxine is what I am on now and that is a SNRI and it does cause me constipation (it is a named side effect)

For me it only became a problem at an increased dose so I’d recommend starting on a very low dose if you go ahead.

I was offered a prescription of Venlafaxine by my Gynae. I have endometriosis and adenomyosis. I'm in peri and can't take hrt as it made my pain worse. I turned down the Venlafaxine as she said it helped hot flushes which I don't suffer from but maybe I should reconsider the offer.

I'd much prefer constipation over diarrhoea. That would actually be a welcome side effects for me.

I have ibs mixed as well and drives me crazy. I'm on escitalopram and had no changes in my gut. Sertraline is pretty well known for giving diarrhoea, although all ssris can. If you've tried most things for your ibs, could it be anxiety/stress related? In which case ssris could potentially help.

Good to know Escitalopram hasn't upset your IBS, that's encouraging.

I do think that I am caught up in quite a vicious cycle of anxiety/stress and gut issues that I am struggling to break. I am getting to the point where I go into a panic attack as soon as I feel my guts starting up. Even if antidepressants did nothing for the actual gut issues and only reduced the stress and panic I get from the gut symptoms that would at least ease something for me. I can't stand the symptoms/stress cycle that I am stuck in.

I'm exactly the same.. when my anxiety was really bad, as spon as I felt a weird gurgle or twinge, it would set off a panic attack. Which then would have me rushing to the loo, it's an awful cycle. I havent had that for a couple of.months though so assume that's because of the escitalopram! My anxiety is much calmer in general too

I could have wrote this.

still haven’t found the guts to try SSRI’s. They terrify me. I also suffer with IBS and hate the fact it will just make my toileting habits even more unpredictable than they are.

sorry I don’t have any advice, but just know you’re not the only one. I’m here suffering with you 🫶

That's exactly what I go through. My guts are growling as I type this and I'm so tense worrying I will need the loo for the third time today before I am supposed to go see a friend. I need to try the meds as I am fed up feeling this way.

I am so sorry you suffer too. I don't think people realise just how controlling this condition is. I really feel for you.

You won't know unless you try.

Have you done any CBT/other therapy, any tools for handling your anxiety in the moment?

I have done lots of CBT, counselling (currently in counselling), EMDR and Acceptance Therapy but nothing has helped me.

I know how to think in a certain way to control the anxiety but it's so hard not to feel panic and a huge feeling of unease when you feel nauseated all the time and have the most unpredictable gut with a myriad of uncomfortable and embarrassing symptoms. My digestive issues are the instigator to my anxiety, if I do have a rare calm gut day it also calms my anxiety. I feel like a different person on the days my IBS is minimal but sadly those days are very few and far between.

I don't think taking an antidepressant will help op. If the reason for your anxiety is your ibs, can't the gp give you something to help with the ibs rather than give you another medication with other side effects. It doesn't seem logical. I can definitely see how ibs would caused anxiety op I'm sorry you have to deal with this. I was on setraline for awhile it's horrible to be honest, makes you feel numb. Came off it and use exercise to keep myself sane. I know this might not work for you if you have ibs though but I think ssris are given out when there are better things people can do to cure thier mental health if its not severe. Good luck

I've tried everything over the last 26 years. Dietary, hypnotherapy, I exercise, do yoga, meditation etc. I've taken all the IBS medication available (on prescription and off the shelf), very little has helped.

My current thoughts on antidepressants is that if they numb me (which tbh I kind of need right now) I might be able to get through each day with my gut symptoms because I won't care so much, the worry about eating, going out etc won't stress me because I won't care?

I'm on Sertraline due to extreme anxiety caused by my IBS and it's absolutely changed my life. Before I avoided going out unless I absolutely had to, and if I did have to go out I'd be stuck on the loo all morning having a panic attack. Since starting the sertraline that panic has gone away, which means my gut/bowels have finally had the chance to calm down.
I did have a bit of nausea and diarrhoea for the first couple of weeks but to be honest I was so bad before it didn't really make much difference to my quality of life. Full disclosure, I did feel very tired, quite depressed and brain foggy for a few weeks but once that lifted I felt amazing.

That's exactly how I'm living right now. Avoiding everything due to my unpredictable gut.

I've been offered Escitalopram by my GP and I know I need to try them.

If that's how you're living now then I'd say you've got nothing to lose by trying it. If it doesn't work for you then you can stop. Hopefully it does work, and you can start getting your life back.