Living Well with GERD: Mental Health Tips for Everyday Life

Do you feel like having Gastro-Esophageal Reflux Disease, more commonly known as GERD, increases your anxiety or depression? Or maybe you think increased anxiety and depression make your GERD symptoms worse? What if I told you…. Both are true! This comprehensive guide will explore the two-way connection between GERD and mental well-being. Discover strategies for managing symptoms, reducing stress, and prioritizing mental health. Learn about everyday mental health issues that contribute to GERD, discover calming techniques, and explore the benefits of therapy. Take control of your mental well-being and live a fulfilling life despite GERD.

The Emotional Rollercoaster of GERD

Studies have shown that having GERD can lead to the development of anxiety and depression. There are multiple reasons this may occur. The acid reflux that occurs is often at night and interferes with sleep, increasing anxiety. Also, esophageal reflux leads to elevated systemic inflammation levels, which can cause the development of anxiety and depression. Studies have also shown that the more severe an individual’s GERD is, the more severe their anxiety and depression symptoms are. 

How Mental Distress Can Worsen Reflux

Increased anxiety and depression may impair esophageal motor function as well as increase the sensitivity of the esophageal mucous membranes to pain. Through the gut-brain axis and esophageal mucous membranes, perception of stimulation is increased when an individual is anxious or depressed. This means that if there is a slight stimulation in the esophagus, reflux, and pain are more likely than in a non-anxious or depressed person. Also, stress increases inflammation in the esophagus, making it easier to be injured by acid reflux if it occurs. 

Strategies for Managing GERD and Mental Health

There are many strategies for managing GERD and mental health. In this article, I will not discuss the “traditional” medications as they are covered in other articles. Have you ever thought talking about your GERD with a therapist could help improve your symptoms? Studies have consistently shown that a specific kind of therapy called cognitive-behavioral therapy (or CBT) is beneficial in reducing the symptoms associated with GERD and the amount of acid the esophagus is exposed to. As previously mentioned, anxiety, depression, and GERD are on a carousel of causing or increasing each other. 

Many people are not familiar with the concept of meditation. There is no single “right way” to meditate. The goal is to relax and calm your mind and body. There are many studies examining different types of meditation and mindfulness (a specific type of meditation), and these studies show a reduction in anxiety and depression and an increase in positive emotions. If you want to explore a how-to on different styles of meditation and mindfulness, the University of Wisconsin’s patient handout is a well-written beginner resource with drawings. 

Another physical intervention that is easy to learn but difficult to master is deep breathing to relieve stress. This may sometimes be called “box breathing” or other terms when practiced to alleviate anxiety, panic, or pain. The name is important; it is learning how to perform it so you can use it when needed. At its most basic, you start by breathing into the abdomen through the nose, slowly counting to four. Then exhale through the mouth, generally twice as long as you count while inhaling. And repeat, counting the cycle of breaths. There is a handout to review to help you learn the breathing exercise technique. 

In today’s world, there is an app for everything. The app I recommend for helping with anxiety and mental health is called “Finch.” It is free, with an option to purchase a premium version but no in-app advertisements, and user-friendly. The app has sections to teach you meditation, mindfulness, breathing techniques, etc., which I have discussed here. It is available to download from your device’s store.

Living Well with GERD and Improved Mental Health

For anyone living with a chronic condition, part of the long-term plan must include acknowledging how their lifestyle may need to be modified, surrounding themselves with a supportive network of friends and family, knowing and connecting with others who understand and recognize what difficulties and triumphs you have, and accepting and advocating for themselves and their health needs. 

For most people, one of the first things they are told when diagnosed with GERD is that they will need to give up some (if not most) of their favorite foods, beverages, and vices, which may include chocolate, coffee, tea, soda, bacon, French fries, donuts, potato chips, chewing gum, beer, liquor, and, cigarettes among other things. 

In my medical opinion, no validated study shows there is one specific diet that provides relief to every person with GERD. In other words, what works for one person to decrease their GERD symptoms may not decrease or increase your GERD symptoms. I will provide the only carved-in-stone medical advice: IF A SPECIFIC FOOD INCREASES YOUR GERD SYMPTOMS, DO NOT EAT IT! When you are first diagnosed, I recommend cutting out foods and products that are the usual suspects for at least a week while keeping a food and symptom log. If your symptoms do not change, you can return to eating raw onions with every meal if that makes you happy, but please eat the bacon in moderation. 

When you have identified what increases your symptoms, advocate for yourself. Please do not feel embarrassed or anxious to speak up and tell others you do not want garlic or peppermint because it worsens your GERD symptoms. Having GERD does not have to hold you back physically or mentally. It is estimated that one out of five American adults have GERD, and almost everyone will experience severe heartburn at some point in their life. Speak up, and you may find some good tips from others on how they manage their symptoms.

1. _{Glasinovic, E., Wynter, E., Arguero, J., Ooi, J., Nakagawa, K., Yazaki, E., Hajek, P., Psych, C. C., Woodland, P., & Sifrim, D. (2018). Treatment of supragastric belching with cognitive behavioral therapy improves quality of life and reduces acid gastroesophageal reflux. The American journal of gastroenterology, 113(4), 539–547. https://doi.org/10.1038/ajg.2018.15}
2. _{He, M., Wang, Q., Yao, D., Li, J., & Bai, G. (2022). Association Between Psychosocial Disorders and Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis. Journal of neurogastroenterology and motility, 28(2), 212–221. https://doi.org/10.5056/jnm21044}
3. _{UW Integrative Medicine Dept of Family Medicine (n.d.). Breathing Exercise. University of Wisconsin School of Medicine and Public Health. https://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/handout_breathing.pdf}
4. _{UW Integrative Medicine Dept of Family Medicine (n.d.). Meditation for Health and Happiness. University of Wisconsin School of Medicine and Public Health. https://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/module_meditation_patient.pdf}
5. _{Zeng, Y., Cao, S., & Yang, H. (2023). The causal role of gastroesophageal reflux disease in anxiety disorders and depression: A bidirectional Mendelian randomization study. Frontiers in Psychiatry, 14, 1135923. https://doi.org/10.3389/fpsyt.2023.1135923}