When people think about inflammatory bowel disease, they usually think about digestive symptoms such as stomach pain and diarrhea. However, a new study suggests the condition may also affect mental health long before doctors recognize the disease. Early treatment of depression and anxiety could improve quality of life and may even help people manage their bowel disease more successfully. The use of nationwide databases and sibling comparisons makes this one of the strongest observational studies on mental health and IBD to date. Nevertheless, it relies on medical records, which may miss milder psychiatric symptoms.