Dear Nurse – Living Well: Supporting Mental Health with a Stoma

26 May, 2026

Barbara Milleret – Clinical Services Lead, Salts Healthcare

In mid-May, the UK marked Mental Health Awareness Week. Given the impact that life with a stoma can have on some people’s emotional wellbeing, Barbara Milleret offers guidance on how managing mental health concerns from the perspective of a Stoma Care Nurse.

Living with a stoma changes more than how your body works. It can affect your routines, your relationships, how you feel about yourself, and your confidence. These emotional effects are completely normal. Whether your surgery was planned or emergency, whether your stoma is temporary or permanent, it’s common to experience a mixture of relief, worry, frustration, and hope regarding your future. This article offers practical, kind strategies for supporting your mental wellbeing as someone living with a stoma.

While a person’s mental health might be affected by having a stoma, this is only one side of the coin. Many people in the population may suffer from common mental health conditions, such as anxiety or depression, for a variety of reasons. For those who also then require stoma surgery, their symptoms might be exacerbated. This article therefore also explores how having a stoma can affect the quality of life for ostomates diagnosed with such pre-existing conditions.

Whatever You’re Feeling Is Valid

There is no “right” way to feel after stoma surgery. People describe a wide range of emotions, often fluctuating from week to week as the body heals and routines settle.

If emotions feel like a rollercoaster, that is expected, especially during the first 3–6 months as you heal and you get used to products and routines. Early, honest conversations with your stoma care nurse can help normalise these experiences, troubleshoot practical issues, and reduce worry before it becomes a bigger issue.

Anxiety often centres on “what if” questions:

• What if I leak?
• What if there’s odour?
• What if I can’t find a toilet?
• What if people stare?

It’s understandable. Your brain is trying to protect you from things that can go wrong. While we can’t erase uncertainty, we can reduce it and build coping mechanisms.

Below are some common areas of concern followed by practical steps you can take to cope.

Common Concerns

• Leaks and odours. Early product trials can feel stressful as you determine the right accessories and stoma care routine for your individual needs.
• Travel and public transport. Worries about finding toilets or managing changes on the go.
• Work and social events. Meetings, long days, or unfamiliar venues can increase anxiety.
• Sleep. Fear of night time leaks can impact rest.

Practical Tools That Help

• Routines that reduce guesswork. Set a routine that suits your output pattern (your nurse can help tailor this). Keep supplies in a consistent place and pre pack a “go to bag”.
• The ‘Rule of Two’. Carry two of each essential (pouch, wipes, disposal bag) when leaving home. This may help to lower your anxiety when out and about.
• Venue planning. When possible, check toilet locations before you go. Many venues list accessible facilities online; maps can be saved to your phone.
• Journaling patterns. A brief log of meals, output, and activities can reveal patterns (e.g. certain foods before travel days, best change times). This can boost a sense of control.
• When anxiety sticks. If persistent worry limits daily life, ask your GP or stoma nurse about psychotherapeutic support. Therapies such as Cognitive Behavioural Therapy (CBT) can offer strategies that target health related anxiety effectively.

How Your Stoma Care Nurse Can Help

Specialist stoma nurses can often support with more than just your medical needs. They can provide holistic care which includes practical, emotional, and educational support to help you manage life with a stoma.

Skin care, diet, travel preparation, activity planning, trying different products, and making small adjustments to your accessories, are all part of the conversations you can have with your stoma care nurse, and which can help reduce depression, anxiety, and self-esteem issues. So don’t feel you must wait for a crisis to reach out.

Consider asking for extra support if, for two weeks or more, you notice:

• Persistent low mood or loss of interest in activities
• Constant worry that feels hard to control
• Avoiding leaving the house or seeing people
• Significant changes in sleep or appetite
• Thoughts of self harm or feeling that life isn’t worth living*

Talking to your stoma nurse can also help to normalise your experiences. You might be surprised to discover “many people feel this way at first.” Hearing other people’s stories may help.

Advocacy and Signposting

If low mood or anxiety is persistent, your stoma care nurse may signpost you to your GP who is able to assess mood and anxiety. They can then signpost you to talking therapies or other types of interventional therapies, alongside reviewing any relevant medication that you may be on.

Your stoma care nurse may also be able to suggest other appropriate options to alleviate low mood and anxiety. For example, local peer support groups, or a direct referral to local mental health services.

Many stoma nurses may also refer you to Colostomy UK which runs a variety of initiatives, all staffed by volunteers with lived experience, aimed at improving mental health and wellbeing.

Pre Existing Mental Health Conditions and Stoma Care Support

According to Public Health England, one in five people in England are living with a common mental health condition such as anxiety or depression. For people who already live with a diagnosed mental health condition, adjusting to a stoma can bring an extra layer of complexity as it can magnify symptoms. This does not mean the journey will be harder for everyone, but it does mean that existing mental health needs deserve specific, proactive support.

People with a history of trauma, body dysmorphia, or disordered eating may experience a stronger emotional reaction to body changes. Medication routines may need review. Absorption changes (especially with high-output stomas), appetite changes, or disrupted sleep can occasionally impact psychiatric medication schedules also.

It’s important to recognise that when you already have a lot on your mind, it can make keeping on top of your stoma care more difficult. If you are also managing your mental health, it’s understandable that this can sometimes feel overwhelming.

If you have a history of mental health needs that are separate from your stoma care, but feel that your stoma may be making things more difficult, speak to your stoma care nurse. They can work with you to ensure you receive the right support and help you access additional services if needed.

If you are experiencing any of these thoughts, contact your GP urgently or call Samaritans on 116 123.

Colostomy UK services include a free helpline, online chat function, wellbeing classes, befriending service, and support group guidance, all aimed at improving mental wellbeing.

Support From Colostomy UK

We offer a wide range of support for people living with a colostomy, including our free Stoma Helpline, live chat support, and opportunities to connect with others through local and online groups. We also provide trusted information and resources to offer practical advice, reassurance, and the confidence to live well with a stoma: colostomyuk.org/support