Some are even forced to quit their jobs: how to overcome irritable bowel syndrome in the form of panic disorder

Many patients turn to neurologists or psychiatrists because they get diarrhea precisely when they are worried or stressed, or every time they go outside. People are forced to constantly run to the toilet, take pills. They try not to eat before the road, they try to build their route so that there is a toilet near! They are afraid of traffic jams, whether to ride buses, minibuses, etc. Avoidance behavior forms a disorder - irritable bowel syndrome in the form of panic disorder. What is this problem and how to deal with it, read on.

- Anxiety is a mental health condition involving long-term manifestations of significant anxiety, nervousness, or fear. In some people, it can cause physical symptoms, such as diarrhea. If you are prone to diarrhea after stressful or anxious situations and events that cause anxiety, then you should understand that you are not alone. Quite common are indigestion associated with anxiety, - explains neuropathologist, psychiatrist Evgeny Skripnik. - Researchers have known since the 1940s that stress can cause intestinal cramps, which can then trigger diarrhea. This is due to the connection between the gut and the brain, known as the gut-brain axis. This axis connects the central nervous system to the enteric nervous system, which acts like the intestinal nervous system. It helps regulate processes in your gastrointestinal tract. But it also affects your emotions and behavior due to its connection to the brain. Everyone experiences stress, which is a typical human response to life situations, and everyone can experience stress diarrhea from time to time. However, there is a difference between stress and anxiety. If you experience chronic stress for an extended period, you may develop anxiety. This can lead to chronic bouts of diarrhea.

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- How common is this and what age patients most often have such a problem?

- Every 5 patients with panic attacks have a problem with the intestines! Irritable bowel syndrome in the form of panic disorder occurs on average in 10% of patients who come to me. But after a full-scale invasion, the number of complaints about this problem is gradually growing, because stress, anxiety and panic attacks have also increased. Patients are usually women aged 40-50 years, they are more vulnerable to psycho-emotional reboots, because they are emotional. With anxious depressive disorders and panic attacks, girls and women 28-33 years old turn to me more. They do not see a doctor for a long time, have avoidance behavior, which then leads to a problem with irritable bowel syndrome over the years. Symptoms are abdominal pain and discomfort that does not go away or keeps coming back, stomach cramps, gas, diarrhea, constipation, or alternating diarrhea and constipation.

- Give examples from practice, and how exactly did the avoidant behavior manifest itself in patients?

- Recently a 40-year-old woman contacted me, she has hardly left her apartment for about 5 years. She has two adult children who live separately in a neighboring town and have their own families. But the woman was afraid to go to them, at most she could walk to the store, which is 50 meters from the apartment. She went to do a manicure at home to the master, a hairstyle too. I chose things on the Internet and ordered a delivery service. It was a typical example of panic disorder.

Only 50 meters further from the house, she experienced anxiety, her legs “kneaded”, dizziness, palpitations, gastrointestinal disorders (diarrhea, calls to urinate, etc.) and immediately returned home. This was a manifestation of avoidant behavior.

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At the reception, it turned out that it all started with ordinary panic attacks 6-7 years ago, when the patient began to avoid those places where it was scary, where panic attacks occurred, then more and more the woman limited her movement and created a comfort zone at home where she was Fine.

I repeatedly repeated to her that it is not necessary to avoid, on the contrary, go where it is bad, remove the avoiding behavior. The brain will then understand that there is no danger.

And after a month of psychotherapy sessions, the patient got rid of this problem and now enjoys life.

In my practice, there were patients who even quit their jobs because, before planning or a large crowd of people, they immediately began panic attacks, which were manifested by pain in the heart, dizziness, abdominal pain and ended with diarrhea. Another woman was generally forced to wear a diaper to work, the third in the summer and spring wore exceptionally long raincoats and dark clothes, so as not to get the so-called embarrassment when urging to go to the toilet. Agree, this way of life is not very pleasant.

- How to deal with the problem?

- When a person fixes on the manifestations, disorders of the gastrointestinal tract, begins to avoid places where there is no toilet, goes outside and returns home when urged, avoidance behavior associated with the intestines gradually develops.
A person starts taking a bunch of drugs that, in his opinion, can improve the condition, especially taking them before leaving the house, taking an unproven medicine for anxiety, before going out, etc., his condition improves slightly, but worsens in the long run.

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That is, taking the medicine for anxiety, at the first pain, grumbling in the stomach is a protective, avoidant behavior, confirming that the danger is real. Although he is not. That is, diarrhea is the same panic attack (palpitations, sweating, respiratory failure), only in the stomach. If you turned to a gastroenterologist and ruled out diseases of the gastrointestinal tract, do not avoid, teach the body to get used to it, that there will be nothing terrible, even if the stomach hurts, you should gradually accustom the body that everything is fine.

Getting help for anxiety can greatly improve both mental and physical symptoms. Talking to a mental health professional is a good first step. Breathe for a few minutes. Slow, deep breathing can help reduce anxiety and calm your stomach. In addition, patients may be prescribed antidepressants. I am against any dietary restrictions, because again this will be a manifestation of avoidance behavior.

Earlier talked about a very effective technique with which the Ukrainian singer overcomes stress due to the war.