IBS and Generalized Anxiety Disorder

worried woman
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Do you find that you experience a lot of anxiety alongside your IBS? You are not alone, as there is often an overlap between the two (not to mention that IBS is anxiety-provoking in and of itself!) Here we will take a look at a condition known as generalized anxiety disorder (GAD) and why it might overlap with IBS.

What Is GAD?

Generalized anxiety disorder is a condition in which a person experiences feelings of overall anxiety and excessive worrying on a regular basis.

Associated symptoms include:

  • Difficulty concentrating
  • Difficulty sleeping
  • Fatigue
  • Feeling jittery, restless or on edge
  • Irritability
  • Muscle tension

Note: Many people experience some of these symptoms throughout their day. GAD is only diagnosed if a person experiences these symptoms most days for a period of at least six months.In other words, your worry would have to be causing you significant dysfunction throughout the day in order for it to be diagnosed as GAD.

Overlap Between GAD and IBS

Estimates of the amount of people who have both IBS and GAD at the same time vary widely - ranging from 5% in an Asian study to up to 34% in Western populations.

Why the overlap? No one knows for sure, but there are some theories. It is possible that anxiety heightens the visceral hypersensitivity that can contribute to IBS pain. Another possibility is that there is a shared nervous system dysfunction that contributes to the symptoms of each disorder.

This may include problems with certain neurotransmitters that are involved in both the expression of anxiety and of digestive symptoms.

What to Do If You Have Both

The silver lining is that things that you do to help one disorder will most likely have a positive effect on the symptoms of the other disorder.

Here are some treatment options:

Psychotherapy: Cognitive behavior therapy (CBT) is a type of psychotherapy that has research support for being effective for both IBS and GAD. CBT works by teaching you different ways of thinking about things and different ways of handling situations. This can help you to both reduce your generalized anxiety and help you to react differently to your IBS symptoms. If this appeals to you, seek out a therapist who has experience in using CBT for GAD. They don't necessarily have to know about IBS, as your digestive symptoms should benefit from the anxiety management techniques they can teach you.

Medications: Although they are called antidepressants, these medications can be effective in reducing anxiety symptoms and are indicated in the treatment of GAD. Luckily, many antidepressants can also be helpful in reducing IBS symptoms. If this idea appeals to you, speak with your doctor for a prescription or a referral.

Self-Care Strategies

  1. Lay low on the caffeine: Caffeine can add to feelings of jitteriness and thus exacerbate the symptoms of GAD. Caffeine may also strengthen intestinal contractions and therefore worsen the symptoms of IBS-D.
  1. Engage in light exercise: Exercise can be a powerful stress reliever and thus may have a soothing effect on your nervous system - therefore addressing some of the factors that are underlying both disorders.
  2. Practice mind/body activities: Mindfulness, meditation, yoga, and tai chi all have a reputation for soothing anxious bodies.
  3. Take care of your gut bacteria: Anxiety can have a negative impact on the balance of your gut bacteria. Taking probiotics, eating more vegetables and fruit, as well as fermented foods, can help to offset the effect of your anxiety on your intestinal health.

Sources:

"Generalized Anxiety Disorder" National Institute of Mental Health Website Accessed September 23, 2015.

Lackner, J., et.al. "Type, Rather than Number, of Mental and Physical Comorbidities Increases the Severity of Symptoms in Patients with Irritable Bowel Syndrome" 2013 1147-1157.

Lee, S., et.al. "Irritable bowel syndrome is strongly associated with generalized anxiety disorder: a community study." Alimentary Pharmacology & Therapeutics 2009 30:643-651.

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