When a doctor talks to people with this digestive disorder, "what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany.
The most common mental ailment people with IBS have is generalized anxiety disorder, Blanchard says. He thinks more than 60% of IBS patients with a psychiatric illness have that type of anxiety. Another 20% have depression, and the rest have other disorders.
Regardless of whether they have irritable bowel syndrome, people with anxiety tend to worry greatly about issues such as health, money, or careers. The anxiety can lead to other symptoms that include upset stomach, trembling, muscle aches, insomnia, dizziness, and irritability.
There are several theories about the connection between IBS, stress, and anxiety:
- Although psychological problems like anxiety don’t cause the digestive disorder, people with IBS may be more sensitive to emotional troubles.
- Strong emotions like stress, anxiety, and depression trigger chemicals in the brain that turn on pain signals in your gut that may cause your colon to react.
- Stress and anxiety may make the mind more aware of spasms in the colon.
- IBS may be triggered by the immune system, which is affected by stress.
Ways to Cope With Stress and Anxiety
There's proof that keeping your stress under control can help you prevent or ease IBS symptoms. Here’s why. Your gut has what you can call a brain of its own. It's the enteric nervous system. And it's the reason you get butterflies in your stomach when you're nervous. This “second brain” controls how you digest food. It also constantly talks with your actual brain. This connection may help you manage your IBS.
What you can do on your own
You can zap tension by simply doing something fun, like talk to a friend, read, listen to music, or go shopping. You might also try:
Exercise. Walking, running, swimming, and other physical activities can reduce stress and depression. They also help your bowels contract in a more normal way instead of overreacting.
Mind-body exercises. Meditation, relaxation breathing, yoga, tai chi, and qi gong can all trigger your body's relaxation response.
Mindfulness-based stress reduction classes and meditation. You can find courses offered online and in person, often at universities. They help you learn to manage stress by changing the way you think. Or you can learn to meditate online, in a class, or from a book.
Relaxation exercises. Relaxation techniques such as deep breathing can help you restore calm. You can also learn about visualization, where you imagine a peaceful scene.
When to consider therapy
If you’re still tense and anxious, talk with your doctor. Make sure you're getting the right medical treatment for your constipation or diarrhea. Then discuss whether talk therapy might help.
People with irritable bowel syndrome "should really start with their primary care physician, and work with that person," Blanchard says. "They should only go to the next step [psychological care] if what they're doing with their doctor is not working."
Blanchard says two-thirds of people with IBS get better with changes in diet and medication. The other third, people with more severe symptoms, might benefit from psychological help. "Without that, they don't seem to get out of the problem that they're in," he says.
A therapist can teach you how to break the mind-body cycle that may be making your IBS symptoms worse. They can also help you come up with strategies to handle your triggers and ways to better deal with challenging situations. Research shows that therapy can also help with some IBS symptoms in many people who try it, though it may not improve your constipation or belly aches.
Therapies to treat IBS focus mainly on behavior. Types of therapy that may be helpful include:
Cognitive behavioral therapy (CBT). This is a type of talk therapy. You work through common situations that trigger your symptoms and learn to handle them in different ways. For instance, if the idea of eating at a restaurant makes you anxious, CBT can help you recognize the thoughts and patterns you have and teach you how to spot and change them.
Psychodynamic therapy. This type of talk therapy looks at how your emotions affect IBS. Your therapist will typically focus on relaxation techniques and stress management.
Hypnotherapy. Therapists use hypnosis to put you in a very relaxed state. That lets you be more open to hearing positive ways to work with stress and change behaviors. You'll still be awake, and you can't be made to do anything against your will.
Relaxation training. There are many ways to calm your nervous system and lower your stress levels. One method is progressive relaxation. With it, you work your way through your body, tightening and then releasing your muscles. Over time, you learn to tell the difference between feeling tense and feeling relaxed. Then you can use the technique to calm yourself.
Biofeedback. With biofeedback, a doctor connects you to a device that gives you information on what's happening in your body. You use that information to make changes. For example, it can help you gain better control over the muscles that control your bowels.