By Jennifer Copley (Last Updated June 22, 2012)
IBS is a digestive disorder that causes recurring diarrhea or constipation as well as abdominal pain, gas, bloating, and/or nausea for many sufferers. It is more common among those with anxiety disorders than in the general population (Lydiard, 2001).
According to the Anxiety and Depression Association of America (2012), IBS is quite common, afflicting 1 in 5 people in the United States. The disorder often arises in the late teens or early twenties.
IBS is stressful and can be painful, but it doesn’t cause any permanent damage to the digestive system or trigger the development of other gastrointestinal diseases.
The Connection Between Stress, Anxiety, and IBS
Up to 90% of those with IBS also suffer from panic disorder, post-traumatic stress disorder (PTSD), social phobia, generalized anxiety disorder, depression, and other psychiatric problems (Lydiard, 2001).
The brain and digestive system are connected, so intense anxiety can make even those who don’t suffer from IBS desperately need to use the bathroom. This occurs because the body’s natural fight-or-flight response has been activated in response to perceived danger. This response helped our ancestors mobilize to escape or defend themselves when most dangers were physical, but in the modern world, threats tend to be psychological, so it can be problematic.
IBS sufferers may have digestive systems that are particularly responsive to stress, which exaggerates the natural tendency to evacuate the bowels under extreme stress. As a result, they can become very anxious if they don’t have easy access to a washroom when feeling anxious.
Anxiety-related problems and IBS can both be triggered by an overreaction of the body’s physiological stress responses, so it’s not surprising that they occur together in many cases. Unfortunately, the two conditions tend to feed one another, with anxiety increasing IBS-related problems and IBS symptoms causing further anxiety. This negative feedback loop worsens both problems, so IBS treatment should include anxiety treatment.
IBS treatments include medication, cognitive-behavioural therapy (CBT), and dietary changes. Medications commonly used include antidepressants (to treat the symptoms of anxiety and depression that can trigger and worsen IBS symptoms) and antispasmodics (to relax the colon). There are a couple of medications designed to treat IBS directly, but they have only been FDA-approved for use with women and can have some nasty side effects.
CBT is designed to improve coping skills and reduce the anxiety and depression associated with IBS. Given the strong mind-body connection with this disorder, CBT can be very beneficial.
Dietary management of IBS involves identifying and eliminating food triggers (keeping a food diary can be helpful for this). Foods that often trigger IBS problems include alcohol, caffeine, gas-producing vegetables, and artificial sweeteners.
Fiber is beneficial for IBS sufferers, though it should be added slowly and carefully to the diet. Barbara Bradley Bolen, PhD (2012), recommends beginning with the addition of soluble fiber (such as psyllium) when diarrhea is the predominant symptom and insoluble fiber if constipation is the primary problem. Eating smaller but more frequent meals over the course of the day instead of the standard two or three big meals can also help.
Given the link between stress and IBS, general stress reduction is also beneficial for IBS sufferers. Relaxation techniques such as meditation, calm breathing, visualization, cultivating mindfulness, and doing yoga may also be helpful. Beneficial lifestyle changes include getting more exercise and improving sleep.
If you suspect that you may have IBS, consult a doctor to ensure that you’re not suffering from a different condition and to discuss treatment options.
Anxiety and Depression Treatments
Because IBS, anxiety, and/or depression often go hand in hand, many IBS sufferers will need to treat anxiety or depression as well. For both conditions, there are medical approaches and complementary therapies. It’s a good idea to explore both and see what works best for you.
This article is provided for informational purposes only and is not intended as a substitute for medical or psychiatric advice. Medical concerns should be referred to a qualified doctor.
- Anxiety and Depression Association of America. (2012). “Irritable Bowel Syndrome.” ADAA.org.
- AnxietyUK. (n.d.). “Irritable Bowel Syndrome (IBS).” AnxietyUK.org.
- Bolen, B.B., PhD. (2012, May 21). “IBS Treatment.” IBS.About.com.
- Bolen, B.B., PhD. (2011, August 24). “IBS and Panic Disorder.” IBS.About.com.
- Lydiard, R.B. (2001). “Irritable Bowel Syndrome, Anxiety, and Depression: What Are the Links?” Journal of Clinical Psychiatry, 62(Suppl. 8), 38-45.
- Nazario, B., MD. (Reviewer). (2009, June 26). “Stress, Anxiety, and Irritable Bowel Syndrome.” WebMD.com.