# IBS-D and anxiety



## 18008 (Oct 29, 2005)

Hi again! New member here with lots of questions and concerns, not addressed for last 20 years, now seeking help. Briefly; dx IBS-D last year after 20 yrs of symptoms and living in fear and worry. Robinul no help...rely on Immodium.Talked to internist last month and discussion turned to anxiety. I won't get into all of the particulars (maybe later if discussion goes that way), but in general:How do you know when it's anxiety due to IBS or IBS because of anxiety? How do you decide to treat with anti-anxiety meds? Dr. and I discussed it, but he felt I was handling things ok, so we put it on hold. He told me to call him if things get to the point I can't handle. It comes and goes...definitely ups and downs as I approach menopause. Still, the IBS continues, causing anxiety...and life goes on with all my worry...causing IBS!How do you make these med. decisions?Thanks!Water Dog Lover


----------



## 14416 (Jun 21, 2005)

hey... i think that the decision is kind of up to you and kind of up to your doctor like you said.i do think that having an anti-anxiety med like xanax on hand to take "as-needed" can be a life-saver. just knowing it's there is often more than enough... it is a vicious cycle, and it's hard to know where one starts and the other ends. on days where you're home, have nothing to do... could sit home all day and watch football for example, do you find that your IBS gets better? for me, it doesn't matter if im home with nothing to do but sleep, my IBS doesn't let up. This has caused me great anxiety now. I still am being treated for anxiety, because I think that either way it's nice to have that kind of crutch to lean on, even if people think its just a band-aid.... I don't care, whatever helps ME, I don't care if 1,000 people say I'm stupid or I'm doing it all wrong.For me, if I had no IBS issues at all, I doubt very seriously I'd have any anxiety problems. Do you think it would be that way for you?outside of IBS, are you still an anxious person, or have you suffered too long to remember?anti-depressants can help with anxiety and IBS... and that's one of the most frequently kind of prescribed medicines in IBS... I take Remeron and Elavil... and also Xanax 3x/day (well when I remember).Xanax isn't a cure all for IBS, but it definitely zaps the anxiety down.


----------



## 18008 (Oct 29, 2005)

Hi SSS -- thanks for the thoughtful response.I have been trying really hard to find patterns and triggers. I am convinced (and my GI agreed) that a lot of it is hormonal. D is def. worse as my period approaches. Interestingly, I was almost D-free and did not take Immodium when preg. both times.Being home is generally better, but not always. Certain foods cause problems, but other times I can eat anything without an issue.Leaving home for major events is anxiety-laden and I always take 4 Immodium as a preventative. Doing my routines (food shopping, volunteering at kids' schools, things I am comfortable with, etc.) are usually ok. But again, if it's "that time of the month" or just a bad patch for an unknown reason, I will take Immodium...again.The intense anxiety comes and goes. Our son is autistic and this is a MAJOR anxiety issue for me...I worry about him constantly and watching him take his karate test, for example, sends me into a terrible downspin. I am always positive with him, but inside, I am dying, watching him struggle and be so awkward and different. I didn't sleep a wink that night and had terrible D next day -- yesteray. AH HAH! A connection??!!I didn't realize that you could take Xanax as needed. I can think of several bad episodes that I could have used real help. Times when I can't control my thoughts and just obsess and worry.Dr. feels the anxiety is contributing to all of my issues...bp, IBS, sleep and weight. I see him for a bp check in Dec. think I will discuss meds with him then.To answer one of your queries: if I didn't have IBS would I have anxiety? Yes. I know who I am...a constant worrier, a pleaser, a too-deep thinker. I cannot "shut my mind off" and I am terribly self-critical. This is certainly an interesting issue, to say the least!Thanks again for your thoughts and help. I feel that I am getting closer and closer to more relief, better relief.Water Dogs Rule!


----------



## 22150 (Oct 12, 2005)

Hi, I think anxiety is the cause of all my problems. I've started two thread on here on exactly that subject - night time incontinence and illness and avoidance - if you read those you will see how I think stress has affected me. I don't take meds for anything (too many dreadful side effects in the past - one effect from anti-depressants gave me ibs in the first place).I hope that you managed to calm down and feel better. I'm trying very hard, break the habit of obsessive thinking. I never used to be this bad so I know it's possible to relax. I didn't have any problems today at all - out of the house all day and had to concentrate on other things. A lot of problems happen if I need to go out and I start thinking of excuses. But if I need to go out and say to myself 'you are going and that's that' - then I feel much better.Good luck.


----------



## 14416 (Jun 21, 2005)

No problem water...Most doctors these days will only prescribe Xanax to take as needed... It doesn't need to build up in your system over time to take effect.. It actually works pretty much immediately after you take it.. With Xanax you're good for 4-6 hours after you take it...I know exactly what you mean.. It's hard to tell what life would be like without IBS... because it's really all I know anymore.When I decided to take Xanax for the first time, it was before a speech I had to give in college. I hate public speaking, and in front of a group of people I didn't know at all with IBS on top of it, I was freaking out! I took that first pill, and surprisingly made it through the whole speech no problems!I even went to Florida with a group of friends and I had such a huge fear of flying. Literally the thought of it sent me into an anxiety attack. This was before I had Xanax. I didn't even need the Xanax on the plane, just knowing it was there, I felt this sense of comfort.My doctor actually wants me to take it 3X/day. He was very adament about it. Probably because he thinks if I continue to go down this road of anxiety and IBS, it will be much harder to treat. So he wants me out doing things to conquer fears, etc. I have to admit, I feel better when I take it 3X/day, it just is hard to remember to take it.It's been a life-saver for me and my anxiety.It actually helps calm down my IBS attacks as well. Not perfectly, but the calming effect of the medicine helps me relax through it.Some doctors won't prescribe this type of medicine, and rely solely on anti-depressants. It's very sad, because of how well this medicine treats anxiety.If you decide to inquire about an anti-anxiety med with your doctor... Its better not to refer to them by name.. That's what people say.


----------



## 19762 (Apr 15, 2005)

Hi all-I have had anxiety disorder since early 20's but only DX 13 yrs ago. To make this short-I was on 1 antidepressant for 12 yrs w/ the help of Xanax. Then the antidepressant just stopped working. Changed Dr's & after a few Dr's & different antidepressants (1 was really horrible) I'm now on Paxil CR & also supposed to be taking Xanax 3X a day. (I for get too-but if having a bad day-it won't let me forget-LOL). I def had anxiety before IBS but I also have had a lot of sad things happen over the past yrs that added to my anxiety (my mom, dad & only sibling-brother all died). So I think between the anxiety disorder & the stress I developed IBS. I have no rhyme oreason or pattern to mine. Maybe 3-4 foods def trigger it- but I eat healthy & still can't figure it out. I too use Imodium & Xanax to help. I also take 1 Fibercon at dinner. If I have someplace to go where I'll be away for awhile (work p/t-concert-friends-etc) I take 2 Imodium & carry Imodium & Xanax w/me. I almost don't care anymore. Thank goodness for a very supportive hubby & 23 yr old son! Hope everyone feels better than I do today!


----------



## 19223 (Oct 18, 2005)

There is a muddy line between anxiety and IBS. With my husband, he is pretty much going to have episodes regardless of what he's doing. However, going places brings on bad D while staying at home the D might not be so severe but the cramps are bad. I hate this because people think he's lazy or anti-social. Quite the contrary! He loves people...but being around crowds is another story. I can't remember who said it, but they said that taking the anxiety medicine was a bandaid. I agree...if there's anything that can help just a little I say go for it. I wish my husband would take an anti-anxiety med but he's going to see a counselor so that's a positive step. Sorry to talk about my situation so much!


----------



## 18008 (Oct 29, 2005)

Thanks, everyone. I agree that there is no clear cut diagnosis here. IBS certainly causes anxiety and if anxiety is the main issue, then bowel can issues arise as well.I am finding more and more information about anxiety meds used as needed. Any of us know -- and I have learned this just recently -- that there are definite times when they're warranted. I will surely discuss that kind of usage with my dr. The 2 or 3 week episode I had this spring was so clear...I now know that feeling and will deal with it more pro-actively, and that may include meds.Best to all! WD


----------



## kitkat17 Lady of the Loo (Jul 21, 2005)

Yep it is a never ending pain in the a-- circle. Get stressed worrying if I am going to have another accident or do I have an accident cause I am stressed. Darned if ya do and darned if ya don't. I give up on the stress factor.Good luck Hope you figure yours out


----------



## joy81499 (Nov 11, 2004)

Waterdogs - I believe my D is completely anxiety related. I don't ever have D if I'm sitting around doing nothing, but I have to run to the loo if I even THINK of making flight reservations. I'm 49, peri-menopausal and agreed that the D went away with my pregnancies. The prenatal iron pills tend to constipate, and also everyone knows that pregnant women always have to pee, so I felt less pressure around others about having to be embarrassed about needing to take frequent restroom breaks.I've had this since my teens (my mother has it too) and let the anxiety about having to "go" run my life. I am also very self-critical and worry about EVERYTHING. Here is my advice: I started Paxil in June and it's made a huge difference in the way I feel. I feel like a normal person who doesn't obsess and think that every time one of my kids gets a headache that it's a brain tumor. If you have not tried this before, you should discuss pharmaceutical therapy for your anxiety. Paxil has its pros and cons (BTW it worked for my mother as well, she had a much worse problem than I did, and at the age of 70 finally got her life back and started going out and doing things), I've talked to others who preferred Lexapro. These are drugs you take every day, not as needed. I admit the Paxil makes me tired and I need more sleep than I did before, but the trade off was worth it. It's not a total cure, but it made me feel INCREDIBLY better. It took me two months to feel a little better on 10 mg/day and then my dosage increased to 20 mg/day where it will stay.Good luck to you.


----------



## 13640 (Nov 4, 2005)

Hi all,just wanted to let you know that xanax is very addictive and you develop a tolerance to this med therefore it should not be used frequently. My therapist told me one of her clients had been told to use it as much as she needed by her doctor. As a result she had become addicted to it and had to get help to get off this drug. Be careful - it's a great PRN but I would hesitate to use it daily. You really have to have some self control to use it. It's unfortunate as it is a wonder drug for me too. I heard of people being put on a very mild dose of it daily, but personally I would avoid this as you will constantly need to up the dose as you become tolerant. Just wanted to give a warning as it seems to have been suggested that it can be used as frequenlty as one would like. Take care!


----------



## 14264 (Nov 3, 2005)

i just joined yesterday and i am already relieved so much to hear other people tell my story. years before i was diagnosed with ibs i was sent to a therapist my freshman year of high school because depression and anxiety which was later realized to be a "side effect" of gi problems. i find that when i get stressed out with school or anything else, i have really bad issues a couple of days later. however, sometimes i get anxiety about going out b/c i am worried i am going to have a problem and what usually happens is worrying about the possibility brings on the ibs problems. its kind of a hard irony to deal with. its funny how it gets you when you don't expect it and it gets you when you think it might come. this prolly isn't the best advice but... i find that if i have a couple glasses of wine or beer or whatever a little bit before i go out, i am not as nervous. it really seems to slow down my anxiety and somehow rest up the gi shtuff. i dunno, alcohol is kinda a bad thing for ibs but it helps with the anxiety which can help out the ibs attack prevention


----------



## Twocups424 (Mar 26, 2002)

I understand


----------



## 16173 (Nov 6, 2005)

Hi Everyone!







I am new here also. IBS-D for about six months now. I have begun to notice that I am in a viscious cycle of anxiety/attacks of 'D' myself.







In fact, I am literally at the point to where if anyone around me just slightly raises their voice - my guts all spasm and I feel the need to run to the bathroom.







I have tried breathing slowly and calming myself when this happens, but it doesn't help a lot. Also, going out causes MAJOR anxiety for me too. Even if I feel completely fine - by the time I get dressed and ready to go, my intestines are fluttering like crazy.







For example, the other night I went to the local bar and grill with some friends. As soon as I got in my truck to go up there, my guts went crazy. I know it was all in my head, but I couldn't make it stop. I took an antispasmodic that the doc gave me, and when that didn't slow down the fluttering, I took a vicodin as it was all I could get to at the moment. The vicodin helped some







, but not all the way. My husband has suggested that I also use Xanex. Right now I am scared to take anything because of the effect it might have on my bowel movements







. Does Xanex effect any of you in that way, or do you find it completely safe to use? I just don't know about all this. It does get frustrating





















sometimes. Sorry if I sound whiney - the last couple of days have been hard.


----------



## 13542 (Nov 10, 2005)

I agree with you waterdogs, what comes first the anxiety then the IBS or the IBS then the anxiety about your IBS? I currently am not taking a drug for my anxiety but I was a year ago and I have to say I slept better, felt better and the attacks were not as often. I am considering talking to my Doc about going on Lorazepam again. Suffering today again. Hey, is there anyone from Canada with IBS? You guys are great but I am feeling kind of alone out here.


----------



## overitnow (Nov 25, 2001)

There are lots of us, freelily, including Jeff, the originator of the site. I'm out in Victoria. Where do you live?Mark


----------



## 13542 (Nov 10, 2005)

Overitnow,I live in Winnipeg - nice to know there are others out there.


----------



## 15256 (Nov 17, 2005)

personally for me it was anxiety induced IBS. my family had problems when i was younger and it caused severre stress when i was little and i developed IBS. today whenever im stressed out it happens. if im not stressed, i usually ok.


----------



## 20322 (Aug 28, 2005)

Hey freelily, lots of Canucks on these boards, I am from Toronto Ontario area.


----------



## kitkat17 Lady of the Loo (Jul 21, 2005)

Jezebel. I take Zanax everyday if I have to go out. Sometimes even when I am at home and feeling anxious or nervious. I have been on it for years. It does not give you D at all. It is to help calm you down which in some cases you anxiety makes your D worse. Your story hits me 100%. I hate getting in the car feeling. I do it almost everyday. I hate it.Good lUck and welcome to this site. Great placeTake careKat


----------



## 19821 (Nov 4, 2005)

Im from Canada.I took anxiety pills the first year but for the last 5 i've just done it on my own. IBS-D has changed my whole life, Im not the same person anymore.


----------



## 16584 (Dec 2, 2005)

Hey gang! I came across this thread and am seeking some advice concerning Xanax. I am having serious issues with anxiety/panic attacks, too, ever since October. I cannot leave my house because I'm so scared that I'm going to get sick. Well, I always do because I talk myself into it!!! I couldn't even make my doctor's appt last week. I cancelled it because last time I went in there, I was in the bathroom most of the time and was shaking uncontrollably while the doctor was examining me. Well, that has me so freaked out that I'm afraid it's going to happen again.....well, every time I go in there. Anyway, last time I was there he could tell I was in a panic/anxiety attack and I asked him if I could have xanax or something to help calm me down and he said NO! "It's addictive". Well, what the hell????He's going to have to give me something or I won't ever be able to step foot in the Dr's office ever again!!!!!!!! What is wrong with him???? Obviously I need something to help my anxiety, I am cancelling my appts to see him. I'm sooo ticked.....I don't know what to do.Please help!!Michelle


----------



## 19821 (Nov 4, 2005)

Find a different Doctor.Thats how i started out 6 years ago. IBS/anxiety, You need to get a handle on your anxiety before you can work on the IBS or it just gets out of control.


----------



## 18204 (Oct 10, 2005)

I agree with lovendag, if your doctor is not willing to work WITH you then find another.I just changed docs 3 months ago hoping the new one would be better, well he is not when it comes to IBS so I only have him dealing with my high blood pressure for now.A couple of months ago my wife happened to find this site for me, and after spending several days reading just about every thread on here I decided to try Mike's Audio Program. It was the best $87 usd I had ever spent. I am currently on day 45 of the 100 day program and over the last week or two I realized I have been leaving the house without HAVING to go to the bathroom first and once on the road I did not even think about where any bathrooms were on my route. This is the first time in 20 years I have felt Like I have a chance of getting a life back.


----------



## 16584 (Dec 2, 2005)

Thanks guys! That is some very good news Robby! I have Mike's program, too!! I am on Day 6 (off day)!! So, hopefully by the time I'm on day 45 I will be able to leave my house without freaking out, too!! I'm glad it's working out for you! This is my last hope because I have already switched doctors twice and this one is a complete moron! He's nice, he's just not willing to help. He does think it's in my head and won't give me any good drugs for it, so we'll see. I will do this audio program and see if it's in my head or not!! I just wish I had something to take the edge off until the hypno starts kicking in. I do believe it's helping a little bit, already, but I still have attacks just about everyday. They're just not as INTENSE as they have been before I started the program. Thank you!Michelle


----------



## 16584 (Dec 2, 2005)

I'm still not comfortable leaving my house, though. I still have panic attacks on the road. Did you see results, immediately??....I'm not, but they say it's too early to judge, so I will just wait till the end and see how I'm doing then. Michelle


----------



## 18204 (Oct 10, 2005)

Hi Michelle, I didn't really notice anything until around day 32, I was driving down the road when I suddenly realized that I didn't even think about having to go to the bathroom before I left. I had just walked out of my house jumped in my truck and took off. Now I'm thinking oh, great, now I will probably have one of my panic attacks and start driving like a mad man looking for the nearest bathroom, well, it never happened. When I got home I was so proud of myself. I have not felt that good in a long, long time and every day just keeps getting better and better. Even my BMs are getting better, my D is not as urgent, explosive or as frequent, in fact, this morning my stool was firm, again it was a first for me in a long time. It's funny to say, but I am looking forward to tomorrow morning to see if this keeps up. Sorry if I am rambling but I just get so excited about the changes I am seeing, its like someone just woke me up from a nightmare.The time it takes to start seeing results does vary quite a bit. There is another member on here that is about a week behind me and they posted in the hypnotheropy forum the other day that they had starting to see results and they were on about the same day that I had started to see results. If you are already feeling it then you are way ahead of us, and the best part is each new day will just keep getting better.Please keep us posted with updates on how you are doing.Robby


----------



## 18204 (Oct 10, 2005)

I know what you mean about new docs, I started seeing a new doc just a couple of days before I found this site. So on my first visit I started talking about the IBS and I could see his eyes just glazing over. Have you tried taking calcium to help your D? I started to but my doc made me stop before I could tell if it would help me any.Robby


----------



## 13540 (Aug 18, 2005)

wow iam in the same boat!!!!I get stressed and freak out when my D hits me and i have been obsesing on the color of my stools i go from normal to soft to normal all in one week and somtimes its yellow in color then the heath axiety kicks in ten fold with worry and neg thinking i am on xanxas and lexapro both i only take the zanaxs when i get worked up are scared but i am always wonder if these meds only mask whats really going on?But i must say the zanax do help cut the edge off..


----------



## kitkat17 Lady of the Loo (Jul 21, 2005)

I Have taken Zanax for ever. Started for ulcerated stomach, then for PMS. A 30 day supply would last me about 6months. Now I tak eit everyday. I STILL GET PANIC ATTACKS. It has not gotten rid of mine. Wonder if I need stronger ones? I do take a whole one to sleep better here latelys.


----------



## 16584 (Dec 2, 2005)

Hey Robby! Hey, I would take seeing results on Day 32! That's like in January, I think. I already mapped it out in my book...... and christmas day a whole bunch of people will be coming to my house and I'm already freaking out about it because I don't like for people to see me sick and of course, it makes me panic, and I get sick anyway!!! So, Christmas day will be day 22. So, I probably will still be freaked out, huh?? Hopefully, I will be doing better than I am right now...I cannot handle company right now. That's so awesome that it's working for you, though. It certainly gives me alot of hope!! It's amazing how your subconscious mind can completely take over your body and well your whole life, basically, and make it a living ###$###!! It's good that we are taking the steps to "reprogram our subconscious mind". Otherwise, we would probably be a whole lot worse than we are right now, right??? Well, I will keep you posted on how I am doing and you do the same! Let me know when you're symptom FREE!!! You're right......IBS is like a nightmare and I am ready to be woken up, too!! It's horrible......Take Care!Michelle


----------



## 18204 (Oct 10, 2005)

Hi Forrest, thats another thing I like about Mike's CDs, its not masking your symptoms, its more like training your body to work properly.You can see how others are doing with it in the CBT & Hypnotheropy forum.And you can check out Mike's website at http://www.ibsaudioprogram100.com/index.html


----------



## 16584 (Dec 2, 2005)

Hey Forrest and Kitkat!I wish I had some of that Xanax or whatever you're taking for your attacks!! I don't have anything at the moment because my doctor's an idiot and won't give me anything. I have Levsin but it triggers my GERD, so I can't take it. Good Luck to you and hope you get to feeling better soon!!Michelle


----------



## 16584 (Dec 2, 2005)

OH, Robby!I did take Caltrate Plus for my D, but the calcium carbonate in it gave me horrible stomach cramps. Anything with calcium carbonate in it tears my gut to shreads. I cannot take rolaids, tums, or anything like that. I have to take antacids with aluminum or magnesium. Calcium does not like me!!!My BM's are not that bad, actually. I just have alot of pain and cramping and the biggest thing is the nausea which triggers my panic attacks every single time!!!! I can deal with pain but I cannot deal with nausea. I have Emetophobia BAD!!!! And it sucks having that when I also have a hiatal hernia and GERD!!! I don't eat anything when I think I'm going to get nauseated, which only makes it worse. But, if I throw up I don't want to be throwing up anything with substance like food or whatever....It's horrible having this!! I think that is what triggers every single one of my panic/anxiety attacks which then triggers my D-Attacks!! It's a viscious cycle!!!Michelle


----------



## 16584 (Dec 2, 2005)

Robby, Do you take a soluble fiber supplement? I have been taking Citrucel 3 times a day. Just wondering. Don't know if I would feel comfortable giving it up.Michelle


----------



## 18204 (Oct 10, 2005)

Thats the biggest problem with IBS, what may help one person won't help another or may even make them worse.Try looking at Xmas this way, you will have home field advantage. If you HAPPEN to reach a point were you are not feeling well you could sneak away into your bedroom or somewhere else quiet, then when you feel up to it, return to your guest and if someone has happen to notice you were gone just tell them you had to get something, look for something, put something away or whatever. We had Thanksgiving at our house which made me happy since I wouldn't have to deal with leaving the house, eating to much food and then having to make it back home.Robby


----------



## 16584 (Dec 2, 2005)

That's a good point. I always feel like I have to be the entertainer and when I get sick and have to go lay down, I feel really bad because everyone is just sitting around not knowing what to do....all our family is from New Mexico and North Carolina. We only see them once or twice a year. So, I feel like it just puts even more stress and pressure on me because we don't see them everyday. So, I try to be well when I do get to see them and always end up sick anyway!!


----------



## 18204 (Oct 10, 2005)

If the Citrucel is helping why would you give it up? Maybe, down the road, once you are feeling better with Mike's CDs you could always try stopping it if you felt up to it and see what happens. I tried Citrucel quite some time ago, I don't remember the problems but it did not agree with me. Actually I am not taking anything right now, except a couple of meds for my high blood pressure.


----------



## 18204 (Oct 10, 2005)

Hey Michelle, we should move this conversation to a chat room.


----------



## 16584 (Dec 2, 2005)

Okay, let me know where you move it too. I am new to this whole forum stuff! I am about to go to sleep but I will be back on tomorrow.Talk to ya then!Hope you have a IBS-FREE night!!Michelle


----------



## 18204 (Oct 10, 2005)

Michelle,I wounldn't be moving whats here, what I meant was since we were here at the same time we could go into a chat room and chat directly to each other. If we happen to be here at the same time again I walk you through getting to a chat room here.BTW, I just noticed this in another forum. Its another case of a med that is used for one thing helped something else.http://ibsgroup.org/eve/forums/a/tpc/f/74410261/m/116108271Who knowsLaterRobby


----------



## 13540 (Aug 18, 2005)

well with xanaxs you cant have anytype of grapfruit and my dad was on them for 12 years and he was dumb and stopped then all at once and it put him into sezures i know they are very habit forming so thats why docs dont like to give them out my pcp wouldnt give them to me made me try all diffrent types from paxil zoloft and buspar..Buspar i wouldnt give to no body them meds gave me crazy dreram made my hands sweat even worse but the lexapro seems to be working pretty good the xanaxs i take are 1mg i only take one a day there is know ay i can take three a day like it says i would be like a zombie but when my stomach and bowells go into over drive my hands begain to sweat real bad i dont know if anyone else does these with there ibs are if it could be axiety...


----------



## eric (Jul 8, 1999)

The Science Of Anxiety --------------------------------------------------------------------------------FYITIMEThe Science Of Anxiety Why do we worry ourselves sick? Because the brain is hardwired for fear, and sometimes it short-circuits By CHRISTINE GORMANJun. 10, 2002 It's 4 a.m., and you're wide awake â€” palms sweaty, heart racing. You're worried about your kids. Your aging parents. Your 401(k). Your health. Your sex life. Breathing evenly beside you, your spouse is oblivious. Doesn't he â€” or she â€” see the dangers that lurk in every shadow? He must not. Otherwise, how could he, with all that's going on in the world, have talked so calmly at dinner last night about flying to Florida for a vacation?How is it that two people facing the same circumstances can react so differently? Why are some folks buffeted by the vicissitudes of life while others glide through them with grace and calm? Are some of us just born more nervous than others? And if you're one of them, is there anything you can do about it?The key to these questions is the emotional response we call anxiety. Unlike hunger or thirst, which build and dissipate in the immediate present, anxiety is the sort of feeling that sneaks up on you from the day after tomorrow. It's supposed to keep you from feeling too safe. Without it, few of us would survive. All animals, especially the small, scurrying kind, appear to feel anxiety. Humans have felt it since the days they shared the planet with saber-toothed tigers. (Notice which species is still around to tell the tale.) But we live in a particularly anxious age. The initial shock of Sept. 11 has worn off, and the fear has lifted, but millions of Americans continue to share a kind of generalized mass anxiety. A recent TIME/CNN poll found that eight months after the event, nearly two-thirds of Americans think about the terror attacks at least several times a week. And it doesn't take much for all the old fears to come rushing back. What was surprising about the recent drumbeat of terror warnings was how quickly it triggered the anxiety so many of us thought we had put behind us.This is one of the mysteries of anxiety. While it is a normal response to physical danger â€” and can be a useful tool for focusing the mind when there's a deadline looming â€” anxiety becomes a problem when it persists too long beyond the immediate threat. Sometimes there's an obvious cause, as with the shell-shocked soldiers of World War I or the terror-scarred civilians of the World Trade Center collapse. Other times, we don't know why we can't stop worrying.There is certainly a lot of anxiety going around. Anxiety disorder â€” which is what health experts call any anxiety that persists to the point that it interferes with one's life â€” is the most common mental illness in the U.S. In its various forms, ranging from very specific phobias to generalized anxiety disorder, it afflicts 19 million Americans (see "Are You Too Anxious?").And yet, according to a survey published last January by researchers from UCLA, less than 25% of Americans with anxiety disorders receive any kind of treatment for their condition. "If mental health is the stepchild of the health-care system," says Jerilyn Ross, president of the Anxiety Disorders Association of America, "then anxiety is the stepchild of the stepchild."Sigmund Freud was fascinated with anxiety and recognized early on that there is more than one kind. He identified two major forms of anxiety: one more biological in nature and the other more dependent on psychological factors. Unfortunately, his followers were so obsessed with his ideas about sex drives and unresolved conflicts that studies of the physical basis of anxiety languished.In recent years, however, researchers have made significant progress in nailing down the underlying science of anxiety. In just the past decade, they have come to appreciate that whatever the factors that trigger anxiety, it grows out of a response that is hardwired in our brains. They have learned, among other things:--There is a genetic component to anxiety; some people seem to be born worriers.--Brain scans can reveal differences in the way patients who suffer from anxiety disorders respond to danger signals.--Due to a shortcut in our brain's information-processing system, we can respond to threats before we become aware of them.--The root of an anxiety disorder may not be the threat that triggers it but a breakdown in the mechanism that keeps the anxiety response from careering out of control.Before we delve into the latest research, let's define a few terms. Though we all have our own intuitive sense of what the words stress and fear mean, scientists use these words in very specific ways. For them, stress is an external stimulus that signals danger, often by causing pain. Fear is the short-term response such stresses produce in men, women or lab rats. Anxiety has a lot of the same symptoms as fear, but it's a feeling that lingers long after the stress has lifted and the threat has passed.In general, science has a hard time pinning down emotions because they are by nature so slippery and subjective. You can't ask a rat if it's anxious or depressed. Even most people are as clueless about why they have certain feelings as they are about how their lungs work. But fear is the one aspect of anxiety that's easy to recognize. Rats freeze in place. Humans break out in a cold sweat. Heartbeats race, and blood pressure rises. That gives scientists something they can control and measure. "You can bring on a sensory stimulus that makes an animal â€” or human â€” fearful and study its effects," says Dr. Wayne Drevets of the National Institute of Mental Health (NIMH). "Then you can take the stimulus away and see how the animal calms down."Indeed, a lot of what researchers have learned about the biology of anxiety comes from scaring rats and then cutting them open. Just as the Russian physiologist Ivan Pavlov showed 100 years ago that you could condition a dog to salivate at the sound of a bell, scientists today have taught rats to fear all kinds of things â€” from buzzers to lights â€” by giving them electrical shocks when they hear the buzzer or see the light. The animals quickly learn to fear the stimulus even in the absence of a shock. Then researchers destroy small portions of the rats' brains to see what effect that has on their reactions (an experiment that would be impossible to conduct in humans). By painstakingly matching the damaged areas with changes in behavior, scientists have, bit by bit, created a road map of fear as it travels through the rat's brain.The journey begins when a rat (we'll get to humans later) feels the stress, in this case an electric shock. The rat's senses immediately send a message to the central portion of its brain, where the stimulus activates two neural pathways. One of these pathways is a relatively long, circuitous route through the cortex, where the brain does its most elaborate and accurate processing of information. The other route is a kind of emergency shortcut that quickly reaches an almond-shaped cluster of cells called the amygdala.What's special about the amygdala is that it can quickly activate just about every system in the body to fight like the devil or run like crazy. It's not designed to be accurate, just fast. If you have ever gone hiking and been startled by a snake that turned out to be a stick, you can thank your amygdala. Joseph LeDoux, a neuroscientist at New York University, calls it "the hub in a wheel of fear."But while the amygdala is busy telling the body what to do, it also fires up a nearby curved cluster of neurons called the hippocampus. (A 16th century anatomist named it after the Greek word for seahorse.) The job of the hippocampus is to help the brain learn and form new memories. And not just any memories. The hippocampus allows a rat to remember where it was when it got shocked and what was going on around it at the time. Such contextual learning helps the poor rodent avoid dangerous places in the future. It probably also helps it recognize what situations are likely to be relatively safe.By this point, the other half of the stress signal has reached the cortex, which confirms that there's a danger present and figures out that it's causing pain. Once the shock has warn off, a part of the brain called the prefrontal cortex sends out an all-clear message and lets the amygdala know that it's O.K. to stand down. At least it's supposed to. It seems that it's harder to turn off a stress response than to turn it on. This makes sense, in terms of survival. After all, it's better to panic unnecessarily than to be too relaxed in the face of life-threatening danger.Discovering this basic neural circuitry turned out to be a key breakthrough in understanding anxiety. It showed that the anxiety response isn't necessarily caused by an external threat; rather, it may be traced to a breakdown in the mechanism that signals the brain to stop responding. Just as a car can go out of control due to either a stuck accelerator or failed brakes, it's not always clear which part of the brain is at fault. It may turn out that some anxiety disorders are caused by an overactive amygdala (the accelerator) while others are caused by an underactive prefrontal cortex (call it the brake).It may also be that an entirely different part of the brain holds the key to understanding anxiety. Michael Davis, a behavioral neuroscientist at Emory University in Atlanta, has spent six years studying a pea-size knot of neurons located near the amygdala with an impossible name: the bed nucleus of the stria terminalis, or BNST. Rats whose BNST has been injected with stress hormones are much jumpier than those that have got a shot in their amygdala. Could the BNST be at the root of all anxiety disorders? The clues are intriguing, but as scientists are so fond of saying, more research is needed.Of course, what you would really like to know is whether any of the work done in rats applies to humans. Clearly researchers can't go around performing brain surgery on the amygdalas of living patients to see if it affects their anxiety levels. But the fascinating case of a woman known only by her research number, SM046, suggests that when it comes to fear, rodents and hominids really aren't so different.Owing to an unusual brain disorder, SM046 has a defective amygdala. As a result, her behavior is abnormal in a very particular way. When scientists at the University of Iowa show SM046 pictures of a series of faces, she has no trouble picking out those that are happy, sad or angry. But if the face is displaying fear, she cannot recognize the feeling. She identifies it as a face expressing some intense emotion, but that is all. Her unusual condition strongly suggests that even in **** sapiens, fear takes hold in the amygdala. But studying brain-damaged patients can teach scientists only so much. They would also like to know how anxiety works in normal, intact brains. For this, brain scans have proved invaluable. For years, doctors have used CAT scans and MRIs to help them diagnose strokes, brain tumors and other neurological conditions. But as the technology has become more sophisticated, researchers have started to employ it to tease out some of the subtle changes associated with mental illness. "We're not yet able to use these scans in a diagnostic way," says Dr. David Silbersweig of the Weill Cornell Medical College in New York City. "But we're getting pretty specific about the areas of the brain that are implicated in a number of psychiatric disorders."One type of brain scan helps identify structures that are the wrong size or shape. Two years ago, researchers at the University of Pittsburgh showed that the amygdalas of a group of overanxious young children were, on average, much larger than those of their unaffected peers. Perhaps they just had more fear circuits to contend with? Neuroscientists are tempted to say yes, but they admit the conclusion is pretty speculative. Another group of researchers found that patients with post-traumatic stress disorder had a smaller hippocampus than normal. Perhaps their stressful experiences had somehow interfered with the hippocampus' ability to make new memories and, just as important, forget the old ones? Again, no one knows for sure.Another type of brain scan tells scientists which brain cells are using the most oxygen or soaking up the most nutrients. The idea, explains Dr. Scott Rauch of Massachusetts General Hospital, is that any area that seems more active than usual while someone is anxious may play an important role in making the person that way. Rauch's team has spent the past eight years scanning groups of combat veterans, some with post-traumatic stress disorder and some without, to see which areas of the brain light up when they hear tapes recounting their most troubling memories. So far, the signals in the amygdala appear to be more active in those with PTSD than in those without. In addition, signals to the prefrontal cortex of PTSD subjects seem to be weaker than in those without the disorder. Perhaps this explains why the patients still feel threatened even when they are perfectly safe.The next step, Rauch says, is to scan groups of people who are likely to be thrust into dangerous situations â€” fire fighters, say, or police officers. Then it may be possible to determine if any changes in their brains are the result of traumatic situations or if the changes predate them. Either is plausible. The stress of surviving a building collapse, for example, could turn a normal amygdala into an overactive one. Or an already overactive amygdala may overwhelm the brain in the wake of a disaster.Eventually, researchers would like to learn what role our genes, as opposed to our environment, play in the development of anxiety. "It has been known for some time that these disorders run in families," says Kenneth Kendler, a psychiatric geneticist at Virginia Commonwealth University in Richmond, Va. "So the next logical question is the nature-nurture issue." In other words, are anxious people born that way, or do they become anxious as a result of their life experiences?Kendler and his colleagues approached the question by studying groups of identical twins, who share virtually all their genes, and fraternal twins, who, like any other siblings, share only some of them. What Kendler's group found was that both identical twins were somewhat more likely than both fraternal twins to suffer from generalized anxiety disorder, phobias or panic attacks. (The researchers have not yet studied twins with post-traumatic stress disorder or obsessive-compulsive disorder.)The correlation isn't 100%, however. "Most of the heritability is in the range of 30% to 40%," Kendler says. That's a fairly moderate genetic impact, he notes, akin to the chances that you will have the same cholesterol count as your parents. "Your genes set your general vulnerability," he concludes. "You can be a low-vulnerable, intermediate-vulnerable or a high-vulnerable person." But your upbringing and your experiences still have a major role to play. Someone with a low genetic vulnerability, for example, could easily develop a fear of flying after surviving a horrific plane crash.There is plenty to learn about how anxiety and fear shape the brain. One of the biggest mysteries is the relationship between anxiety and depression. Researchers know that adults who suffer from depression were often very anxious as children. (It's also true that many kids outgrow their anxiety disorders to become perfectly well-adjusted adults.) Is that just a coincidence, as many believe, or does anxiety somehow prime the brain to become depressed later in life? Brain scans show that the amygdala is very active in depressed patients, even when they are sleeping. Studies of twins suggest that many of the same genes could be involved. "There's a lot of overlap," says Dr. Dennis Charney, chief of the research program for mood and anxiety disorders at the NIMH. "Anxiety and depression have a similar underlying biology, and the genetics may be such that anxiety surfaces early in life and depression later on." Still, no one can say for sure.Certainly antidepressants, like the serotonin reuptake inhibitors (Prozac and others) have proved very helpful in treating anxiety; some doctors think they are even more effective against anxiety than they are against depression. Although no one knows exactly why these antidepressants work, one important clue is that their effects don't show up until after a few weeks of treatment. The pathways for toning down anxiety are apparently much more resistant than those for ratcheting it up.It's a mistake, however, to think that pills alone can soothe your neurochemistry. Remember the cortex? That's where you would expect psychotherapy to work, increasing the repertoire of calming messages that can be passed along to the amygdala. Certain desensitization techniques can also help the brain learn, through the hippocampus, to be less reactive. Of course, you have to do it right. Reliving a trauma too soon after it happened could also make the memory harder to erase.There are no guidebooks to tell you when it's safe to venture out again. In many ways, the whole country last September was made part of an unwitting experiment in mass anxiety. Our brains are even now in the process of rewiring themselves. How successfully we navigate this delicate transition will depend a lot on our genes, our environment and any future attacks. â€” Reported by Alice Park/Bethesda, Leslie Whitaker/Chicago and Dan Cray/Los Angeles


----------



## 16584 (Dec 2, 2005)

Hey, Robby! OH, I understand we wouldn't be moving what's here. I just thought you were going to start a different topic thread in a different forum on the hypnosis or whatever. I didn't know you were talking about an actual chat room.....Anywhooo.....It's very interesting that you posted that thread about the antihistimines. I was talking to one of my friends on a different forum that has IBS/anxiety and she's pregnant with twins and her doctor told her to take Unisom for morning sickness. So, of course I have been taking Unisom, too.....OH, yea as soon as she told me that it helped her nausea, I ran to the store and bought a bunch of it!!! It does help. Isn't that wild?!? I take 1/2 three times a day and 1 whole one at bedtime (like my friend was told to do by her MD) and it does help. I still get nausea spells but they're not as bad. I want to find something to kick it for good!! I don't want ANY NAUSEA at all!!! LOL!!! Maybe I should just take another 1/2 tablet when the nausea kicks in or something like that.Thanks for that post!Michelle


----------



## 18204 (Oct 10, 2005)

Hi Michelle,At first I wasn't sure if Mikes tapes would help with nausea but after reading Erics post above I don't see why they wouldn't. How long have you been doing the Unisom? Since you were worried about Xmas I take it that it is not helping quite enough. Just keep telling yourself that by the time Xmas gets here Mikes tapes will help you take care of what the Unisom does not and you will have a great day with the family.Robby


----------



## eric (Jul 8, 1999)

A side effect in using Mike's tapes is reduced anxiety. But HT also works on IBS physically.In the above post you'll notice the fight or flight responce.What is the "fight or flight response?"http://www.thebodysoulconnection.com/Educa...nter/fight.htmland what does this have to do with IBS. This is one of the worlds top neurogastroenterologists studying IBS."The Neurobiology of Stress and EmotionsBy: Emeran A. Mayer, M.D., UCLA Mind Body Collaborative Research Center, UCLA School of Medicine, California We often hear the term "stress" associated with functional gastrointestinal (GI) disorders, such as irritable bowel syndrome (IBS). Many patients experience a worsening of symptoms during times of severely stressful life events. But what is stress? How often does it occur? How does our body respond to stress? This article explores the mechanisms that link stress and emotions to responses that have evolved to ensure survival and that, in the modern world, affect healthâ€"including gastrointestinal function. "http://www.aboutibs.org/Publications/stress.htmlThe fight or flight also has to do with parasympathetic and sympathetic nervous system function.The autonomic nervous system helps control and run digestionThe ANS is most important in two situations:In emergencies that cause stress and require us to"fight" or take "flight" (run away) andIn nonemergencies that allow us to "rest" and "digest."http://faculty.washington.edu/chudler/auto.html


----------



## 16584 (Dec 2, 2005)

Yea, I think the hypno helps with the nausea, too. I have only learned about the Unisom since last week. So, maybe I just need to give it more time. I found out this morning that I cannot take it on an empty stomach!!! I took a whole one (not the usual half) this morning on an empty stomach (which I haven't done before either) and I almost threw up!! It made my stomach hurt sooo bad......I actually got severely nauseated which triggered a panic attack and then I had a D attack!!! So, I took some Imodium and Pepto and laid back down for an hour and I'm okay, now. Won't ever do that again!!!! That Hurt!!!Michelle


----------



## knothappy (Jul 31, 1999)

My dr. changed me from Xanax to Klonopin. he said it lasts longer,but works the same. He seemed afraid to give Xanax even though he only gave me 30 days supple with no refill and I had to come back in 6 months for another,>>>> maybe my imagination,but the Klonopin does not work as well.


----------



## 16584 (Dec 2, 2005)

My doctor would not give me Xanax, either! So, maybe if I ask him about the klonopin, he "might" give me some of that. Probably not!! Worth a shot, though. Thanks for your input!Michelle


----------



## 18204 (Oct 10, 2005)

Hi Michelle,How are you doing? How are the tapes going? Are you still worried about Xmas or have you been able to get yourself excited about it?Robby


----------



## 16584 (Dec 2, 2005)

Hey Robby,I'm on day 8 and I actually had a viscious attack yesterday evening AND this morning. I couldn't even eat until 12:00 today. I feel pretty crappy!! Well, I guess I'm okay right now but I had to take 3 Imodium this morning and about 4 pepto to stop the BM!!! It wouldn't stop. I don't know why I'm having a setback......It sucks, though!So, needlesstosay, I'm definitely NOT feelin' any better about christmas so far!!How 'bout you??? How are you doing with your hypno?? Any ideas why I am having these attacks?? I was doing better!!Michelle


----------



## 18204 (Oct 10, 2005)

Hi Michelle,Sorry to here about the tough time you had. I really hope you start feeling better so you can look forward to Xmas and seeing the family. oh, did you see the thread about Aloe juice in the OTC forum, might be worth looking into for a quick fix. Marilyn or Eric know more about the tapes than I do but I have a feeling that your feeling better so early in the program may just be a coincidence. Just don't give up, you know the program WILL work for you, think positive.The way you are feeling right now I almost hate to say it but for me the tapes have become my miracle. I tested myself yesterday by getting in my car at 8:15am and ran a couple of errands and got back home at 10am without any problems, this may not sound like a big deal to the average joe but I have not left my house before 11am in 4 years. Everytime I need to make an appt to see the doc or anyone else my line is automatically "afternoons works better for me"Well, I will be heading out in a couple of minutes to meet up with some friends at a local bar for chicken wings and a few cold beers. I will probably be back around 7 or 8.LaterRobby


----------



## 16584 (Dec 2, 2005)

Drink one for me!! I miss my Bud Light more than life, itself!! I haven't drank in over 2 years!!!Wahhhhhhh!!!! I am taking aloe juice now. I think that I might have drank too much of it, yesterday. Maybe that's why I had the D attack, today!! But, see I also have a hiatal hernia with GERD on top of my IBS-D!!!! So, I try soo much #### to get rid of my reflux that I never know how it's gonna come out the other end!!! And then the foods that work better on my D, give me reflux!! It's a viscious cycle, I tell ya!!! It really sucks having both GERD AND IBS!!! I have to fix problem #1 before I can work on problem #2. Hopefully, this is where the hypno will give me a hand. Hopefully!!Have fun! I haven't left my house....in...ummmm....I don't know how long, now. I can't leave. I always feel like I'm gonna puke when I walk out the door. Michelle


----------



## miranda (Apr 16, 2004)

hi,i found the combination of meds and therapy (cbt specific) to be the most helpful with my ibs-D. partway thru my therapy i went on lexapro/clonazepam for 3 months. my anxiety was just too high for the cbt to be effective. once i was calmer i was able to resume cbt and really benefit from it.i would highly recommend seeking a cbt therapist and supplementing meds short term if needed. we did some work from this bookhttp://www.amazon.com/gp/product/157230135...=books&v=glancei have gone for approx 15 sessions now in 6 months, its amazing to compare my 'poop diary' from then and now. no one understands the joy of normal poop like a person with ibs!m


----------



## 16584 (Dec 2, 2005)

Well, after I cancelled my doctor's appt for the 3rd time on Tuesday the doctor that wouldn't give me ANYTHING for my anxiety FINALLY gave me 15 Xanax pills and told me to get an appt with a psychiatrist. Does anyone know what the psychiatrist will try to start me on for my anxiety?? Xanax isn't a long-term anti-anxiety, right?? I couldn't take Buspar because it triggered IBS-D attacks. So, he (reg MD) took me off of it. I haven't taken any of the Xanax yet. Any bad side effects that I should know about?? Thank you for all your support!Michelle


----------

