# the chicken or the egg?



## AlmostFamous (Apr 11, 2004)

I really believe that if I knew my stomach wasn't going to freak on me when I go out to events and such, that I wouldn't have anxiety attacks. Some think my anxiety attacks are causing the stomach freakouts, but I really believe it is the former because the panicking didn't start till all my tummy trouble started up. It's because I haven't narrowed down the final causes for me of what causes D or nausea spells so there is a fear that something will start up down there when I'm out.Just wondering what everyone else felt?


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## Maria Z (Feb 20, 2001)

AlmostFamous,If you check the 5HT3 forum, you'll find that many people who take Lotronex or other antidiarrheal meds will tell you the same thing. There is definitely a mind/gut connection. Doctors know that now. They also know, however, that serotonin (the hormone found in your brain) is only present 5% in the brain and 95% in the gut! Therefore, if serotonin levels are out of whack in your gut, you can either have IBS D or IBS C depending on how the serotonin reacts on the receptors in your gut.I know that if you haven't heard about this stuff before, it can be difficult to understand. However, being a member of the Lotronex Action Group, I think I'm close to getting my honorary degree in IBS studies.Just thought I share with you that yes, your gut could be the cause of your anxiety problems and not the other way around. For too many years, doctors told us it was all in our heads. They are now learning that this is not the case. Yes, stress can be a trigger to IBS symptoms, but it is NOT the cause of our IBS. They keep learning more and more about this every day, and it's about time as far as I'm concerned.Maria


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## editor (Jun 20, 2004)

Hi Almost Famous,I think the fear of all those what ifs can certainly escalate anxiety. Some anxiety triggers are obvious: eek! being chased by a bear; having to give a presentation at work; associating a difficult & stressful period with a place, person or food stuff. Sometimes, people can go through a period of major stress, and the anxiety comes *after* the event. It's almost as if at the time, your body goes into "I have to deal with this now" protection mode, and then later, when the danger has passed, that's when you can allow yourself to be anxious.And, like you said, if you've been out and about and had an attack of IBS then it's very hard to fight against "what if it happens again?"I think there are two modes of attack here: one, try to manage the distressing symptoms of IBS as much as you can. This will gradually allow you to build up confidence to go out and do things. Also, try and get to the root of your anxiety. That can be very difficult to do. With an anxiety response, thoughts = physical reaction (**unless** there's an underlying medical cause; get your doctor to check you out.) If you were watching a scary film, for example, your heart might start to pound. What is it about the film that sets you off? The music? The effects? The suspense? Everything? Now see, if you say "everything" that's too vague, so, go back a step to each section. "Bah, I'm a paramedic. I've seen far worse things than *that* in my job!" - ok, so it's not the effects. Scary music? Hrmm...is that it? What is it about the music that sets you off? And keep going 'till you get to the cause. Keep a diary at first and on each page, draw an "anxiety thermometer" - 0 is you're pretty chilled, 10 would be a full blow anxiety attack. You'll notice that anxiety ebbs and flows: people cannot remain in a highly anxious state 24 hours a day, even if it feels like it.







When you feel yourself hitting a 6 (or wherever it happens to be for you) try and write down your thoughts. You'll gradually see a link between thoughts = physical reaction. If you have trouble at first (and it is hard) try and get someone to help you.Also, look for the *evidence* to support how you're feeling. Saying: "But that's how I feel!" won't help you. Why do you feel like you are - before, during and after the event? Do you see? It's a bit hard to explain, heh. Example:#aim: I will attempt to leave the house today.[anx. therm = 4 thinking about it]# action - reaching for your coat, putting your shoes on.[anx. therm = 6]# thoughts: pops into your head as you are putting your coat on etc: eek! I think I need to go to the toilet. But I've just been! Nope, I really need to go. [so you go drop your coat in the hallway, and race to the loo]*thoughts crowd in and physical feelings mount up:*man! I can't even leave the apartment! Am I ever going to get out of the bathroom?!I feel really unwell. My gut's gone into meltdown. [anx. therm. whilst on the loo = 8]thought: I'm useless!That's it! If I can't leave the house without my gut playing up, Im not going out at all![anx. therm = 10]Compare that, to this: aim: today, I'm going to go just outside my front door and no further. I'll keep the door open behind me. I'm going to be safe. Nothing bad will happen to me.action: putting on shoes. [anx therm = 4]action: about to open door [anx.therm = 6] I need the loo! [Ok, so go to the loo, but keep telling yourself, you're only going to just go outside your front door. You can do it!thought: what if I can't even open the door?!##challenge thought## I will be able to open the door, and nothing bad will happen. I can stand outside the open door, and I will be fine.Actually do it.Once you've done it, and achieved your aim, note how you feel anxiety wise. It *does* come down. It's not pleasant, but it does come down.


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## AlmostFamous (Apr 11, 2004)

I'm definitely going to keep a diary of anxiety. I had started to do that, and then stopped. I think that's a really good idea! Then maybe I can write down how I calmed myself down too. Thanks for the idea!


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