Anxiety: Overcoming Nausea and Avoidance Behavior

Anxiety disorder. Frequently feels nauseous and has the urge to vomit?

I tend to be easily anxious, feeling uncomfortable when going out, taking public transportation, traveling, or during exams.
I often feel down and worry about many small details, fearing discomfort while outside, which leads me to avoid these situations.
When I get anxious, I feel like vomiting, although I have never actually vomited.
This has been going on for two years, and I am currently on medication.
Do these symptoms align with an anxiety disorder? What methods can help improve this condition?

Ms. Lu, 10~19 year old female. Ask Date: 2019/04/15

Dr. Tang Jiahong reply Psychiatry

Hello.
When experiencing symptoms of nausea and the urge to vomit, it is typically recommended to first consult a gastroenterologist to rule out any gastrointestinal issues.
If no problems are found, then it may be considered that the symptoms could be related to a psychological cause.
Symptoms of anxiety disorders indeed include nausea and the sensation of wanting to vomit during times of tension.
With appropriate pharmacological treatment to improve the condition, as well as non-pharmacological therapies such as relaxation training, significant improvement in both the psychological and physical symptoms of anxiety disorders can be expected.
Feel free to come in for a consultation and discussion.
Thank you!

Reply Date: 2019/04/15

More Info

Your experiences and feelings are indeed indicative of anxiety, particularly when you describe symptoms such as nausea, avoidance behavior, and a tendency to feel uncomfortable in various situations like traveling, taking exams, or even just going out. These are common manifestations of anxiety disorders, which can significantly impact daily life and overall well-being.

Anxiety disorders encompass a range of conditions, including Generalized Anxiety Disorder (GAD), Panic Disorder, and Social Anxiety Disorder, among others. The symptoms you describe, such as feeling tense, worrying excessively about small details, and experiencing physical symptoms like nausea when faced with stressful situations, align closely with these disorders. The fact that you have been experiencing these symptoms for two years suggests that it may be beneficial to seek a comprehensive evaluation from a mental health professional if you haven't already.

In terms of treatment, medication can be an effective part of managing anxiety. Common medications include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and beta-blockers like Inderal (propranolol), which can help manage physical symptoms of anxiety, such as rapid heartbeat and tremors. However, medication alone may not be sufficient for long-term management. It is often most effective when combined with psychotherapy.

Cognitive Behavioral Therapy (CBT) is one of the most effective forms of therapy for anxiety disorders. CBT helps individuals identify and challenge negative thought patterns and behaviors that contribute to anxiety. It also teaches coping strategies and relaxation techniques that can help manage symptoms in the moment. Exposure therapy, a component of CBT, gradually exposes individuals to the situations they fear in a controlled manner, helping them to build tolerance and reduce avoidance behavior over time.

Mindfulness and relaxation techniques, such as deep breathing exercises, progressive muscle relaxation, and meditation, can also be beneficial. These practices can help ground you in the present moment and reduce the physiological symptoms of anxiety, such as nausea and tension.

Additionally, lifestyle changes can play a significant role in managing anxiety. Regular physical activity, a balanced diet, adequate sleep, and reducing caffeine and alcohol intake can all contribute to improved mental health. Engaging in social activities, even when it feels uncomfortable, can also help reduce feelings of isolation and avoidance.

It's important to remember that recovery from anxiety is often a gradual process, and setbacks can occur. However, with the right combination of medication, therapy, and self-care strategies, many individuals find significant relief from their symptoms and can lead fulfilling lives.

If you are currently on medication, it is crucial to maintain open communication with your healthcare provider about your symptoms and any side effects you may be experiencing. They can help adjust your treatment plan as needed and provide additional resources or referrals to mental health professionals.

In summary, your symptoms do align with anxiety disorders, and there are various methods to improve your situation. A combination of medication, therapy, lifestyle changes, and self-care strategies can significantly enhance your quality of life and help you manage your anxiety more effectively. Don't hesitate to reach out for support and guidance from healthcare professionals who can assist you on your journey to feeling better.

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