Overcoming Anxiety: Navigating Life with Gastrointestinal Issues

Easily anxious?

Hello Doctor,
I apologize for bothering you, but I have been experiencing issues that are affecting my daily life.

1.
When I was a child, I had an all-you-can-eat experience where I may have overeaten, which made my stomach feel strange.
I thought drinking some water and burping might help, but I felt very uncomfortable emotionally and ended up vomiting shortly after.
2.
After that incident, I developed a bit of an aversion to food and became hesitant to eat too much.
I also became reluctant to drink water, which led to avoiding graduation trips, outings with friends, and using public transportation (fearing that I might suddenly feel anxious and vomit, causing trouble for others, and worrying about being judged).
3.
During college, I sought counseling and gradually overcame some of these issues.
However, recently, due to the demands of shift work, I am unsure if my irregular meal times and increased stress are contributing to my discomfort.
Last November, when I went out to eat with friends, my stomach started feeling uncomfortable again, reminding me of that past experience.
I consulted a Western doctor and took medication for my stomach, which showed some improvement (I had mild gastritis).
I am currently seeing a Traditional Chinese Medicine practitioner for treatment, but I feel that psychological factors play a significant role.
I often find myself worrying about what would happen if I vomited, regardless of the situation.
Whenever my stomach feels slightly uncomfortable, I start to panic.
Recently, I feel this has worsened; sometimes during meals, I feel nauseous, and I worry about not being able to go to work and causing inconvenience to others.
This leads to a lot of negative thoughts, and I dislike feeling this way.
4.
I want to confirm whether I might have autonomic nervous system dysregulation.
I have noticed that I frequently experience symptoms such as cold hands and, at times, severe shaking and weakness.
However, when I am not experiencing these episodes, I feel fine.
I wonder if my ongoing issues are related to shift work, irregular meals, late nights, and my tendency to overthink and become anxious.
I apologize for not articulating my situation well, but since that incident in my childhood, it has impacted me up to now, and I feel I have not fully overcome it.
I would like to ask if it would be better for me to see a doctor or seek counseling.
Thank you, Doctor.

Lin, 20~29 year old female. Ask Date: 2023/01/02

Dr. Wu Enliang reply Psychiatry

If it is indeed affecting your daily life, it is advisable to seek medical assistance from a specialist.
If you don't mind paying out of pocket, many medical institutions also have autonomic nervous system measurement devices available for testing.
Dr.
Wu Enliang.

Reply Date: 2023/01/02

More Info

Navigating life with anxiety and gastrointestinal issues can be incredibly challenging, especially when past experiences have left a lasting impact on your mental and physical health. Your description highlights a common interplay between anxiety and gastrointestinal symptoms, which can create a cycle that is difficult to break.
From what you've shared, it seems that your initial experience of vomiting after overeating as a child has led to a heightened sensitivity to bodily sensations, particularly those related to your stomach. This is not uncommon; many individuals who have had traumatic experiences related to food or digestion develop a fear of similar situations occurring again. This can manifest as anticipatory anxiety, where the fear of vomiting or feeling unwell leads to avoidance behaviors, such as not eating certain foods or avoiding social situations where food is involved.

Your concerns about your gastrointestinal health are valid, especially since you have experienced symptoms like nausea and discomfort that trigger anxiety. It's important to recognize that anxiety can exacerbate gastrointestinal issues, leading to a cycle where anxiety causes physical symptoms, which in turn increases anxiety. This is often referred to as a psychosomatic response, where psychological factors manifest as physical symptoms.

Given your history and current symptoms, it would be beneficial to consult with both a gastroenterologist and a mental health professional. A gastroenterologist can help rule out any underlying gastrointestinal conditions that may be contributing to your symptoms, such as gastritis or functional dyspepsia. They can also provide treatment options to manage your symptoms, such as dietary changes or medications.

On the mental health side, a therapist or counselor can help you work through your anxiety and develop coping strategies. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders, as it helps individuals identify and challenge negative thought patterns and develop healthier responses to anxiety-provoking situations. Exposure therapy, a component of CBT, may also be useful in gradually desensitizing you to the fears associated with eating and social situations.

Additionally, it may be helpful to explore relaxation techniques, such as mindfulness meditation, deep breathing exercises, or yoga. These practices can help reduce overall anxiety levels and improve your ability to cope with stress. Regular physical activity can also be beneficial, as it releases endorphins that improve mood and reduce anxiety.

Regarding your concerns about autonomic nervous system dysregulation, symptoms like cold hands and shaking can indeed be related to anxiety. The autonomic nervous system controls involuntary bodily functions, and anxiety can lead to an overactive sympathetic nervous system response, resulting in physical symptoms. A healthcare professional can help assess whether your symptoms are related to anxiety or if there may be other underlying issues that need to be addressed.

In summary, it is crucial to approach your situation holistically, addressing both the physical and psychological aspects of your health. Seeking help from both medical and mental health professionals can provide you with the support and tools needed to manage your symptoms effectively. Remember, you are not alone in this journey, and with the right support, it is possible to regain control over your life and health.

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