Managing Anxiety-Induced Nausea: Insights and Solutions

Issues related to anxiety and nausea?

Hello, Doctor.
I have some questions I would like to ask you: Current situation: When I eat a little too much, I feel a tightness in my throat (around the junction of my head and neck) and have the urge to vomit.
I also feel a bit nauseous while brushing my teeth or taking a shower.
Additionally, I have an increased production of saliva (not sure if it's just more saliva?), and the urge to vomit is most severe during brushing my teeth, showering, and after meals, leading to several instances of spitting.
I have been seeing a traditional Chinese medicine practitioner for about six months, taking herbal medicine and decoctions, and I am currently reducing the dosage.
I have noticed some improvement compared to before starting the medication, but I am not completely better.
My question is: how can I resolve my current situation? I am worried that it might worsen when school starts again, as I tend to feel particularly uncomfortable when I am anxious, such as before exams, but I feel much better after the exams.
The traditional Chinese medicine practitioner mentioned that herbal medicine can only help to a certain extent.
However, I am hesitant to see a psychiatrist (I had consulted one before starting traditional Chinese medicine, but the side effects of psychiatric medications were a bit frightening, which is why I sought help from traditional Chinese medicine).

Nìmíng, 20~29 year old female. Ask Date: 2023/01/30

Dr. Qiu Junda reply Psychiatry

Hello.
Feeling nervous and nauseous before an exam are symptoms of anxiety.
You can start by searching online for information on overcoming nervousness and learn some non-pharmacological methods, such as deep breathing and progressive muscle relaxation techniques.
If these methods do not yield significant results, it is advisable to consult a psychiatrist for further improvement.
You can also discuss your concerns about side effects with the doctor, who will assess and try to minimize them.

Reply Date: 2023/01/30

More Info

Managing anxiety-induced nausea can be quite challenging, especially when it interferes with daily activities such as eating and personal hygiene. Your symptoms of throat tightness, nausea, and increased salivation during stressful situations are common manifestations of anxiety. It’s important to understand that anxiety can trigger a range of physical symptoms, including gastrointestinal distress, which can exacerbate feelings of nausea.

Firstly, it’s commendable that you have sought help from a traditional Chinese medicine (TCM) practitioner and have noticed some improvement. TCM often focuses on balancing the body's energy and can be effective for some individuals. However, if your symptoms persist or worsen, it may be beneficial to consider a more comprehensive approach that includes both TCM and Western medicine.

Anxiety can lead to a heightened state of arousal in the body, which can affect the gastrointestinal system. When you experience anxiety, your body may enter a "fight or flight" response, leading to physical symptoms such as nausea. This is due to the release of stress hormones like adrenaline, which can affect digestion and cause discomfort.

Here are some strategies that may help you manage your anxiety-induced nausea:
1. Cognitive Behavioral Therapy (CBT): This form of therapy is effective for anxiety management. It helps you identify and change negative thought patterns and behaviors that contribute to your anxiety. A therapist can guide you through techniques to cope with anxiety-provoking situations, such as exams.

2. Mindfulness and Relaxation Techniques: Practices such as deep breathing, meditation, and progressive muscle relaxation can help reduce anxiety levels. These techniques can be particularly useful before situations that trigger your symptoms, such as exams or public speaking.

3. Dietary Adjustments: Pay attention to your eating habits. Eating smaller, more frequent meals rather than large ones can help reduce feelings of fullness and nausea. Avoiding spicy, greasy, or overly rich foods may also help. Staying hydrated is crucial, but try to sip water throughout the day rather than drinking large amounts at once.

4. Gradual Exposure: If certain situations trigger your nausea, consider gradually exposing yourself to these situations in a controlled manner. This could involve practicing relaxation techniques beforehand and slowly increasing your exposure to the anxiety-inducing scenario.

5. Medication: If your symptoms are significantly impacting your quality of life, it may be worth reconsidering a consultation with a psychiatrist. While you mentioned concerns about side effects, there are various medications available, including selective serotonin reuptake inhibitors (SSRIs) and other anxiolytics, that can help manage anxiety with a favorable side effect profile. Discussing your concerns with a healthcare provider can help you find a suitable option.

6. Support Groups: Connecting with others who experience similar issues can provide emotional support and coping strategies. Consider looking for local or online support groups for anxiety management.

7. Regular Exercise: Physical activity is a natural stress reliever and can help reduce anxiety levels. Aim for at least 30 minutes of moderate exercise most days of the week.

8. Sleep Hygiene: Ensure you are getting adequate sleep, as fatigue can exacerbate anxiety. Establish a calming bedtime routine and create a sleep-friendly environment.

In conclusion, while TCM has provided some relief, it may be beneficial to explore additional options, including therapy and possibly medication, to address your anxiety more comprehensively. Remember, it’s essential to communicate openly with your healthcare providers about your symptoms and concerns to develop a tailored treatment plan that works for you. If you feel hesitant about seeing a psychiatrist, consider discussing your fears with a trusted healthcare professional who can help alleviate those concerns and guide you toward the right resources.

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