GI Specific Anxiety
GI disorders don’t only dysregulate the body they also can dysregulate our mental and emotional life. One result of this dysregulation is a type of anxiety that gets focused on the GI symptoms themselves. Due to being put in a prolonged state of threat, something called “GI-specific anxiety” can develop.
Here are the main components of this type of anxiety.
Excessive Worry
Unhelpful negative and catastrophic thoughts about what will happen related to symptoms or might happen if you don’t take precautions. Often worries are focused on a food’s negative effects or of a sudden and humiliating GI episode in front of others. Even when there’s awareness of the worry being unhelpful it’s difficult to reduce the worry.
Vigilance
Increased attention to and awareness of sensations related to the symptoms you experience or your overall GI health. This often looks like being hyper-aware of every rumble, twinge, or sensation in your abdomen, chest, throat or wherever symptoms most occur for you. This can be joined by over-monitoring your diet, bowel movements, or frequency of symptoms, always on the lookout for something going awry.
Sensitivity
Increased bodily sensitivity to sensations in the GI tract is often amplified while eating or in times of stress. Sensations of normal bodily functions are misinterpreted as signals of threat and signs that symptoms are starting or worsening. In addition, when symptoms do occur they become amplified by the nervous system and experienced as more painful than they would be otherwise.
Avoidance
In response to this anxiety, people might engage in unhelpful safety behaviors, rituals, and reassurance-seeking.
Avoiding social situations: Skipping events or outings out of fear of experiencing symptoms in public.
Dietary restrictions: Excessively avoiding certain foods or drinks out of fear they'll trigger symptoms despite encouragement by trusted professionals to expand the diet.
Over-preparation: Carrying medications, spare clothes, or other "just-in-case" items everywhere.
Bathroom location scouting: Always knowing where the nearest restroom is when out, or avoiding places where restrooms aren't easily accessible.
Excessive medical consultations: Seeking frequent medical reassurance or undergoing repeated tests for the same concerns.
For those people who develop this type of anxiety, the different parts tend to feed off each other and create a vicious cycle where worry amplifies sensations, which then triggers avoidance, which then reinforces the anxiety and perceived need to be vigilant. Breaking the cycle often requires someone to become more aware of how this is playing out for them and then learn effective tools to stop feeding the anxiety.
You can learn more about the concepts & tools of GI psychology here.
Additional Resource:
The Visceral Sensitivity Index is a measure used in both research and practice. It has 15 questions focused on measuring the factors noted above. Here’s a snapshot of the questions.