anxiety trigger 'bypassing' straight to gut?

Hello again, Saturn,

Therapists differ greatly, some say that they help with all sorts of problems but they don't necessarily fully understand the problems. Some are counsellors and call themselves psychotherapists because they are allowed to but don't have the full mental health training. It's best to check their qualifications and experiences first.  If they're  not listening, that is a major issue.  Many don't understand neurodivergence either. Having said that, a well qualified, therapist could be helpful even without fully understanding autism.  Energy psychology, experienced therapists can help. I suggest 'Advanced Integrative Therapy' (AIT),' EMDR' and 'Emotional Freedom Technique', which is a tapping technique.. Tapping and AIT have helped me.  I hope this helps you further in your search.  It's can be re-traumatising or at least disheartening to share your troubles with a counsellor who doesn't understand or doesn't listen.  There are different levels of training from a diploma in counselling all the way through to Phd.  A diploma doesn't teach about mental health or how to help.  Good luck!

Fingers crossed (⁠•⁠‿⁠•⁠)

It is all very interesting, but not very pleasant for you.

I read something once about anxiety related toilet use. And it suggested that sometimes people have these urgent suddenly needing to empty themselves moments due to survival instincts. It suggested that this happens so you can basically flee faster. This seemed a bit backwards as it would take you longer to go to the toilet so I googled it some more. It suggested that whilst probably not to actually allow you to run faster, activating fight or flight may not just stick to running away. It can trigger hormones and the body parts involved in digestion to think need to take action now. Hence the urgent need to completely empty yourself. Again, no idea how factual this is but it seemed interesting and definitely possible in your case. 

It's also possible you may have had a slightly more sensitive gut to begin with. So when you get the anxiety symptoms it is a bit more dramatic for you than for others.

As far as how to help the interoception issues, I don't know how possible that is. Have you ever tried mindfulness? It's not something I like but I'm hyper not hypo sensitive to things. I wonder if trying it when you're relatively calm where it talks you through isolating parts of your body and identifying how it feels could help you to start noticing it and then perhaps when your anxious you'll be able to feel it and also possibly have a technique to help?

COVID was very difficult to come back from and I was not in the position you were so I really do sympathise with that. I found that COVID life of isolating actually suited my brain so much better that leaving it was really really difficult.

oh no, sorry, I just checked and you are right, pregabalin is not a beta blocker.  I am not sure where I got that from.

Glad to hear the side effects of propranolol were minimal for you, which means there is hope for me!

No, you are not repeating what others have said.
You are agreeing with what the dietician told me (which I had recently also read about) that it is more common for autistic people to have gut related issues.  If only I had been diagnosed earlier than aged 53.

I also strongly also suspect that interoception has a lot to do with my illnesses.  I know I feel hunger and thirst differently to other people, though I seem to be over- and under-sensitive to these at different times.  I am also sure that I sense abdominal pain (and I guess all pain) differently.  I also agree that I seem unaware of being anxious until it affects my gut.  But I do not know how to change all these sensitivities to make them 'normal', or whether that is even possible.

I am definitely very easily triggered.  My latest psychotherapist explained to me about how to try reframing situations that are not intrinsically harmful, but I tried this and found it impossible.  And my stomach is not just a bit uneasy - I am running to the toilet and having to stay there for an extremely long time.  And yes, this does make me even more vigilant for the next time, and the next time, and so on, and it will not stop, but I understand that that is the pattern of anxiety attacks.

You say you are not a medical professional but what you say is in line with information that I have been finding out only this year really.  I think that being autistic set me up to be wired differently and to therefore feel things differently.  Very long-standing anxiety has made my digestion worse.  The worry of not being able to do anything or go anywhere or earn enough to live on has worsened things further.  And then the fact that I am on immunosuppressants for life made me Clinically Extremely Vulnerable to coronavirus, and the people I work(ed) with cannot wear masks, so doctors kept telling me to continue to stay home, so I ended up shielding for 3 years, making it even harder to start venturing out.

I have had several conversations with several GPs regarding my mental illnesses and regarding my debilitating digestive problems, but these conversations have not led to anything helpful.

I was referred to a psychiatric hospital nearly 3 years ago, and they have not helped me at all.  I was prescribed sertraline then mirtazapine then fluoxetine then pregabalin then amitriptyline then venlafaxine, and at the moment I am taking buspirone at a dose higher than the manufacturer has licensed it for, and none of these have helped me at all.  One of the psychiatrists told me straight a few times that I am running out of options.

The mental hospital told me to seek talking therapy too.  But after about 5 psychotherapists I have seen, my situation and symptoms are worse than ever.  One of the psychotherapists told me straight that the NHS will never help me, and this is because each area treats only 1 thing, eg the psychiatric hospital will not discuss my autism with me.  I was told I need to try and find someone who is an expert in all the complexity of what is going on with me, ie autism and IBS and anxiety and depression, as these are all interacting and need to be sorted out together.

A GP referred me to a gastroenterologist about 10 years ago, but he said to try cutting out various foods and see what happens, and that it is up to me to manage my IBS.  The food regime made no difference to me at all.  10 years later I am even worse at managing the IBS.

Then nearly 2 years ago I was referred to a gastroenterologist again, who seemed surprised that my digestive tract was never investigated after all these years.  A colonoscopy showed that everything is normal - it only showed visceral hypersensitivity which means it is IBS.

After a decade of horrible decline, the psychiatrist told my GP to refer me to a dietician.  My first appointment was a couple of weeks ago - she said she needs another session to assess me, and mentioned ARFID - Avoidant/Restrictive  Food Intake Disorder - which definitely sounds like me.

Yes, I am aware that diazepam is addictive and therefore prescribed only short term, which therefore does not help me.  I have also been prescribed promethazine to try, though that tends to make people drowsier.

Yes, not going outside makes it very difficult to exercise, so my health just deteriorates.

I told a psychotherapist about my anxiety attacks including the time I actually passed out and had to be revived by a team of doctors.  I was in hospital at the time (awaiting a new liver), and when I regained consciousness I found new drips in my arms, and electrodes on my body.  The psychotherapist told me she had 30 years' experience and had never heard of anyone actually passing out from anxiety.  Years later, I was talking to a doctor via 111 about an anxiety attack I was having, and I explained that I felt I was going to pass out, but a psychotherapist had told me that that is impossible, and the doctor told me I was right, that it CAN happen.

My autism diagnosis was not a shock to me.  I suspected it for the last 40 years.  But when I mentioned it to the highly experienced psychotherapist who did not know about the effects of anxiety, she took a quick look at me and told me I am not autistic.

In summary, I have been contacting experienced professionals for decades, I have had lots of conversations over the years with GPs and gastroenterologists and psychiatrists and psychotherapists but my situation continues to deteriorate.  I was just asking a question here to see if any other autistic people experience anxiety differently (but similarly to me), and this was triggered by my latest psychotherapist telling me he is aware that our experiences differ from neurotypical people, but anxiety is still anxiety, it just affects different people in different ways. 

Thanks for that.  I am looking into their channel and have (re)discovered a few things about being autistic and how to try and get around issues.

Hi Saturn 

Mmm I didn't know Pregabalin was a beta blocker? I know it's a powerful medication used for pain relief and it can have strong side effects. 

I hope you get to try propranolol and you get some relief from it. For me the side effects were minimal.

Wishing you well.(⁠•⁠‿⁠•⁠)

I apologise if I'm repeating what others have said but I'm too tired to read them all. There are certainly links between anxiety and stomach issues and it does seem to be more common for autistic people to have gut related issues. 

I wonder if what you're experiencing is to do with your interoception (internal senses) though? Some autistic people for example find it very difficult to know when they're hungry or thirsty or have a low or high pain threshold. This could also be the case for anxiety symptoms. You may just not be aware that you are experiencing them until it affects your gut.

We also tend to be triggered more quickly and intensely than other people so it may also be that it is all happening very quickly for you.

I do get anxiety symptoms such as a tight chest but I do also get an uneasy stomach when I'm anxious. I believe that this leads to being very tense which can upset the stomach further.

It may be that there is a combination of things going on that is leading to you having more intense stomach symptoms.

I am no medical professional - just pondering.

I feel that my aim is sort of opposite to yours.   I remember years ago at work once I was shaking a lot due to anxiety, and I remember feeling that I just wanted to be able to hide the shaking, and that the anxious thoughts themselves were less of a priority.  The people around me were getting very concerned about me shaking and were making comments about it, and that bothered me a lot more than how much I hated the job, and how I felt about my colleagues that were causing me to shake.
I feel it is more important to hide the emotions, especially the darkest thoughts, and be able to pretend to be ok just to be able to work and earn an income, but I cannot even do that now.  What happens to my body is worse than what is happening in my mind, because it is my physical symptoms that stop me being able to go anywhere or do anything.

I have not really felt afraid that I was losing the plot, but then a few months ago a psychiatrist told me I should try an antipsychotic (risperidone), and I tried to argue that I have not lost contact with reality, but that made me think that she thinks maybe I have.  I even told them about hallucinations I have and they told me I am NOT psychotic.  It is hard to make sense of it.

Many thanks for explaining that.
The more I read about it, the more I am aware that the nervous system of the gut is not really separate from the brain.  I even heard someone at the cutting edge of research in this area say that the gut is the 1st brain,  and the brain is the 2nd brain (in terms of the timing of their development).  If only there was an easy way to fix this communication, but that seems even harder to achieve now that I know my wiring is different.

Thanks for letting me know I am not alone in the way anxiety affects me.  Sorry to hear it shows up in a similar way for you.

Hi.  Thanks for sharing your insight.
Yes, my anxiety is very very long term, so maybe that is why, as you say, it affects me differently, apart from being due to being autistic.
I have seen about 5 therapists so far and none of them have helped me with my mental illnesses.  I am up for trying again with a 6th therapist and beyond, but I am not holding my breath.  They seem to either not want to listen and understand, or to be unable to suggest anything that will help.

Hmm, a psychiatrist did mention me trying propranolol for anxiety, but then another one said not to because all it will do is stop the symptoms.  But now I am thinking that stopping the symptoms does not sound like such a bad thing, so I will mention it at my next appointment.  However, I have just had a quick look online and see that it is a beta blocker.  I tried another beta blocker called pregabalin, which I was told to take 3 times a day but I found that taking it even just once a day made me want to sleep all day and night.  Thanks for sharing your experience, and I am glad to hear your issues improved.

Dysautonomia can present this way. My son has blood pressure drops. Fight or flight response he nearly faints. Has problems with standing. Can affect people differently, can affect gut. Seems to be a dysregulation with many on the spectrum. Not talked about enough really.

Hi Saturn 

Sorry to hear that the heath issues you are experiencing are impacting your life to the the extent that you barely leave the house, that must be tough.

I can't really help with the how and why this is happening to you, but I can tell you that I have had very similar issues with my health. Things did get worse for me during the(I hate mentioning the M word) so I'm not going to.

Quite by chance I was put on Propranolol to treat the migraines, which had also got worse during this time.

Anyway I'll get to the point. The Propranolol has not only worked for the migraines it has also reduced my gut related issues. 

I hope this helps.

Hi Saturn,  anxiety is felt in the vagus nerve, travelling from the brain to the gut.  Many digestive/gut issues are caused by long term, underlying anxiety. I hope this basic information makes sense!  I am a psychotherapist and anxiety affects different parts of the body. There is anxiety about particular issues in the moment, which cause heart palpitations, shallow breathing etc but we can experience anxiety over many years and since childhood and will affect the gut.  Therapists who work with the mind and body and particularly trauma therapy, can help ease your anxiety.  I hope you can find a therapist who can help.  

Anxiety does not truly "bypass" the brain, but rather activates the "brain-gut axis," a bidirectional communication pathway that sends stress signals to the digestive system via the nervous system, particularly the vagus nerve. This communication results in physical symptoms such as stomach pain, nausea, cramping, changes in gut motility, and a knot in the stomach, often referred to as the "fight or flight" response impacting your gut. - Office ally

I get this too, my anxiety doesn’t always show up with the usual fast heartbeat or shaky breathing, it often goes straight to my stomach and I’ll end up with cramps or an IBS flare almost right away. It took me a while to notice the pattern, but once I did it made sense because I’ve always had gut issues that get worse when I’m stressed. From what I’ve seen, other autistic people talk about the same thing, so I don’t think you’re alone in feeling it skips the “typical” signs of anxiety.

Anxiety does not truly "bypass" the brain, but rather activates the "brain-gut axis," a bidirectional communication pathway that sends stress signals to the digestive system via the nervous system, particularly the vagus nerve. This communication results in physical symptoms such as stomach pain, nausea, cramping, changes in gut motility, and a knot in the stomach, often referred to as the "fight or flight" response impacting your gut.