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anxiety trigger 'bypassing' straight to gut?

Saturn

I am 53 and was diagnosed as autistic 4 months ago.  I have had mental illnesses (depression and anxiety) for a very long time, at least as far back as my teens.  I also suffer very badly with IBS, and all of these issues have become much more severe in the last few years, meaning that I have not gone out to work for about a year, and rarely leave the house anyway.

I was explaining to my current psychotherapist that a psychiatrist told me to try diazepam when I am particularly anxious, but to me it feels like often when I experience a trigger, I do not really feel that my breathing nor heart rate are increasing, though I may start sweating a bit, but what I really notice is that straight away I feel pain in my lower abdomen, leading to an episode of awful IBS (without wanting to explain it too graphically).  I feel that somehow the worry goes straight to my gut, 'bypassing' the 'normal' symptoms of anxiety involving faster breathing and heart rate.  It is as if the IBS starts very very quickly, but the lungs and heart are not really involved.

The psychotherapist has admitted that he is not an expert on autism nor IBS, but he told me that he has heard of other autistic people experiencing this 'bypass' of symptoms of anxiety.  I had never heard of this before, though I have researched the area quite a lot.  So is he correct?  Is this really a common autistic experience of an anxiety-inducing trigger?  Has anyone else felt that this happens to them?

Many thanks in advance.

Parents

  • 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.

  • in reply to Expecto_Patronum

    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.

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  • in reply to Expecto_Patronum

    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.

Children
  • in reply to Saturn

    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.