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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.

  • I had a problem with being given medication for anxiety to alleviate the physical symptoms and not the psychological ones. For me the psychological symptoms were the worst of it and far outweighed any physical symptoms I may have been experiencing because they were at the back of my mind. I wasn’t afraid of something happening to my body but I was petrified of something happening to my mind like going insane or completely losing the plot, this was true terror. Beta blockers may work for those concerned over their bodies during episodes of anxiety but that really isn’t at the core of what I feared. I’ll be honest at times I wanted to be sedated, desperately. During those times I wasn’t scared of a heart attack, I just wanted to keep my sanity. There are strong links between the brain and the gut, you may need to go more urgently when anxious and from what I recall reading it’s due to the body needing to make itself lighter to run from danger. Mostly my experience of IBS is a grinding stomach, bad wind and constipation if that’s not a separate condition.

  • There is a YouTube channel, Auticate with Chris and Debby. I am not sure whether he has IBS, but he mentions that stress causes him to go to the bathroom.

    When I am stressed, say I think I will be late for a blood sample appointment, I feel a tightness in my chest around my sternum and anxiety. But I am not sure how much my breathing and heart rate change. It also affects my digestion, in that it seems to stop it, the opposite of your issue.

    The tightness increases and decreases but i can talk and breathing seems the same. I can sweat more.

    The blood test showed I was stressed.

    So I think you can be stressed and have an adrenal response, which influences your gut quite quickly and causes sweating, without necessarily have a racing heart or breathing heavily.

    I don't know that you can have a stress response without any noticeable symptoms though.

  • I am sorry you are experiencing this unpleasant combination of issues.

    Having thought about how you described everything - I really think this is a conversation you need to have with your GP.

    My understanding is that your GP would want to better understand the Diazepam situation - because although it is sometimes suggested for anxiety / IBS it is only usually supposed to be a very short term support mechanism - and not usually one suggested when someone is managing long-term depression.  

    Your abdominal pain is also something your GP would likely want to check.

    One of the difficulties with IBS is people are encouraged to do plenty of exercise - but if you rarely leave the house at the moment - I imagine that must be difficult for you to achieve the level of exercise that you used to do.

    The link between some Autistic people experiencing anxiety and IBS is quite well documented in NHS support and guidance - but the concept of "bypass" symptoms of anxiety to IBS is not something of which I am aware.  Maybe your GP might have more up to date information on that specific question.

    Don't forget to mention to your GP that you can start to sweat a bit too - as you are working on the assumption everything is anxiety / IBS related but your GP might want to discount other physical considerations too.

    For instance, feelings of panic can be powerful and involve a lot of different body sensations and emotions - sometimes quite a frightening experience for people.

    I was also thinking that on top of your anxiety / depression / IBS / rarely leaving the house / not currently having the routine of going to work - it is only about 4 months since you received your Autism diagnosis - which many of us can experience as something of a shock to the system (mind and body).

    So what I am trying to say is: you are coping with a lot of different things (all at the same time) so a review with your GP (mind and body) might be the safest next step for you.

    Take care.