JK, 44 years old, who had a three decade long history of Irritable Bowel Syndrome (IBS) was referred by his physician with complaints that emerged after an unexpected job loss – sleeplessness, worry, anxiety and depression. His IBS related symptoms had also worsened following this stressful life event.
IBS is a disorder characterized by gastrointestinal symptoms – abdominal pain, cramping, gas, constipation, and diarrhea. Approximately one in five adults has IBS. This condition is more common in women, and has an onset in late adolescence. Individuals with IBS have a colon that is more sensitive and reactive to certain foods and stress. IBS can be painful and distressing. However, it does not damage the intestines, nor does it cause other gastrointestinal diseases.
JK reported that, ever since he remembers, he had also been an anxious individual – he worried on trivial issues and frequently had bodily symptoms when anxious – a pounding heart, restlessness, sweating, giddiness, a sinking sensation in the pit of the stomach, abdominal pain and dry mouth. During times of stress, his IBS symptoms worsened.
He said that he had, after the job loss, developed a “very sensitive stomach”. Any worry or stress now gave him a feeling that he had to pass motion and he had to rush to the nearest toilet. His was terrified that he may suddenly need to use the washroom and may not find one in time. Consequently, he developed a fear of travelling – and he worried that his line of work involved travel. He linked his distress to several foods and had a long list of foods which he felt worsened his problems – and this list kept getting longer till a point came where he was on boiled rice and vegetables.
Now, each morning, he had now a detailed ritual in the washroom, so as he could “clear his bowels completely”. If something interrupted this routine, or he did not go through this routine to his satisfaction, he was anxious the whole day.
Also, frequent abdominal pain, bloating, constipation and loose stools that were a part of his life due to IBS, worsened after this stress.
Anxiety and Depression worsens IBS. Further, people with IBS frequently suffer from anxiety and depression. This sets up a vicious cycle – one worsening the other. The gastrointestinal tract is in part controlled by the nervous system, which responds to stress. Also, the immune system responding to stress and plays a role.
After a complete psychiatric assessment, JK was given the necessary medical treatment for the anxiety and depression by the psychiatrist. He was also given cognitive behavioral therapy (CBT) by the clinical psychologist. CBT also focused on the cognitive and behavioral components of his IBS. There was a remarkable improvement in his anxiety and depression. He also had significant relief in the IBS symptoms.
Subsequently, over the next few months, though he continued to have occasional, mild IBS symptoms, he was able to make significant all round progress. He found a new job – and was able to overcome his fear of travel, was able to consume a wider range of food, regained his confidence and was positive and cheerful.
Please note that the information in this case study should not be considered as medical advice for an individual’s condition. If anyone shows or feel symptoms of a possible medical condition, we strongly encourage you to seek advice from your primary physician or a mental health professional for an evaluation as soon as possible.
The names been changed to protect the privacy of individuals.