IC’s Related Conditions: Anxiety Disorder

Anxiety disorder is commonly found in IC patients. In fact, IC patients are 4.37 times more likely than the general population to have been diagnosed with general anxiety disorder previous to their IC diagnosis. And if they weren’t, patients are still 2.4 times more likely to be diagnosed with anxiety after the onset of their urinary symptoms.(1) Interestingly, when anxiety is treated, urinary symptoms often reduce dramatically.

Why? What’s the connection? New research has found that patients who struggle with chronic overlapping pain conditions (IC, IBS, vulvodynia, fibromyalgia, TMJ, migraines and more) have a central nervous system and brain stuck in “fight or flight,” often the result of physical or emotional trauma in childhood. This results in a gradual, sometimes persistent, sensitivity of nerves and muscle tension throughout the body, including the bladder and bowel. Thus, in addition to struggling with IC symptoms, many of you are also struggling with chronic anxiety disorder and there is a downside to that. Pain that is accompanied by anxiety is intensified by the midbrain but pain accompanied by laughter is minimized by the brain. Of course, almost every IC patient can attest to the fact that their IC symptoms have occasionally been exacerbated by stress.

“Every day I work with patients who have chronic anxiety disorder, often triggered by a traumatic event or PTSD early in their life. Some are so anxious that they are literally spinning in place, unable to take any step forward in their medical care,” offered national IC support group leader Jill Osborne. “What they don’t see is that their anxiety is not only worsening their pain, it’s causing the nervous system to become more sensitive. Every catastrophic thought triggers a “fight or flight”  response that, over months or years, can take a terrible toll on our nervous system.” Unchecked anxiety disorder and catastrophizing are common.

Symptoms

One common symptom is feeling nervous, restless or tense.(2) These feelings are intense enough to interfere with regular activities and can be difficult to control. They are often out of proportion to actual danger and can last a long time. In fact, patients may avoid places or situations.

There are many medical conditions that can also exacerbate anxiety, including: heart disease, diabetes, thyroid problems, menopause, respiratory disorders and chronic pain. Some medications can also cause anxious thoughts.

There are situational risk factors for developing an anxiety disorder as well. Going through a traumatic event at any age can put you at higher risk for developing anxiety. Stress buildup – meaning either a big stressful event or multiple smaller ones – can trigger anxiety. While situational anxiety can be temporary, it can also trigger an anxiety disorder.

Having other mental health disorders, such as depression, or having blood relatives with an anxiety disorder can increase your risk as well.

Certain personality types are also at greater risk. If you were shy or had behavioral inhibitions as a child, you are more likely to be diagnosed with an anxiety disorder.(5)

Your doctor will evaluate you with a physical examination, an interview and some lab tests. Once any physical reason is ruled out, your doctor may refer you to a mental health professional for further evaluation. Mental health professionals can then help you identify your specific anxiety disorder type and come up with a treatment plan.

Regular exercise, a healthy diet and good sleep are great places to start. Reducing or eliminating alcohol is important as both can worsen anxiety symptoms.

If stress is out of control, we encourage patients to try some new stress management techniques. Guided relaxation, meditation, repeating a mantra, visualization WILL help to calm and retrain more sensitive nerves and is considered a foundation of success. The ICN offers several free guided relaxations that you can do every single day.

Mindfulness is a core foundation of most chronic pain management programs because it acts to “wind down” an overactive nervous system, thereby calming pain responses. It also gives patients a much stronger sense of control rather than the powerlessness that many feel.

Pay attention to what triggers your anxiety and what helps. Consider writing down your feelings and experiences in a journal to help both you and your medical provider sort them and determine the best treatment plan. But, don’t forget to give yourself some grace as you are working through your anxiety journey. Some days will be harder than others.

Look for a support group (either in person, online or both). Reach out to friends and family instead of isolating yourself. Find a trusted person who can help you through your difficult days and cheer you on during your good days.

There is no shame in having anxiety. It happens to everyone. But we must each take a moment and ask if our anxiety is interfering with our lives. Has it gotten so bad that you are “ruminating” and/or dwelling on events that haven’t even happened yet? Are you catastrophizing about the future, assuming that you will not get better? You weren’t born with the skills to handle life with IC and/or, honestly, life during a pandemic. We have to learn them.