Gut Health and Mental Health Go Hand in Hand

A lot of people are surprised at how often digestive issues (things like IBS and nausea) are directly related to underlying — generally undiagnosed — anxiety.

There’s a quick way to assess whether or not the problem is influenced by psychological factors. Ask yourself:

Does it get worse with stress?

If yes, then you’ve got a situation that is — at least in part — related to your mental state. This means that even if you have your nutrition dialed in, your probiotics in check, and all the other biological factors sorted out, you’re still susceptible to GI distress until the psychological factors are addressed.

Here’s how it works…

Anxiety isn’t just — as people often think — a matter of panic attacks and worry. It’s a matter of a mind/body split, an attempt to negate some unwanted emotional experience.

Anxiety “communicates” in two different ways.

The first of these is through striated muscle anxiety, the contractions of muscle that leave you tense. As uncomfortable as this can be, it’s actually a sign that you’re able to tolerate the emotions that are activated.

The second of these, however, is a sign that you’ve exceeded your body’s ability to handle the emotion. In this case you’ll experience disruptions in the smooth muscles of the body, resulting in things like gastrointestinal issues, blurred vision, ringing in the ears, migraines, confusion or brain fog.

Think of these as related to the two different branches of the autonomic nervous system. The sympathetic nervous system activation results in activity in the striated muscles, as if readying you for fight or flight. The parasympathetic nervous system activation results in activity in the smooth muscles, leaving you to freeze in the face of an overwhelming threat. It’s a bit more complex than that in that it’s not just one or the other, but I trust that you get the point.

So what do you actually do about this?

Glad you asked.

The first thing that I encourage clients to consider is that these symptoms don’t just occur at random. They occur in context. And just like our words, our symptoms only make sense in context.

The most important part of the process is “containing” the experience of anxiety by putting it in relation to the stressful event. If you know, for example, that your symptoms increase when stressed, see if you can specify a situation in which you were stressed that resulted in those symptoms getting worse. Getting a clear picture of what happened/where/when/with whom helps clarify the context.

The next part would generally be to fully experience the underlying emotion, but in this case, since what you’re experiencing leads to this smooth muscle anxiety, there’s an important detour. Regulating this anxiety is essential before going off exploring the emotions. When I work with clients, we generally use a three step approach to regulate this intense anxiety when it arises.

1. First, I direct their attention to where they make contact with support (for example, the places where their body connects with the chair or floor beneath them). A few moments here “grounds” the anxiety.

2. Then I direct their attention to the sensory details of their immediate environment. Most often this involves visually scanning the room, often — half joking — saying out loud “There are no tigers here about to pounce on me.” Again, the important thing is to establish an immediate sense of safety in the here/now environment.

3. Lastly, I direct their attention to their breath, focusing first on an exhalation - no “deep breaths in” here. Why the exhalation? There’s a reflexive response that results in a slower heart rate on an exhalation relative to an inhalation. When we’re agitated, it makes sense to slow things down rather than speed them up, right?

These are so useful for the regulation of this more intense, smooth muscle anxiety.

When this is comfortably familiar, then it’s time to turn toward experiencing the emotion underlying the anxiety. This is where it becomes important to have identified the context that resulted in stress and a worsening of symptoms. What is the feeling that arises in relation to that context? For an emotion to be experienced fully, it must be 1) labeled (e.g., guilt, excitement, sadness, anger), 2) felt as a physical sensation (sinking feeling in the chest, rising heat from the belly), and 3) its impulse explored in imagination (the action that would be required to make the situation right).

This, I should say, is extremely difficult to do on one’s own. I’m currently working on research to determine how effective it could be and what possible modifications can increase the solo efficacy, but the primary thing to keep in mind is that emotional experience depends in large part on a secure enough attachment relationship. Having somebody guide you through the process provides the external reference point that brings more to your awareness than would otherwise be available.

After the emotion has been labeled, felt as a bodily experience, and followed through in imagination, there is almost inevitably a dramatic reduction in anxiety, including a pervasive feeling of calm, a release of tension, and an immediate cessation of those smooth muscle symptoms like nausea, bowel distress, migraine, dizziness, etc. This will be instantaneous when performed correctly. If it does not occur spontaneously afterwards, you’ve missed the core of the emotion.

The great thing is that when you’ve performed this correctly, your system is better able to handle emotional conflicts when they arise in the future, making you less susceptible to this intense form of anxiety.

That means your gut can finally begin to heal and make the most of all the nutritive interventions you’ve been practicing, and as you optimize the absorption of nutrients, your overall sense of vitality improves - quite quickly. Your energy levels increase, you recover better from your workouts and experience less soreness and tension, and you’re able to focus more effectively in your work, resulting in greater and greater performance.

Again, I can’t stress this enough: this should occur quickly when performed correctly. If it doesn’t, you know that something is amiss in your approach. Anxiety levels can be brought down dramatically in a single session, symptom remission can occur within a couple of weeks, and although there’s some longer term work to be done finding your new “balancing point” in work and relationships, the situation can easily stabilize at a significantly higher level of performance within a few months.