Anxiety + IBS (a Functional Medical Problem) = 1 Problem, Not 2

by | May 16, 2018 | Anxiety, The Nervous System | 0 comments

Anxiety is a common psychological problem among patients with Irritable Bowel Syndrome (IBS). My aim is to help you to understand the nature of anxiety and how to work with it so that you can better regulate your nervous system and body, thereby decreasing your psychological and physiological symptoms.

There are a lot of important pieces of information in the last blog post, so I recommend starting with the last blog post, the beginning of this series on anxiety. Here’s a quick recap before we move on:


Your functional medical problem or functional gastrointestinal problem represents a tangled web of dysfunction. Anxiety is very much a part of this web, not some separate diagnosis unrelated to your physiological symptoms.

Anxiety is a whole-body experience of stress without a clear stressor generated by the Sympathetic Nervous System. You may or may not recognize anxiety as it is occurring. If you are anxious (or stressed) yet not realizing it, then you are more likely to become stuck in a state of chronic anxiety (or stress).

Your body has a certain capacity to manage anxiety (stress). As your body responds with stress to various stressors over time, the level of anxiety (stress) in the body can exceed its capacity to manage it, leading to the development of all kinds of digestive problems which are often referred to as functional gastrointestinal problems. Anxiety underlies many other functional medical problems as well.

The Worst Kind of Anxiety

Now, let’s move on and talk further about anxiety…The worst kind of anxiety is anxiety that you don’t even realize is there. Without realizing that your nervous system is under the influence of stress, you are unlikely to take the necessary action to help your body to shift from a state of greater stress to a state of lower stress, thereby reducing anxiety (stress), leading to a better regulated nervous system.

If you have a functional medical problem like migraines, back pain, inexplicable heart arrhythmia or other symptoms, even if you haven’t been diagnosed with anxiety, you may as well assume that your body is operating under the influence of stress (or anxiety) because the treatment is the same: Regulate the Autonomic Nervous System (ANS).

Why Focus on Regulating the Nervous System

There is no question that your nervous system is implicated in functional gastrointestinal problems like Irritable Bowel Syndrome (IBS), cyclic vomiting, rumination, etc. The real question is: To what extent is your ANS is playing a role in the generation and perpetuation of your symptoms?

Even if you have non-digestive functional medical symptoms, your ANS is still very likely playing a rolein your physiological symptoms.We know that the ANS is connected to and affects many other systems in the body, so we can deduce that your symptoms are connected to the way your nervous system functions. So again, to what extent is your ANS playing a role in the generation and perpetuation of your symptoms?

Your Autonomic Nervous System (ANS) Connects to Many Different Parts of Your Body

Your ANS is comprised of three components that all work together to regulate your whole body in many ways:

  1. The Sympathetic Nervous System is your body’s Fight-or-Flight system that gets activated when the brain perceives danger. Sympathetic arousal prepares the body for action, oriented towards survival.
  2. The Parasympathetic Nervous System (theorized as one system with two branches) is the body’s Rest-and-Digest, Feed-and-Breed, and Tend-and-Befriend system when activated under safe conditions. In perceived life-threatening situations, the dorsal vagal parasympathetic branch activates a freeze or shut-down response. Your parasympathetic nervous system is housed on the vagus nerve [link to prior blog post], which connects the brain and the gut, allowing them to communicate back and forth. your body shifts out of a more action-oriented state into more of a state of energy conservation. Under perceived life-threatening conditions,
  3. The Enteric Nervous System, containing more neurons (nerve cells) than your spinal cord, is the body’s “second brain” responsible for digestion and is housed in the gut along with the majority of your immune system.

Your Autonomic Nervous System is by design a highly integrated system. That is part of what makes it highly effective at keeping you safe and enabling you to survive threatening, dangerous, and even life-threatening situations. Anxiety is not a function of your body doing something wrong. Most certainly your ANS is not trying to harm you. It is just doing its job!

Assume Your Symptoms Are Happening for a Valid Reason

Bodies don’t lie. Symptoms are the body’s way of revealing to us that something is happening. When you have anxiety, panic symptoms, or functional medical symptoms, then your body is generating these symptoms for a reason. What that reason is….now that is the million-dollar question!

What your ANS is reacting to when it generates anxiety is a question worthy of your exploration, but answering that question is unlikely to happen just by thinking logically, rationally, or analytically. The answer is probably just outside of your conscious awareness. Things outside of conscious awareness are there because we are too busy or stressed to manage that particular data or because they are too painful, ugly, horrible, or traumatic to have in our conscious awareness. Your ANS is trying to protect you by keeping things out of sight, out of mind, but the problem is that they are not out of your body.

When you have anxiety, panic, and/or functional medical or gastrointestinal symptoms, one of the things you’ll want to develop is accessing more unconscious material within yourself. That begins by increasing your global self-awareness. By becoming more self-aware of what you experience mentally, physically, emotionally, relationally, and spiritually (if that resonates with you) in your day-to-day life, you will become more adept at noticing reactions you have automatically to all kinds of stimuli, reactions generated by the ANS.


As I mentioned in the last blog post, your anxiety and functional medical problem are part of a tangled web of dysfunction generated by the Autonomic Nervous System. When you have anxiety (and/or panic) and a diagnosed functional medical problem, you don’t actually have two distinct problems. You really only have one problem: a dysregulated nervous system and body. Try not to get caught up in treating each cluster of symptoms separately. Instead, focus on regulating your nervous system. 



Photo by kazuend on Unsplash







You can learn more about the ANS here and by clicking on the “Nervous System” category to the right.



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<a href="" target="_self">Dr. Jennifer Franklin</a>

Dr. Jennifer Franklin

I'm a somatically-oriented, mindfulness-based psychologist specializing in helping people to heal and recover from functional medical problems and to resolve anxiety, panic, trauma, attachment wounds, and relationship difficulties.