Gastric related anxiety

[Evan James]

I'm new here, so I'll start from the top. Apologies in advance for what may be a long post!

My name is Evan. I've been suffering with anxiety for many years now, but have only been on Mirtazipine for a little over 2 years. When I started taking it, I felt a lot better, the anxiety had decreased to almost nothing and I felt normal again. But now it has come back with a vengeance. I'm finding it difficult to distinguish between anxiety and what could actually be a legitimate problem with my body. I've been through the list of anxiety symptoms (I get around 80% of those I reckon) but I don't see much about digestive system problems on there. I generally get reflux quite often which is a known symptom of anxiety but I have had this for around 10 years.

I've been going back and forth with my doctor to diagnose what could be the cause of me being out of breath/rapid heart rate on minor exertion (walking up stairs, etc). Heart has been tested, chest x-ray clear, lung function seems normal and doesn't improve with ventolin.

A little over a week ago I took myself off to hospital as I had a chest pain for 10-15 seconds, followed by a very intense anxiety attack. They did the usual, ECG, physical checks, etc. All was ok and I was discharged. Three days ago I went for a walk with my girfriend, nothing crazy, just a relaxed stroll. Towards the end we walked up a flight of stairs and when I got to the top, my heart rate went through the roof and I had shortness of breath, it was difficult to draw in. Typical clammy hands, restlessness, confusion, felt like I had to sit down, then stand up. My legs felt like they were roasting on the back. This lasted for about 20-25 minutes. Off to hospital again, a different one this time. ECG, blood test (to check for signs of heart attack, pancreas, liver, etc), blood pressure, blood sugar, listening to my breathing, etc etc. Again, all appears ok.

Since then, I've had a tightness/discomfort in my upper chest, excess gas buildup causing me to belch very frequently, the burning feeling in the back of my legs won't go away and is there 24/7. I've been to see my doc to get a referral for a gastroscopy as was recommended by the doctor on my last hospital visit, but that won't be until the 22nd August and I'm going away on holiday from the 1st-11th. So naturally, I'm even more anxious about going to another country while I'm feeling like this. I tried to go to work today but only lasted 2.5 hours. I've been on medication for the last 2 days to neutralise the acid in my stomach, that seems to be helping a little but it's still very prominent.

I guess my question at this stage is what is the possibility that anxiety is causing this? Has anybody else experienced something similar before? I look forward to hearing your replies!

Evan :)

[Nowuccas]

Hey Evan,

From https://www.drugs.com/sfx/mirtazapine-side-effects.html

Gastrointestinal
Very common (10% or more): Dry mouth (up to 25%), constipation (up to 13%)
Common (1% to 10%): Nausea
Uncommon (0.1% to 1%): Abdominal pain, abdominal syndrome acute, vomiting, diarrhea
Rare (0.01% to 0.1%): Abdomen enlarged, eructation, glossitis, nausea and vomiting, gum hemorrhage, stomatitis, colitis, oral hypoesthesia
Very rare (less than 0.01%): Tongue discoloration, ulcerative stomatitis, salivary gland enlargement, increased salivation, intestinal obstruction, pancreatitis, aphthous stomatitis, gastritis, gastroenteritis, oral moniliasis, tongue edema
Frequency not reported: Dyspepsia, flatulence, oral paresthesia, mouth edema[Ref]

Cardiovascular
Common (1% to 10%): Peripheral edema, edema
Uncommon (0.1% to 1%): Hypertension, vasodilation, orthostatic hypotension
Rare (0.01% to 0.1%): Angina pectoris, myocardial infarction, bradycardia, ventricular extrasystoles, hypotension
Very rare (less than 0.01%): Chest pain substernal, atrial arrhythmia, bigeminy, cardiomegaly, phlebitis, left heart failure
Frequency not reported: Chest pain, palpitation, tachycardia, postural hypotension, ECG changes
Postmarketing reports: Ventricular arrhythmia, Torsades de pointes, generalized edema, localized edema[Ref]

There was a mean increase in heart rate observed in patients given this drug compared to placebo (3.4 bpm versus 0.8 bpm, respectively); however, the clinical significance of this difference is unknown.[Ref]

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I suggest that you view the side effects in full, and wean off the Mirtazipine as advised by your prescriber, or at 10% less weekly.

Why were you prescribed it; had you already been tried on SSRI and SNRI anxiolytics / antidepressants?

Avoid citrus fruits, tomatoes, chillies, highly spiced foods and excessive alcohol consumption.

Use proton pump inhibitors or antacids for as short a time as possible. I found that taking slippery elm bark (health food stores, or online suppliers) with water before meals helped my gastritis.

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http://www.belmarrahealth.com/gastritis-stomach-inflammation-symptoms-causes-and-treatment/
Foods to avoid to prevent gastritis

Here is a list of foods you should avoid to prevent gastritis. These foods can irritate and aggravate the stomach, making a person more prone to gastritis:

Alcohol
Coffee and tea; foods to avoid to prevent gastritis
Whole milk (including chocolate)
Citrus fruits and juices (oranges, lemons, limes, grapefruits)
Peppers
Garlic powder
Highly spiced meats (sausage, bacon, salami)
Tomato and tomato products

Foods to enjoy with gastritis

If you’ve already been diagnosed with gastritis, here are some foods which are safe to consume.

Vegetables
Poultry
Whole grains
Brown rice
Beans
Eggs
Nuts
Olive oil
Treatment of gastritis

Even though gastritis can be acute and go away on its own, there are treatment options to prevent it from worsening.

Some typical medical treatments of gastritis are:

Medications to treat bacteria, if that is the cause
Medications to block acid production
Antacids to neutralize stomach acids
Although these are what the medical world suggests when treating gastritis, there are natural means which you can opt for as well.

Related reading: Do these 4 things at night for a healthier stomach

Natural home remedies for the treatment of gastritis

To treat gastritis naturally there are some lifestyle changes you can do.

For starters, stop smoking and limit drinking.
Avoid trigger foods and eat smaller meals more frequently to avoid indigestion.
Control stress.
Limit the use of pain-relievers and anti-inflammatory medications.
Consume licorice prior to eating a meal. Licorice is known to aid in digestion problems, but it may increase blood pressure so get the OK from a doctor.
Ginger has been shown to be quite beneficial for the stomach, so it may also help with gastritis.
Drink lots of water (at least eight glasses a day).

[Nowuccas]

Another forum member provided the following useful information:

Common Anxiety Symptoms

Here are some of the many symptoms associated with anxiety disorder (because each person has a unique chemical make up, the symptoms and their intensity will vary from person to person).

The Member's area of this website contains explanations on what causes many of these symptoms and why they occur:
Body

* Burning Sensations throughout the body
* Chronic Fatigue
* Electric shock feeling
* Excess of energy, you feel you can’t relax
* Feel like you are going to pass out or faint
* Feeling cold or chilled
* Hyperactivity, excess energy
* Increased or decreased sex drive
* Muscle twitching
* Neck, back, shoulder pain, tightness/stiffness
* No energy, feeling lethargic, tired
* Numbness or tingling in hands, feet, face, head, or any other places on the body
* Persistent muscle tension, stiffness
* Sore or tight scalp or back of the neck
* Startle easily
* Sweating, uncontrollable profuse sweating
* The floor feels like it is moving either down or up for no reason
* Trembling or shaking
* Urgency to urinate, frequent urination, sudden urge to go to the washroom
* Warm spells
* Weak legs, arms, or muscles

Chest

* Chest pain or discomfort
* Concern about the heart
* Feel like you have to force yourself to breath
* Find it hard to breath, feeling smothered, shortness of breath
* Frequent yawning to try and catch your breath
* Heart – beating hard or too fast, rapid heartbeat, palpitations
* Heart - Irregular heart rhythms, flutters or ‘skipped’ beats, tickle in the chest that makes you cough

Emotions

* Dramatic mood swings
* Emotional blunting
* Emotions feel wrong
* Frequently feel like crying for no reason

Fears

* A heightened fear of what people think of you
* Afraid of being trapped in a place with no exits
* Constant feeling of being overwhelmed.
* Fear of being in public
* Fear of dying
* Fear of losing control
* Fear of impending doom
* Fear of making mistakes or making a fool of yourself to others
* Fear that you are losing your mind
* Fears about irrational things, objects, circumstances, or situations
* Fears of going crazy, of dying, of impending doom, of normal things, unusual feelings and emotions, unusually frightening thoughts or feelings
* Heightened self awareness, or self-consciousness
* Need to find nearest washrooms before you can feel comfortable
* Need to seat near exits

Head

* Dizziness or light-headedness
* Frequent headaches, migraine headaches
* Feeling like there is a tight band around your head, pressure, tightness
* Head, neck or shoulder pain, tightness/stiffness
* Giddiness
* Shooting pains in the face
* Shooting pains in the scalp or head
* When you close your eyes you feel like are beginning to, or will, float upwards
* Sore jaw that feels like a tooth ache

Hearing

* Frequent or intermittent reduced hearing or deafness in one or both ears
* Low rumbling sounds
* Ringing in the ears, noises in the ears, noises in the head

Mind

* Desensitization, depersonalization
* Fear of going crazy
* Fear of losing control
* Fear of impending doom
* Feelings of unreality
* Frequent feeling of being overwhelmed, or that there is just too much to handle or do
* Having difficulty concentrating
* Obsession about sensations or getting better
* Repetitive thinking or incessant ‘mind chatter’
* Underlying anxiety, apprehension, or fear
* You often feel you are carrying the world on your shoulders

Mood


AnxietyCentre.com

* Always feeling angry and lack of patience
* Depression
* Feeling down in the dumps
* Feeling like things are unreal or dreamlike
* Frequently being on edge or 'grouchy'
* Frequently feel like crying for no apparent reason
* Have no feelings about things you used to
* Underlying anxiety, apprehension, or fear
* You feel like you are under pressure all the time

Mouth/Stomach

* A ‘tinny’, ‘metallic’ or ‘ammonia’, or unusual smell or taste
* Choking
* Constant craving for sugar or sweets
* Constipation
* Diarrhea
* Difficulty swallowing
* Dry mouth
* Feeling like you can’t swallow properly or that something will get caught in your throat
* Feeling like your tongue is swollen
* Frequent upset stomach, bloating, gaseous
* IBS
* Lack of appetite or taste
* Nausea or abdominal stress
* The thought of eating makes you nauseous
* Tight throat, lump in throat
* Vomiting

Sleep

* Difficulty falling or staying asleep
* Frequent bad, bizarre, or crazy dreams
* Hearing sounds in your head that jolt you awake
* Insomnia, or waking up ill in the middle of the night
* Jolting awake
* Waking up in a panic attack
* You feel worse in the mornings

Sight

* Distorted, foggy, or blurred vision
* Dry, watery or itchy eyes
* Eye tricks, seeing things our of the corner of your eye that isn’t there, stars, flashes
* Eyes sensitive to light
* Spots in the vision
* Flashing lights when eyes are closed
* Your depth perception feels wrong

Touch

* Numbness
* Pain
* Tingling, pins and needles feelings

Other symptoms are described as:
Being like a hypochondriac, muscle twinges, worry all the time, tingles, gagging, tightness in the chest, tongue twitches, shaky, breath lump, heart beat problems, head tingles, itchy tingling in arms and legs, and so many more.

In addition to these symptoms, you may also find yourself worrying compulsively about:
• Having a heart attack
• Having a serious undetected illness
• Dying prematurely
• Going insane or losing your mind
• Harming yourself or someone you love uncontrollably
• Being embarrassed or making a fool out or yourself
• Losing control
• Fainting in public
• Not breathing properly
• Choking or suffocating
• Being alone

(NOTE: Each symptom is further described and explained in the Symptoms Demystifed section in the members area.)

These are some of the more common symptoms, but this list is certainly not exhaustive.

It is common for people to experience one or more of these symptoms. While some may experience them all others may experience only a few anxiety symptoms.

[Nowuccas]

A previous post on anxiety follows, modified for you:

Limit "worrying time" to 30 - 45 mns, daily, possibly when you get home, or after your evening meal, but not too close to bedtime, after which, resolve firmly to refuse to worry again on that day. Understand that to do otherwise would be counterproductive to your mental health, and enjoyment of life. Having had your "worry time" for the day, you can just write down any more thoughts that come to mind, and say to yourself: "Well, I'll just have to worry about that tomorrow, won't I?".

It's important to regularly monitor, and deal with a negative internal monologue (self talk), or mental process, such as disturbing thoughts, images, impulses, or emotions, by the process of (a): recognising it, and (b): challenging it immediately.

Technique For Re-Programming Negative Thoughts: When you notice something negative, such as: "I can't do this/ am never going to get over this!" or: "Why am I always so useless/such a loser?" or even an image, emotion, or a memory; recognise that it is being generated from the negative part of your mind. After identifying, and labelling it, visualise a large, red, flashing, "STOP!" sign, and/or possibly a stern faced person wagging an index finger at you in a negative manner, then say to yourself as forcefully as you can, even aloud in a big voice, if alone: "I know this tactic: GO AWAY FOR A WHILE !!!" You may want to use either: "ruse", "ploy", "game", or "trick". In the case of an image, visualise a large "STOP" sign, or your preferred version.

Some people go so far as to keep a wide rubber band in their pocket, then put it around their wrist, when they catch themselves backsliding, stretch and release it, as a method of reprogramming their mind sooner, but I don't regard it as being strictly necessary. Remember to remove it, afterwards, if you use this method.

I'm aware of the opinion that inflicting pain doesn't prevent fear, but the intention is to reprogram, and establish a different way of thinking, by commitment to repetition. It usually takes around 25 to 40 repetitions to establish a new habit.

Try replacing a negative thought with a positive affirmation of your choice, like: "I am a unique individual, with my own set of skills, and good points", or "I may not be perfect, but I'm doing the best I can, right now".

Practice a relaxation method, daily, and when needed, such as http://www.drcoxconsulting.com/managing-stress.html or http://altmedicine.about.com/cs/mindbody/a/Meditation.htm
or www.wikihow.com/Meditate and/or Tai Chi, Qi Gong, or yoga.

Give the EFT a good tryout, to see if it helps you. It is free via the searchbar at *http://eft.mercola.com or www.tapping.com (13 free videos) or YouTube EFT. Professionally instructed is best. There is a version for use in public places*, (you can claim to have a headache, as you employ the acupressure massage/tapping on your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind: "Even though I have anxiety, I deeply and completely accept myself."

Herbal remedies, such as chamomile, passionflower, or St. John's wort, (many brands contain insufficient hyperforin to balance its hypericum content; Kira, Jarsin, and Perika brands are recommended; take with a meal) are often effective, but the idea is (as with anxiolytic medication) to use them like water wings, or training wheels on a bicycle, providing initial support, and giving time for other treatments, such as therapy, and relaxation techniques, to take effect. See http://altmedicine.about.com/cs/conditionsatod/a/Anxiety.htm

Imagine, as vividly as you possibly can, that your concerns, anxieties, worries, fears, your self-recriminations, all the agonizing "I'm-so-Stupids"; every painful "I-can't-do-it", etc., are huge raging, hurtful bulls snorting and charging at you. You see them coming at you and you hold out your red matador's cape at arms length and simply let them charge right by. Every time they come at you, hold out your arm with the red cape and let them rage and snort and go right on past. A free E course in CBT for anxiety is at: http://ecouch.anu.edu.au/welcome

85% of people are suggestible, to some extent, so consider professional hypnotherapy, or more alternatives along such lines are at: http://your-mental-health.weebly.com/i.html where this came from; see the rest.

Try your bookstore, Amazon.com, or BarnesAndNoble.com for: How to Control Your Anxiety before It Controls You, by Albert Ellis, & Self-Coaching: How to Heal Anxiety and Depression, Joseph J. Luciani Ph.D., & Anxiety and Phobia Workbook, by Edmund Bourne, & Natural Relief for Anxiety: Complementary Strategies for Easing Fear, Panic & Worry by Edmund J. Bourne, Arlen Brownstein, and Lorna Garano, & The 10 Best-Ever Anxiety Management Techniques: Understanding How Your Brain Makes You Anxious and What You Can Do to Change It by Margaret Wehrenberg, & Managing Anxiety. Kennerley, Helen., and/or "Calm : a proven four-step process designed specifically for women who worry" - Denise Marek, Hay House, c2006. and/or "Women who worry too much : how to stop worry & anxiety from ruining relationships, work & fun" - Holly Hazlett-Stevens.

Other relevant posts:

HERBAL ANXIOLYTICS: (passionflower, valerian, St. John's Wort, etc.) http://anxietyforum.net/forum/showthread.php?34269-5-Powerful-Tools-You-Probably-Haven-t-Tried-Yet&p=225415#post225415

NON HERBAL NATURAL (NON PHARMACEUTICAL) ANXIOLTYICS: (5-htp, etc.) http://anxietyforum.net/forum/showthread.php?34355-Help-Please!!!/page2

ANXIOLYTICS: http://anxietyforum.net/forum/showthread.php?34327-Need-so-much-advice-Have-so-many-questions&p=225657#post225657

Hoping something in the above helps.

[Kirk]

I also have GI symptoms sometimes. Stress is known to sometimes cause nausea, diarrhea, reflux symptoms, IBS, etc.
My GI physician told me that it is pretty common to run tests if symptoms don't get better or get worse. My wife once went to the
ER with chest discomfort and vomiting. It was GI related and nothing serious. GI symptoms can cause chest discomfort and pain.

[Evan James]

Thanks Nowuccas, looks like I have some reading to do! Interesting theory about the wide rubber band, I haven't heard of that before so might give it a try! Kirk, it's reasssuring to know that gastric issues can also cause chest discomfort and pain. I feel a touch better today but I put that down to the acid neutralising medication I've been on. Hopefully I'll be back to 'normal' soon enough. Thanks for your input guys, much appreciated :)

Evan

[ltomama0945]

"I Loved You" is a single by British deep house duo Blonde featuring vocals from British singer Melissa Steel. The track uses interpolations of "More", a song from the album of the same name by Canadian singer Tamia. It was released through Parlophone on 30 November 2014 in the United Kingdom. The song has peaked at number 7 on the UK Singles Chart.