Your brain plays a role in how well, (or not) you poop. If you’ve ever lived through a nerve-wracking or mortifying experience, you might know the feeling of bolting to the bathroom, cheeks fully clenched, to do an emergency number two. It’s an unseemly subject, I hear ya. But the fact is that people get diarrhea when they’re nervous, and for those who live with anxiety as a mental health condition, gastrointestinal issues are a pretty common physical symptom.
(Cue soapbox moment of me calling for the normalization of anxiety poops!)
If your digestive system goes off the rails at the first sign of trouble — even if it’s worry about toilet trouble that elevates your anxiety — it’s a good idea to stay on top of why that happens or what your triggers might be so you can keep things under control. We asked professionals about how to cope when anxiety has your gut in a knot, and here’s what you need to know.
How Anxiety Impacts Your Gut
ICYMI, bodies and brains are one interconnected unit. “The entire gut is lined by the enteric nervous system (ENS), which is your ‘second brain’” explains Dr. Amol Sharma, Associate Professor of Gastroenterology and Hepatology at the Medical College of Georgia. “The ENS interacts constantly with your gut environment, microbiome, and brain.”
So what happens to your gut during stress, when your brain is in fight or flight mode? Dr. Sharma notes that blood is diverted from your gut which changes the pattern of secretion of hormones and fluids, and can slow or speed up transit through different portions of your gut. These chemical signals are your body’s natural laxative which can send you to the bathroom ASAP, or keep you blocked up.
“Some people have predominant rapid transit of their small bowel, leading to diarrhea (i.e. think of a nervous kid before the exam who has the runs),” Dr. Sharma says. “Others have predominant slowing of transit through the colon leading to abdominal pain and constipation (i.e. think of the office worker who constantly has more responsibility than they can handle).”
For people with anxiety and depression, serotonin is a hormone that also plays a key role, because those conditions are associated with altered levels of serotonin. Greater than ninety percent of the body’s serotonin is produced by the gut, and as such any alterations in serotonin signaling may be responsible for IBS symptoms, re: diarrhea, constipation, bloating, gas pain and any other gnarly stuff.
Stop Those Anxiety-Triggered Poops For Good
After you’ve relieved yourself in the restroom, you’re probably able to continue on with your day like nothing happened — but what about the next time?
If you’re experiencing occasional stress poops, there’s no need to worry because it’s a pretty common issue for people. Keep in mind, though, that your poop is an important indicator of your overall well-being — so if GI symptoms persist and start to impact your life on a deeper level, there are a few steps you can take to manage them. You don’t have to be a passive victim to anxiety diarrhea!
“You may be able to find an effective, internal solution through yoga, mindful meditation, or with the help of a cognitive behavioral therapist,” Dr. Sharma says. Specifically related to IBS, he also notes that mindfulness practice has proven more effective at managing symptoms than low-dose prescriptions of neuromodulators for anxiety and depression, including common selective serotonin reuptake inhibitors (SSRIs) like Prozac, Celexa, Lexapro and Paxil.
Mindful meditation is a helpful tactic because it basically halts your stress response, stopping your body from triggering any accompanying physical reactions (like a diarrhea attack). Some other soothing ways to manage anxiety might look like breathing exercises, sipping on calming tea, or reaching out to loved ones when you need a little extra support.
Ken Goodman, producer of The Anxiety Solution Series, emphasizes that stomach distress worsens and persists when you are fearful of the symptoms and try to stop them. “Anxiety sufferers can reduce their distress over time by accepting what they can’t control and focusing on living their life,” Goodman says. “Eating healthy, deep breathing, guided meditation, exercise, and talking about the source of one’s anxiety will also help.”
Getting help for your anxiety will make a big difference on physical symptoms, which means talking to a mental health therapist and discussing treatment options is a good first step. If you make changes and nothing improves (if your gut is still causing all kinds of unpleasant stuff like diarrhea and cramps in an unlivable way), it might be time to see a healthcare provider who can offer some other suggestions for treatment.
A version of this story was published June 2020.