Panic Disorder Related Conditions The Link Between Panic Disorder, Anxiety, and IBS By Katharina Star, PhD Katharina Star, PhD Facebook LinkedIn Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. Learn about our editorial process Updated on September 17, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print gawrav/Getty Images. Irritable bowel syndrome, or simply IBS, is a type of gastrointestinal condition that disrupts the colon and causes problems in the digestive system. IBS is estimated to affect between 10 to 15 percent of people worldwide. The symptoms of IBS can vary for different people. Although IBS is not a life-threatening illness, it often develops into a chronic condition that can greatly impact many aspects of one’s life. The Connection Between IBS and Panic Disorder Research has indicated that rates of IBS are high among people diagnosed with anxiety disorders and/or mood disorders. The frequency of IBS symptoms has been found to be especially high for people diagnosed with anxiety disorders such as panic disorder. Much like panic disorder, IBS poses many distressing symptoms that can be embarrassing and difficult to manage. Recurrent and often unexpected panic attacks are the main symptom of panic disorder. Similar to IBS, panic attacks are characterized by many uncomfortable physical sensations. Some of the most common symptoms of panic attacks include sweating, trembling, chest pain, accelerated heart rate, and shortness of breath. Both conditions also share many of the same symptoms, such as anticipatory anxiety and avoidance behaviors. The symptoms of both IBS and panic disorder can be upsetting, embarrassing, and difficult to manage. IBS Symptoms Abdominal pain Frequent stomachaches Cramping Bloating and excessive gas Constipation, diarrhea Changes in bowel functioning (fluctuating between constipation and diarrhea) Panic Disorder Symptoms Recurrent panic attacks Sweating Trembling Chest pain Accelerated heart rate Shortness of breath Symptoms of IBS It is currently unclear why a significant percentage of panic disorder sufferers also struggle with the symptoms of IBS. It has been hypothesized that both conditions are triggered by the fight or flight stress response. The fight or flight response is prompted by the sympathetic nervous system, causing changes in the body to prepare to fight off or flee from a perceived threat. Common physical reactions include sweating, rapid heart rate, and a slowing down of the digestive system. People with panic disorder and IBS may have an overactive fight or flight response, causing strong somatic reactions despite a lack of danger. The incidence of IBS is even higher for those diagnosed with panic disorder with agoraphobia. People with agoraphobia display many avoidance behaviors in which they steer clear of places and situations that they fear will trigger panic attacks or that escape might be difficult or embarrassing. It has been speculated that the higher rates of IBS for agoraphobia sufferers could in part be due to overlapping avoidance behaviors, such as worrying about where to find a restroom, embarrassment associated with the symptoms of IBS, and having to manage the difficult gastrointestinal symptoms. There is also some evidence that certain foods, substances and lifestyle choices elicit panic disorder and IBS symptoms. Common dietary triggers for both conditions include caffeine, alcohol, and sugar. IBS and panic disorder symptoms can also worsen due to chronic stress and habitual negative thinking. The Role Your Diet Is Playing in Your Panic Attacks Treatment Options for IBS and Panic Disorder Much like panic disorder, there is currently not a cure for IBS. However, both panic disorder and IBS are treatable conditions. Many of the common treatment options for panic disorder have also been shown to safely and effectively treat IBS. For example, some selective serotonin reuptake inhibitors (SSRIs) commonly prescribed for panic disorder have also been found to reduce IBS symptoms. On the other hand, some of the medications for panic disorder can worsen IBS symptoms, so it is important that you discuss your symptoms and treatment options with your doctor. Panic Disorder Treatment Psychotherapy is also a common treatment option that can help with both panic disorder and IBS. Psychotherapy can assist with stress management techniques, as high-stress levels often exacerbate both conditions. Going to therapy can help you deal with the physical and emotional feelings associated with both disorders. Additionally, psychotherapy can assist in reducing the symptoms of common co-occurring conditions, such as depression. Panic Disorder Discussion Guide Get our printable guide to help you ask the right questions at your next doctor's appointment. Download PDF Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. Research has shown that cognitive behavioral therapy (CBT), in particular, can be an effective type of psychotherapy for people struggling with both IBS and panic disorder. CBT often encompasses education, desensitization activities, homework assignments, and relaxation techniques to assist in managing your conditions. CBT techniques can help reduce the symptoms of panic disorder and the digestive problems associated with IBS. The 7 Best Online Anxiety Support Groups A Word From Verywell The symptoms of IBS can greatly impact one’s quality of life. Having both IBS and panic disorder can be extremely difficult to deal with. However, by getting professional help and managing your stress, you can learn to effectively cope with both of these conditions. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. IFGD. Facts about IBS. Popa SL, Dumitrascu DL. Anxiety and IBS revisited: ten years later. Clujul Med. 2015;88(3):253–257. doi:10.15386/cjmed-495 MedlinePlus. Panic disorder. Cleveland Clinic. Stress. Fadgyas-Stanculete M, Buga AM, Popa-Wagner A, Dumitrascu DL. The relationship between irritable bowel syndrome and psychiatric disorders: from molecular changes to clinical manifestations. J Mol Psychiatry. 2014;2(1):4. doi:10.1186/2049-9256-2-4 Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights. Psychol Res Behav Manag. 2017;10:231–237. doi:10.2147/PRBM.S120817 Additional Reading American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision 2000 Washington, DC. Gros D, Antony M, McCabe R, Lydiard R. A preliminary investigation of the effects of cognitive behavioral therapy for panic disorder on gastrointestinal distress in patients with comorbid panic disorder and irritable bowel syndrome. Depress Anxiety. 2011 Nov;28(11):1027-33. doi: 10.1002/da.20863. Epub 2011 Jul 18. PMID: 21770001. Gros D, Antony M, McCabe R, Swinson R. Frequency and severity of the symptoms of irritable bowel syndrome across the anxiety disorders and depression. J Anxiety Disord. 2009 Mar;23(2):290-6. doi: 10.1016/j.janxdis.2008.08.004. Epub 2008 Aug 27. PMID: 18819774. Sugaya N, Kaiya H, Kumano H, Nomura S. Relationship between subtypes of irritable bowel syndrome and severity of symptoms associated with panic disorder. Scand J Gastroenterol. 2008;43(6):675-81. doi: 10.1080/00365520701883478. PMID: 18569984. By Katharina Star, PhD Katharina Star, PhD, is an expert on anxiety and panic disorder. Dr. Star is a professional counselor, and she is trained in creative art therapies and mindfulness. 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