IBD & PTSD
If you live with ulcerative colitis or Crohn’s disease then you know how much of an emotional toll this very physical disease can have on your life. While neither of these Inflammatory Bowel Diseases (IBD) is caused by stress or our emotions, these illnesses cause emotional stress and turmoil.
When I was in my first severe flare-up in 1998, I became house-bound because I simply could not get out of the bathroom. I was having 15-30 bowel movements per day and had very little time to get to a bathroom after the urge hit. To make matters worse, I had an accident in our local grocery store. It took me three months before I could go back.
I also had my first bout of claustrophobia about six months into my diagnosis. I had to travel and have always loved airplanes. I grew up flying on six-seater airplanes with my dad as the pilot. So fear of flying was not the cause of my panic attack. It was a concern of being strapped into my seat with 200 other passengers, two bathrooms, and the fact that you can’t just get up and go any ol’ time you want.
It took years before a friend, who is also a psychotherapist, suggested that I may have a mild form of Post-Traumatic Stress Disorder (PTSD). She pointed me to a study that was published in the December 2, 2010 issue of BMJ - British Medical Journal.
The study was conducted in Switzerland and followed the health and psychological well-being of 600 adults who had been diagnosed with Crohn’s disease and lasted 18 months. The participants all had a mental health assessment at the beginning of the study using a 17-item validated PTSD scale. The scale scores the degree of fear, suffering and impaired quality of life associated with PTSD from 0-51.
Patients scoring at least 15 points are suggestive of PTSD. In this study, nearly 1 in 5 (19 percent) of participants achieved this score. The results of the study showed that those Crohn’s patients who also had PTSD were more than four times as likely to experience a worsening of symptoms as those who scored below the threshold of 15, and more than 13 times as likely to do so as those who scored zero.
According to the Mayo Clinic, "Post Traumatic Stress Disorder symptoms may start within three months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions."
In my case, I have experienced intrusive memories of accidents or uncontrolled symptoms; avoidance of many social situations; and changes in emotional reactions.
A number of things have helped me to re-engage in my life without fear:
First, I worked with a psychologist who was able to help me work through my fears and provide realistic coping mechanisms. She is now helping me to explore EMDR - Eye Movement Desensitization and Reprocessing, which I will discuss in another post after my treatment is complete.
Second, I have taken control of my ulcerative colitis by changing how I eat. If you are a follower of my posts then you know that I eat according to the Specific Carbohydrate Diet (SCD). Since beginning the SCD three and a half years ago, my symptoms are nearly 100 percent gone and flare-ups are a thing of my past.
Third, hatha yoga and meditation are now a part of my weekly schedule. I began with a simple yoga program as outlined in Richard Hittleman’s book, Yoga, 28-day Exercise Program. For the meditation I read Jon Kabat-Zinn’s book, Full Catastrophe Living and bought one of his meditation CDs.
Like anything the meditation and the yoga take practice and patience and it took me a good six months to get comfortable with both new practices. But, here I am nearly 16 years after that first flare-up and diagnosis living my life on my terms.
Elizabeth wrote for HealthCentral as a patient expert for Digestive Health.