Do you have GAD/panic? If so do you also have an ongoing problem with physical pain?

[jonchoo]

I'm trying to test the idea that GAD/panic is caused by pain/damage in the body, not by a malfunctioning mind.
I'm a sufferer, not a 'scientist', but the more I look into it the more it seems plausible.

[Capercrohnj]

I have 2 severe GI diseases so idk if my answers count. My GAD started way before I developed those diseases. I can't take most OTC pain meds because of my gut issues (everyone stay far away from NSAIDs if you have gut issues). Opioids kinda help my pain but not anxiety. Cannabis helps my anxiety not pain. The tricyclic antidepressants didn't do anything.


My diseases (Crohn's and gastroparesis) didn't cause my anxiety and were not caused by anxiety though anxiety makes the worse.


ETA: I have had my colon and rectum removed and ghat difn't decrease my anxiety at all other than the fact I have 0% chance of crc now so don't have to worry about that.

[MyNameIsTerry]

This being the HA board the nature of the fears will differ greatly to most on the GAD board, speaking as a GAD & OCD sufferer myself.

It sounds like you are asking about a chicken & egg scenario of whether GAD has been caused by disease/injury that has made the person hypersensitive to symptoms of their disease/injury. That's complicated by the fact trauma may be healed but left solely in the subconscious like in PTSD.

In my case, I do suffer loads of aches & pains like anyone on here but find my anxiety has always latched onto them big time to amplify them (my GAD that is, my OCD has no health elements). But it wasn't injury or illness that caused my GAD, it was not spotting the signs of working myself into the ground until BANG one day something snapped in me at work.

Are you looking into the inflammation side of mental health?

[jonchoo]

My GAD started way before I developed those diseases.
Have you considered that your gut may have been in distress, but didn't present obvious symptoms? You obviously have severe problems with your gut - I can't imagine that they appeared out of nowhere.
What I'm driving at with this idea/theory is that anxiety is linked to 'pain'. There is published evidence to support this (Google "anxiety paracetamol").
Now, when I say 'pain' I'm not only referring to the sort that we actively feel (like a toothache) but also signals that the body sends to the subconscious about 'damage', 'inflammation' or 'malfunction'. I wrote a more thorough explanation in another thread if you are interested (I can't post links yet apparently).

[MyNameIsTerry]

Many antidepressants treat pain too, among other meds (Pregabalin, for instance). They work on the neurotransmitters that also work with pain reduction. But I wonder just how much anyone knows about this stuff other than "we observed it helped" in a study and therefore we'll give a go? :shrug:

When my adrenaline levels are ramping up, up goes any existing pain with it even if it's not actually any worse.

What do you make of the studies of things like Mindfulness, and even CBT, in reduction of pain symptoms?

You will be able to post links once you're post count hits 10. It's just to help keep the spammers out.

[jonchoo]

Mindfulness, and even CBT, in reduction of pain symptoms
That's interesting - I hadn't heard about that, but it certainly backs up my 'theory'. Meditation could fall into the same category.


Many antidepressants treat pain too
The evidence just keeps on mounting. :) What if ... just imagine ... WHAT IF I'm right about this.

---------- Post added at 08:13 ---------- Previous post was at 08:08 ----------

The latest drug they have me on is Mirtazapine. I just checked and guess what - its effective at treating chronic pain. Google "Mirtazapine pain" and you'll find the study. The very first thing I noticed when I took the first pill was that my gut stopped bothering me.

[pulisa]

CBT and psychological therapies are all part of Chronic Pain Management programmes in hospitals.

[Capercrohnj]

There are lots of antidepressants that help with pain and are given to chronic pain patients. None of them worked for me though (including mirtazipine).

I 10000000% agree anxiety can cause gut pain but not necessarily gut pain causes anxiety (except worrying about the pain).

My GAD started as a teenager. I was diagnosed with Crohn's at 38 almost 39 so Crohn's didn't cause my anxiety.

---------- Post added at 09:42 ---------- Previous post was at 09:25 ----------


CBT and psychological therapies are all part of Chronic Pain Management programmes in hospitals.

Yes because chronic pain is difficult to live with and causes/worsens depression and hopelessness. I have aevere chronic pain all the time and it sucks bigtime.

[pulisa]

I have chronic neuropathic pain and it certainly gets you down. Not a good combo with GAD but you just have to cope with it as best you can.

[Capercrohnj]

I have chronic neuropathic pain and it certainly gets you down. Not a good combo with GAD but you just have to cope with it as best you can.

I have neuropathy too I believe (lyrica helps my body pain but not my abdominal pain).

[MyNameIsTerry]

That's interesting - I hadn't heard about that, but it certainly backs up my 'theory'. Meditation could fall into the same category.


The evidence just keeps on mounting. :) What if ... just imagine ... WHAT IF I'm right about this.

---------- Post added at 08:13 ---------- Previous post was at 08:08 ----------

The latest drug they have me on is Mirtazapine. I just checked and guess what - its effective at treating chronic pain. Google "Mirtazapine pain" and you'll find the study. The very first thing I noticed when I took the first pill was that my gut stopped bothering me.

Mindfulness and therapeutic forms such as CBT aim to change how you feel about your symptoms and your situation. You learn to accept it and learn to be more positive about it. So much the same as they are used to treat mental health conditions.

I would be wary of bias with your theory as many more people who suffer painful conditions, or traumas, never go on to become mental health disorder sufferers. So it can't be as formulaic as one creates the other there is a big question mark over why it also doesn't, pretty much that Holy Grail of anxiety disorders we would al like to get a firm answer from the medical world on. And comorbidity doesn't have to mean causality.

[jonchoo]

many more people who suffer painful conditions, or traumas, never go on to become mental health disorder sufferers

The basis of my idea is that pain/discomfort (even subconscious signals) are interpreted by some people's minds in such a way as to trigger anxiety/panic/depression. So it could, in that sense, be described as a malfunction in the brain.
The people who have the malfunction are diagnosed with GAD/panic/depression, and given pills to 'treat' their minds.
Perhaps we could, instead, cure the root cause/trigger or simply find ways to prevent the trigger from firing.
I am only a sample size of one, but I know that this makes sense in the framework of my own experience. I have also read many experiences of other people that broadly align with my 'theory', along with the scientific studies I have mentioned (loperamide, paracetamol, anti-inflammatory drugs/supplements/herbs, the gut-brain connection, pain and anxiety activating the same areas of the brain, anti-depressants as painkillers, dietary anxiety triggers, links between auto-immune inflammation and diet, and probably some more that I'm forgetting).
I'm sure you'd agree that even if this only works with 5% of sufferers, it would still be worth pursuing. But I think there's something real here.

[MyNameIsTerry]

I doubt any of us on here would disagree that they have the potential to cause a disorder as many people's HA has come from something traumatic whether mental or physical and then we have Adjustment Disorders, PTSD, etc.

It's something worth understanding but it's going to be one of many reasons I suspect as many more go through the same and don't experience our disorders therefore there is at least another factor involved, a pre-disposition as some might say.

I suspect you are looking into Methylation. That would tie in with a pain disorder creating an environment where the negative can thrive but again, it's only some people. What if there is no pre-disposition? Maybe some have a gene that can be flicked to "on" but that's not enough because otherwise it would mean some people are bulletproof to such traumas however it could be argued that since our genes can change throughout life Methylation can always be in play.

And what part of the body has the most genes? Yep, it's gut! :yesyes:

Like with PTSD, why do some people experience it whilst others don't in the same circumstances? Why do some HAers on here experience their HA starting from health scares or bereavements whilst the majority of the population don't? All very complicated stuff!

[jonchoo]

Like I said, I'm not a scientist, but I have noticed several things that seem to have a link to anxiety, along with symptoms that tend to be present in anxiety sufferers, such as :
- Methylation
- Histamine
- Sulphites
The common factor to all of this seems to be inflammation.
The inflammation is largely thought to be an auto-immune response.
Many of the 'supplements' that come up when looking into this have natural anti-inflammatory properties (eg. curcumin).

So what I have so far is :
- Genetic bad luck creates an auto-immune response to [chemical x]. This can happen suddenly and at any point during a person's lifetime.
- Auto-immune response either triggers pain/discomfort or simply 'silent warning messages' that are not consciously perceived by the brain.
- Conscious mind attempts to make sense of the pain/warning signals.
- If the mind cannot properly process the data (perhaps for genetic reasons, perhaps due to life experience) then it cannot properly 'solve' the problem that it is presented with.
- Conscious mind attempts to fill in the gaps
- Anxiety, panic, depression, perhaps even OCD ensue.

[jonchoo]

I'm going to continue dumping information here in the hope that it helps somebody.
Today's findings : I thought I'd look into anti-inflammatory drugs. Guess what - they interact badly with anti-depressants. Could this be because they both act on the same systems that cause inflammation, thus creating an 'overdose' effect when combined?

So I started to look into the anti-inflammatory properties of anti depressants and bingo :
Venlafaxine is an anti-inflammatory
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556757/
Mirtazapine is an anti-inflammatory
https://www.hindawi.com/journals/crips/2013/697872/
Citalopram is an anti-inflammatory
https://www.ncbi.nlm.nih.gov/pubmed/20131240
Prozac is an anti-inflammatory
https://www.wiley.com//WileyCDA/PressRelease/pressReleaseId-70017.html
And more
https://www.medicalnewstoday.com/articles/303618.php
and more
https://onlinelibrary.wiley.com/doi/pdf/10.1111/joim.12093
and more
https://www.livescience.com/56519-anti-inflammatory-drugs-depression.html

Why aren't doctors aware of all this?

I'm telling you guys - 'unexplained' anxiety, panic, GAD & depression are CAUSED BY INFLAMMATION.

---------- Post added at 13:44 ---------- Previous post was at 13:36 ----------

The word of the day is "cytokines", ladies and gentlemen.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3741070/

[Capercrohnj]

Pain clinics use antidepressents all the time not because they are "anti inflammatories" but because they effect your neurotransmitters that send pain signals to the brain. If you rrally think you are full of inflammation get a
CRP and ESR test. I get them regularily now a days mine is usually normal but I'm still depressed.

[jonchoo]

So it's all just a massive coincidence then?

[Capercrohnj]

The jury is still out. It could be a correlation vs causation thing but who knows. Thw most common antidepressants used by pain clinics are actually ones that are not that effecrive in treating depression (eg tricyclic antidepressants). Also I've never had any dr tell me that I can't take anti inflammatories (other than the ones I can't take because of crohn's) at the same time as antidepressants. I have been on prednisone and mirtazipine at the same time. Pain, especially chronic pain, is a very complex issue and so is mental health. I don't think very is one cause of either. It's probably a combination of lots of things.

[jonchoo]

Also I've never had any dr tell me that I can't take anti inflammatories
https://www.rxlist.com/drug-interactions/ibuprofen-oral-and-venlafaxine-oral-interaction.htm
https://www.rxlist.com/drug-interactions/aspirin-oral-and-venlafaxine-oral-interaction.htm
etc.

mine is usually normal
Am I to infer that there have been times when they weren't normal?
There's no way all this is a coincidence. Inflammation is the key.

[MyNameIsTerry]

There are many interactions between antidepressants and other meds but they can be Minor or Moderate which is nothing to a doctor as they probably spend most their's of time managing such things.

But doctors also don't understand all interactions in my experience as it's more for pharmacists who do check before dispensing and will refuse to where doctors make mistakes.

[Capercrohnj]

https://www.rxlist.com/drug-interactions/ibuprofen-oral-and-venlafaxine-oral-interaction.htm
https://www.rxlist.com/drug-interactions/aspirin-oral-and-venlafaxine-oral-interaction.htm
etc.

Am I to infer that there have been times when they weren't normal?
There's no way all this is a coincidence. Inflammation is the key.
I have Crohn's disease so yes when in a flare they aren't normal. What I'm saying I have depression and anxiety all the time not just when I have inflammation. If inflammation is the key then wouldn't it stop when the inflammation is gone?

---------- Post added at 13:50 ---------- Previous post was at 13:44 ----------

So many drugs interact with each. I have had pharmacists refuse to give me meds because of interaction issues (I'm on dom peridone). I've had more than 2 long term drugs stopped and replaced because of this. I've never had a pharmacist say anything about prednisome and anti depressants. The bleeding risk is definitely related to the NSAIDs. That's why I can't take ibuprofen, aspirin, naproxin, toradol etc.

[jonchoo]

wouldn't it stop when the inflammation is gone

Perhaps the inflammation is never really gone. As I understand it, Crohns is a chronic disorder that doesn't ever 'go away' and 'come back'.
I may be using the term 'inflammation' in a way that isn't compatible with the medical usage. They seem to describe something as 'inflamed' only when they can pick up certain chemical markers.
I'd argue that if you have Crohns (and any number of other conditions) then your gut is never going to be 'well' or 'healed'. It is going to send out 'distress' & 'damage' signals (via chemical messages) constantly, because it is always 'inflamed' / 'damaged' / 'distressed' / [pick a word]. This is more or less the idea that I started with in this thread : http://www.nomorepanic.co.uk/showthread.php?p=1816176#post1816176