It is very common for people with endometriosis to feel anxious. People with endometriosis tend to have higher levels of anxiety and depression than the general public. (1) There are many potential reasons for increased anxiety in endometriosis.
Firstly, the experience of symptoms which can be very painful, tiring and uncomfortable can directly impact anxiety levels. When we are experiencing physical discomfort this changes how our nervous system and brain functions. When everything is well, we can have what is called “homeostasis” in the body. This means that everything is balanced and at an equilibrium. However, when we start to experience disruptive physical symptoms, this throws our balance off. (2,3) It can activate the sympathetic nervous system, which is the fight/flight/freeze branch of the nervous system and cause us additional physical and psychological stress in the body. So biologically, the experience of symptoms can cause significant stress, with accompanying emotional experiences of anxiety without even having had a conscious thought.
When we take into account the thoughts and worries that can come up in endometriosis, this adds significant layers to anxiety. Worries and concerns about what is happening inside the body, what the consequences are and how you can cope with this can come up repeatedly. With these thoughts can come a lot of distress and anxiety. This is exacerbated by the uncertainty, which as humans, we generally don’t tolerate very well particularly when there is a potential threat.
In these moments, our brain wants to problem solve but because the emotion and fear centres in the brain are so highly activated, our ability to do so is compromised. This can lead to cyclical thoughts which then keep the anxiety going.
For these reasons, it is important to build skills in calming down and regulating the nervous system and with that brain activity. The first step is acknowledging how you feel and extending your exhale out to activate the soothing branch of your nervous system (parasympathetic nervous system). This will not be a magic wand but it is a foundational skill in building your capacity to get back to homeostasis in the face of stress.
REFERENCES:
- Van Barneveld, Esther, et al. "Depression, anxiety, and correlating factors in endometriosis: a systematic review and meta-analysis." Journal of women's health 31.2 (2022): 219-230.
- Guidi, J., Lucente, M., Sonino, N., & Fava, G. A. (2020). Allostatic load and its impact on health: a systematic review. Psychotherapy and psychosomatics, 90(1), 11-27.
- Mickle, A. M., Garvan, C. S., Bartley, E., Brooks, A. K., Vincent, H. K., Goodin, B. R., ... & Sibille, K. T. (2022). Exploring the Allostatic Load of Pain, Interference, and the Buffering of Resilience. The Journal of Pain, 23(5), 30