by Brooke Keefer
It is common for SOD patients to develop anxiety, depression, and health-related post-traumatic stress disorder (PTSD). I say this from my own experience and the experience of listening to other SOD patients in support groups. Many SOD patients complained they developed a fear of doctors and hospitals and a fear of illness in general. Some avoided doing things they used to enjoy for fear it would cause an SOD flare up.
SOD Patients Doing Better than We Thought
Patients with painful functional gastrointestinal disorders (FGIDs) have been reported to have a high prevalence of psychosocial disturbance. This has not been studied extensively in patients with suspected Sphincter of Oddi dysfunction (SOD) until the Evaluating Predictors and Interventions in Sphincter of Oddi Dysfunction (EPISOD) study a few years ago. A total of 214 patients with post-cholecystectomy pain and suspected SOD were enrolled in seven US centers in a multicenter-randomized trial. Baseline assessments included pain descriptors and burden, structured psychosocial assessments of anxiety/depression, coping, trauma, and health-related quality of life. Patients with high levels of depression, suicidal ideation, or psychosis were excluded.
The study concluded that psychosocial comorbidity in SOD is high. However, it did not appear to differ significantly from that reported in surveys of age- and gender-matched general populations, and may be lower than reported with other FGIDs. This is good news because, in a nutshell, it is saying our symptoms aren't psychological and we are doing emotionally better than we think; and better than people with other digestive conditions. We are a strong bunch and should take pride in this. For all we endure, we are coping fairly well. However, regardless of what this study purported, PTSD is definitely alive and well in the SOD community. I can attest to that.
By the time I recuperated from my SOD health crisis I had developed an intense fear and resentment of doctors and hospitals. I have had several severe pancreatic pain episodes over the past year yet I refused to go to the emergency room because of my health-related PTSD. There are many contributing factors to my PTSD, including mistreatment by health care staff and doctors, doctors not believing me, being treated as a drug seeker because of normal test results, isolation from society, nearly dying on a few occasions, spending a good portion of a year in the hospital, and just the fact I was sick 24/7 for several years.
Lack of PTSD for SOD Resources
If you google “mental health therapy for cancer patients” thousands of search results appear, anything from where to get therapy to resources for support groups, general information, research on the mental effects of cancer, etc. The American Cancer Society has online modules for patients on how to mentally and emotionally deal with anything related to their illness. No surprise when I searched online for mental health and SOD resources I found nothing except a few research articles stating anxiety/depression could cause SOD or those with SOD may have higher instances of anxiety/depression (both of which were proven to be unfounded).
The best thing I’ve done for my health-related PTSD was when I sought help from a qualified mental health therapist. Therapists who focus on trauma issues are ideal for SOD patients. A therapist once told me that the form of PTSD I had from my health nightmare was severe and required evidence-based treatment. Never underestimate the damage this condition can do to one’s mental, emotional, and spiritual state. The best form of therapy I received was from the hypnotherapist I saw for pain. He helped teach me coping and self-soothing skills not only for my pain but also for the mental anguish I endured. He also incorporated evidenced-based trauma techniques. I also saw a few therapists before him who were helpful but the therapies seemed to run their course and I needed to move on.
There are many different types of therapy for PTSD. Some of the most common therapies for trauma are Cognitive Behavioral Therapy (CBT), Narrative Exposure, Prolonged Exposure, and Eye Movement Desensitization and Reprocessing (EMDR). Most psychotherapists are versed in CBT or “Talk Therapy”.
I had positive results with CBT. It focused on exploring relationships among a person's thoughts, feelings and behaviors. During CBT a therapist will actively work with a person to uncover unhealthy patterns of thought and how they may be causing self-destructive behaviors and beliefs. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. CBT can be a very helpful tool in treating mental health disorders, such as depression, PTSD, or an eating disorder. But not everyone who benefits from CBT has a mental health condition. It can be an effective tool to help anyone learn how to better manage stressful life situations.
I have heard great things about EMDR, a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories. According to the EMDR Humanitarian Assistance Programs website, EMDR therapy is an eight-phase treatment which comprehensively identifies and addresses experiences that have overwhelmed the brain’s natural resilience or coping capacity, and have thereby generated traumatic symptoms and/or harmful coping strategies. Through EMDR therapy, patients are able to reprocess traumatic information until it is no longer psychologically disruptive.
Psychopharmacology is also an effective way to treat anxiety, depression and/or trauma. There are many different types of antidepressants and antipsychotics. In my opinion and experience, do not rely on your family physician to prescribe these medications. Go to a psychiatric nurse practitioner or psychiatrist. They are well versed in what works best for each person’s situation and body chemistry. Ask about genetic testing to see which medications to try and which to avoid for your genetic body type. Since these medications are heavily metabolized in the liver, genetic mutations of liver enzymes can predict which may work best for you. Alternatively, you can seek a consult with a natural health practitioner. They may be able to treat your condition with supplements, herbs, or diet.
Online Links for Coping
There is a plethora of great information out there for anxiety, depression, stress, and PTSD self help, so much it can be overwhelming. I love YouTube for online tutorials as I am a visual learner. Search online or on YouTube using the keywords, "health PTSD", "health anxiety", "free CBT", or something similar. Here are some of my favorites sites for PTSD resources:
The National Center for PTSD: Here is a link to a list of PTSD apps you can get for your phone or tablet.
Coping Statements for Anxiety: This website has a list of phrases you can use to self talk your way out of anxiety. When these rational self-statements are practiced and learned, your brain takes over and they automatically occur. This is a form of gentle conditioning, meaning that your brain chemistry (neurotransmission) actually changes as a result of your new thinking habits.
Emotional Freedom Technique or Tapping: This is a YouTube demonstration of a technique to reduce anxiety. I had a therapist teach me tapping and, with consistent practice, proved beneficial.
Get Self Help Website: This website is very basic, no frills. However, it is jam-packed with free self help worksheets, links, and even a few courses.