“When you lose control of your bowels, one of the most basic bodily functions, the feeling of losing control in the rest of your life is huge,” says Cleasby. “I was so scared of having an accident in public that I would avoid going out, and I became very isolated. And, when you hide away in your home, alone, it’s easy to allow fear and anxiety to take over.”According to Mayo Clinic, signs and symptoms of anxiety include:Difficulty controlling worried thoughtsWeakness or tirednessIncreased heart rateRapid breathing (hyperventilation)Difficulty sleepingNervousness, restlessness, or tensionA sense of impending danger, panic, or doom“People think a panic attack is all in your head, but it’s such a powerful physical thing. My hands would cramp until I couldn’t move them, my chest felt like it was being crushed, I couldn’t breathe, my vision would blur. It’s terrifying,” says Cleasby.The symptoms of IBD, along with many other diseases, often worsen in times of stress, according to a review published in January 2021 in the Journal of Clinical Medicine. For example, stress may be related to a flare-up of symptoms such as abdominal pain or diarrhea, Dr. Petrik says.“When the body’s stress response is activated, it can result in physiological changes in the functioning of the digestive system,” Petrik explains. According to the American Psychological Association, chronic stress can also weaken the immune system.To help you manage anxiety while living with UC, follow these tips:Talk to a ProfessionalBased on Cleasby’s experience, working with a therapist or other mental health provider is an important part of managing UC.“I think the most important way to deal with anxiety and depression is to speak out about it,” Cleasby says. “It’s easy to feel so alone and that no one will understand you, but actually, just voicing your fears takes away some of their power.”Petrik recommends cognitive behavioral therapy (CBT), a type of talk therapy that helps people develop skills to cope with emotional challenges, such as those associated with UC. Acceptance and commitment therapy (ACT) is a type of CBT that helps people who have a chronic illness manage symptom-related anxiety. ACT has been shown to reduce stress and depression, but not anxiety, in people who have IBD, according to a review published online in December 2022 in Frontline Gastroenterology.Petrik says to ask your doctor if there is a mental health provider on staff or if they can recommend a therapist that specializes in chronic illness or IBD. Psychology Today also maintains a searchable database of verified mental health providers across the United States. A therapist can help determine whether or not anxiety medication is a good fit for you.Identify Stress Triggers and Explore Relaxation TechniquesMaintaining low baseline stress levels through meditation, yoga, or other types of exercise can help keep a particularly stressful event from triggering anxiety.It may also help to keep a journal of your thoughts, so you can recognize what causes anxiety for you specifically (it’s different for everyone).“Recognizing the initial symptoms and heading them off with deep breathing and meditation works for me. But, it’s about finding what works for you,” says Cleasby. “Speak to your doctor about how you are feeling and to your loved ones. There is no shame in needing support.”Dr. Zein recommends eliminating everyday stressors that could trigger anxiety with a few simple rules of thumb:Set realistic goals for yourself each day, and break big tasks into smaller ones.Do some prep work at night, such as packing a lunch or laying out your clothes, to decrease stress the following day.Build structure into your days, whether you’re in a flare or in remission. Zein suggests using a calendar or daily planner to keep track of your activities and appointments.Zein says relaxation techniques can reduce anxiety after it’s set in. These include breathing exercises, muscle relaxation, and meditation. “Oftentimes, using apps like Calm or Headspace can be really useful to guide people through these techniques when they’re feeling more anxious,” says Zein.“One technique is to combine slow, deep breathing with muscle tensing and relaxing,” Zein explains. “Try balling your fists while inhaling, holding, and then releasing them slowly while exhaling. [Doing this] is enough to relieve anxiety.”Another technique is to inhale slowly while raising your arms overhead and exhale slowly while lowering them back to your sides.Cultivate a Support SystemTo help you learn more about your disease and form a network of people who are living a shared experience, you can join an online support group or a local group. According to an analysis published in May 2023 in Frontiers in Psychology, support groups can help people who have been recently diagnosed with IBD feel less alone.“Having good support is an important part of managing physical and mental health in IBD. Asking for and accepting help from family and friends is important,” says Zein.And whatever your ritual, “It’s really important to develop coping skills that work for you,” says Zein.