Patients with Interstitial Cystitis (IC) have increased numbers and activity of sympathetic nerves supplying the bladder as well as extensive connections between the nerves and local mediators of inflammatory tissue reaction such as mast cells (Theoharides et al. 1997) The sympathetic nervous system is activates with your perception of stressful events. So after an argument with your husband let's say you'd stimulate the sympathetic nervous system which causes mast cell production and inflammation of the bladder.

Stress = Inflammation = pain and urgency.

The opposite of the sympathetic nervous system is the parasympathetic nervous system (PNS). The PNS helps you stay calm and relaxed. Both the SNS and the PNS are needed for survival but uncontrolled over activity of the SNS causes pain discomfort and many other health problems. Thus the presence of stress may be particularly problematic in IC patients that may already be plagued chronic inflammation (Chrousos 1992)

Clinically I have always wondered what comes first; IC symptoms causing stress or life-stress causing IC symptoms. I have noticed that stress may be both a consequence of IC symptoms and a source of symptom exacerbation. However only 13.3% of patients reported IC symptoms as their primary stressor. (Rothrock et al. 2001) Meaning that often times its not IC symptoms the induces stress (and then pain and urgency) but other life stressors; a break-up an unhealthy work environment death of a loved one etc. that makes IC symptoms worse.

Previous research has demonstrated that stress can exacerbate IC symptoms in a laboratory setting suggesting that stress may be causally related to processes involved in symptom exacerbation in IC. (Ludendorff et al. 2000)  All that indicates that life stressors are associated with greater urgency pain and frequency in patients with IC particularly in those patients with moderate and severe symptom intensity.

What should you do?

Stop stressing! Ok I know that's easier said than done. So here are some powerful 7 tips:

7 tips to lower stress and improve IC symptoms

1. Try magnesium also known as the relaxation mineral. Between 100mg to 250mg a day should work.
2. The herb Lemon balm (Melissa officionalis) has been well studied to produce calmness and alertness. (Kennedy et al. 2004)
3. Exercise regularly. Try Yoga. THIS YOGA DVD is specifically made for patients with pelvic dysfunction and bladder pain.
4. Breath deeply regularly. This helps immediately to activate the PNSA thus calming down the sympathetic nervous system. 5 deep breaths two to three times a day is a good start.
5. Remove refined carbohydrates (RC) from your diet as they cause nutritional stress and inflammation. By the way RC are the foods most commonly eaten during stressful times. They worsen pain however.
6. Try adaptogenic herbs (herbs that help you adapt and balance your response to stress) such as ginseng Rhodiola rosea Siberian ginseng cordyceps and ashwagandha. Rhodiola is my favorite it works really well.
7. Challenge your beliefs and change them accordingly. Reframe your point of view to reduce stress. Its almost always small stuff so don't sweat it.