context: It's not totally clear how stress, anxiety, and irritable bowel syndrome are related -- or which one comes first -- but studies show they can happen together. When a doctor talks to people with this digestive disorder, "what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, Ph D, professor of psychology at the State University of New York at Albany. The most common mental ailment people with irritable bowel syndrome have is generalized anxiety disorder, Blanchard says. He thinks more than 60% of IBS patients with a psychiatric illness have that type of anxiety. Another 20% have depression, and the rest have other disorders. Regardless of whether they have irritable bowel syndrome, people with anxiety tend to worry greatly about issues such as health, money, or careers. Thos can lead to other symptoms that include upset stomach, trembling, muscle aches, insomnia, dizziness, and irritability. There are several theories about the connection between IBS, stress, and anxiety: Although psychological problems like anxiety don't cause the digestive disorder, people with IBS may be more sensitive to emotional troubles. Stress and anxiety may make the mind more aware of spasms in the colon. IBS may be triggered by the immune system, which is affected by stress. There's proof that keeping your stress under control can help you prevent or ease IBS symptoms. You could learn about relaxation techniques such as deep breathing or visualization, where you imagine a peaceful scene. Or you can zap tension by simply doing something fun -- talk to a friend, read, listen to music, or go shopping. It's also a great idea to exercise, get enough sleep, and eat a good diet for IBS. Try different stress-busting techniques to see which may help ease your IBS symptoms. If you're still tense and anxious, talk with your doctor. Make sure you're getting the right medical treatment for your constipation or diarrhea. Then discuss whether talk therapy might help. People with irritable bowel syndrome "should really start with their primary care physician, and work with that person," Blanchard says. " They should only go the next step [psychological care] if what they're doing with their doctor is not working." Blanchard says two-thirds of people with IBS get better with changes in diet and medication. The other third, people with more severe symptoms, might benefit from psychological help. " Without that, they don't seem to get out of the problem that they're in," he says. Research shows that therapy can help some IBS symptoms in many people who try it. Options include relaxation therapy, biofeedback, hypnosis, cognitive behavioral therapy, and traditional psychotherapy. Therapy has limitations, though. Some studies have found it doesn't help the constipation or constant belly aches that come with IBS. You could join a self-help group for people with irritable bowel syndrome or other digestive disorders. Members of these groups know what it's like to live with IBS. Sometimes they can offer more meaningful support than you could get from even your closest friends. " You are not alone in trying to handle it all," says Lynn Jacks, founder of an IBS support group in Summit, N. J. There are support groups around the globe. One option is Web MD's Digestive Disorders Support Group, which is available 24 hours a day.