The dichotomy of alexithymia and panic disorder.

This manuscript presents a novel model of psychophysiologic markers for the stress response. The hypothesis describes what we believe is a human analogue of the physiologic changes described in animal models of inescapable shock. This is bolstered by laboratory and clinical data derived from patients with stress-related functional gastrointestinal disorders. The idea explains the clinical findings of simultaneous analgesia and somatization in alexithymics. The implications for understanding the physiologic relationship between panic disorder and functional bowel disorders in the context of the stress response is discussed along with novel treatment strategies for these disabling conditions.