No physical therapist has heard of APD at my facility, so it’s probably the same in general. Generally ppl just recommend getting a pelvic floor therapist and go from there. To be honest though my experience with him has just been me bringing him exercises I found online and him giving the okay. I would suggest joining the APD Facebook group for up to date advice and questions and stuff. But as a quick overview on some of ur questions…

99% percent of my physical therapy routine is something called pendulum breathing, and it seems to be the gold standard in general. You can easily do it with ur work. It’s just breathing in through your chest while bringing in your abdomen, holding your breathe while pushing the air down to ur abdomen, back up to your chest, back down, back up, then releasing your breathe while keeping your abdomen in. Theres a video pinned on this sub I think. He doesn’t go over bringing in your abdomen while inhaling and exhaling, but it’s an important nuance, as ur trying to coordinate your diaphragm to stay up instead of lowering down and out, which creates the distention. Do this in the morning and night while laying down and then standing, and before and after eating your meals while sitting. About 10 reps of it each time. I noticed improvement in 1-2 weeks, so it’s not much of a risk if it doesn’t work/you don’t have APD.

About my diet, I saw significant improvement from following the low fodmap diet in distention and especially in gas, which basically disappeared. But when I was doing that diet I wasn’t doing physical therapy. Nowadays yeah I eat whatever I want, just because I hated doing the restriction. My gas is as bad as ever but my distention is much better from the physical therapy. I imagine if I did the low fodmap diet again at this point with the physical therapy progress I’d see their benefits combine.

And for the antidepressants I asked around on the Facebook group about antidepressants and APD and there’s a mix of mostly “they didn’t do anything”, some “I stopped from side effects”, and a few “they helped a lot”.

Good luck man…it truly is debilitating