Anxiety

[villen]

So...I have written about this before...I just seem to struggle with whether I have POTS second to the anxiety or anxiety second to pOTS. My doc believe the first...I kind of do that my self. And I really don`t know if the betablocker help me with this or what. I have been really bothered with anxiety the last year, "stressed out my body", lost weight, and the good shape I was in. Isn`t it true that severe stress/anxiety causes your nerves in the veins to "get fatigued"? And that stress/anxiety also cause the blood vessels to "open" and blood pooling in them? I sometimes believe I have developed CFS, after lots of Stress, and POTS is one of the symptoms here.

Anyone has some reassurence on how to deal with the anxiety and "the freaking out"thing when I get symptoms?

thanks:)

Hope you are coping.

[mvdula]

just wanted to say that i understand the anxiety reaction to symptoms - i can get very anxious and almost panicky when i have symptoms. i have also had times where i felt the anxiety was very physical, i.e. not related to my thoughts but started in my body - so sometimes not sure which is which! all i can say is i sympathize!

[Miriam Poorman-Knox]

Hi,

First I don't think it matters much where the stress originated. Its here treat it and live --hopefully a bit better. Second our veins and nerves at totally seperate. There are no nerves in our veins. Although they do run along the same pathways. It is entirely possible to have other diagnosis. with this. The point for me is to treat the symptoms and know that dysautonomias are ever evolving. M

[maryfw]

Stress does me in. My hubby has been very sick and even though I think I am dealing with it well I get run down really quickly. Just do the best we can do. mary

[Guest tearose]

I think it is different from person to person. I think stress is different from anxiety too.

Temperature, big meals, colds or physical exertion are types of stress. Stress does not have to cause anxiety.

I think of anxiety as a type of fear or feeling of nervousness. I rarely feel anxious. I am a thinker and not an anxious kind of person.

If I am not following my treatment plan of heavy compression, electrolytes, hydration, rest, pacing myself; and then I have to stand in a line for 15 minutes I will most surely trigger my reaction. I first get a heavy feeling in my legs, then I get some white spots in my eyes, then comes shortness of breath and I may even be talking to someone and this can all be happening. then I feel a rush of clammyness and I must sit down immediately. I don't feel anxious when this happens, more like a out of breath, limp rag doll.

In the days before my diagnosis when I was standing and making a presentation for example, I never understood why I was sweating tons and speaking so fast! I intuitively learned to sit and make a presentation and felt less racey and would speak and answer questions better.

The question to ask yourself is how do you feel? What comes first?

I do believe it helps in knowing what comes first to better know how to treat our symptoms.

I meditated many hundreds of hours in regular zen practice and finally realized that the only way to slow my heart was by serious compression! What a moment of enlightenment that was!

Hope you figure out your cause and effect soon.

best regards,

tearose

[villen]

thanks to everybody. Really appreciate your comments. I have read many places that stress and anxiety is the same thing. Anxiety and the reactions (adrenaline, poudning heart, weak legs etc) is just symptoms of an overstressed body like mine. I am not saying you are anxious/have anxiety, I am just saying that most anxiety sufferers are just upset and worry about their symptoms, and keep them self in a sensitized state (its not the acutal cause, fex something happening in childhood, etc) but worrying about their symptoms that keep their anxiety living. I know that my anxiety symptoms came first (racing heart, panic feeling (not pots symptoms) but after a long period of no workout and being too exhausted to move alot, I developed POTS symptoms. I guess treating my anxiety will help my dysautonomia. I don`t often feel faint, I just have the extreme pounding heart (eith panic)when moving, changing positions, exercise etc.

thanks again.

Villen

[juliegee]

Dear villen,

Being the mother of a sufferer (and a sufferer, too!) and a mental health professional, I'm a pretty strong advocate of the other argument. With my son and myself, I feel that any anxiety we have experienced is definately secondary to the symptoms we have experienced. I know we are all different, but could your "panic attacks" really have been a result of the very real physical symptoms that you describe so eloquently (blood pooling, etc.)? Or, if you are experiencing a lot of stress or anxiety due to what's going on in your life; would you have developed a full-blown panic attack if your autonomic nervous system behaved normally? Something to think about.

For my son (who is a laid-back skateboarder type), he began to feel anxiety about 30 mins. before his BP would plummet. His doctor, at Johns Hopkins, described this as a phsyiological phenomenon as opposed to an emotional weakness. During his TTT, he said "I feel sick, I feel lightheaded, I'm gonna' barf." He repated these words throughout the ordeal, growing increasingly more paniced....until at 35 mins., he did barf and faint. When he first began complaining his vitals were normal. His BP precipitiously dropped from 120/80 to 40/0. It's almost as though his body intuitively "knew" something bad was about to happen.

Some experts claim that true panic attacks are the result of unresolved emotional conflict. Others claim an inbalance in brain chemistry. Still others point to genetics, we are much more prone if other family members suffer. Among fellow dsyautonomiacs, I think too many here have been DXed by medical doctors, fully unqualified to render such a DX, because they (the docs) are unable to come up with an explanation for the symptoms.

When my son was unable to eat or stand upright, I was horrified when his pediatric GI declared that he was mentally ill. I even took him to a psychologist to rule that out. The psychologist was adamant that any anxiety Mack was experiencing was secondary to a physical illness.

I can't think of a better phsyiological explanation for a "panic attack" than a greatly elevated HR and/or plummetting BP simply from remaining upright. Consider the idea that your "panic attacks" may really be due to body mechanics as opposed to emotional distress.

All the best-

Julie

[mvdula]

this is an interesting thread - for me, i think there have been both physical and mental components to the anxiety. i did become anxious and panicky when i started having scary symptoms without knowing the reason. Having a reason helps, but does not take away all the anxiety at all. Anxiety/panic is our natural reaction to danger. When I am very symptomatic, I do feel in danger. I think it is natural to respond this way - the way your son did on his TTT. I am confused by tearose, who said she is a thinker and not an anxious type of person. Well, I am both. Very much a thinker - but the past year or so (and even before that with my SVT), I have become very anxious because of my symptoms. Personality certainly has a lot to do with it, but that is not all. I have learned to deal with the mental anxiety better. But, as I said, if your body is not working properly, it is very natural to have both physical and mental reactions to that - and that is the way your body was made to react - to keep you out of danger. It also seems to me that we all have different versions of dysautonomia - I have had times where I felt my anxiety was purely physical - as if it is actually a physical symptom of POTS - I have heard this echoed by many other people on this board too. Just another testament to the fact that we all have our own version of this awful thing.

[Guest tearose]

mvdula,

To be more specific why I refer to myself as a thinker when it comes to managing or avoiding a sudden flare:

I have had POTS since 1991 and I am so use to dealing with it. For years using compression and learning the little warning signs way before I get into a dangerous heart rate, and I know to sit or lay down then I am fine again. I think through my feelings and I don't have to feel any anxiety because sitting down is always available. I don't have anxiety and then trigger POTS. I have damage in my legs and that leads to the blood pooling and the heart to start racing. I don't feel anxious and then cause the heart to race. I can not take medications. BB's do harm to my heart so I use non drug methods to maintain my body. I had to learn not to interpret most heart sensations as dangerous and to ignore many symptoms. I have had to learn behavior modification because I have lymphedema and too much salt causes swelling and numbing nerve problems with my lymphedema. I just have had to use thinking to survive so I don't interpret these POTS symptoms in a nervous or anxious way.

I hope this explains it but ask more if you have any questions.

best regards,

tearose

[mvdula]

thanks tearose. here's the problem. my triggers are not as predictable - when i have an episode, it can last up to 2 hours. sitting down makes no difference. i have no way of helping myself feel fine again - i just have to try to get through it - which is a very scary nightmare....and i know, it doesn't exactly sound like POTS - possibly some related type of dysautonomia

[Megan]

As far as anxiety goes, I wonder a lot whether my anxiety (and depression) came first, or if it was a development of taking so long to be diagnosed and having episodes that doctors repeatedly told me were all in my head. I'm pretty sure it was the latter. And although the Prozac and Klonopin have always helped, they are both meds sometimes used to treat POTS...so it's hard to tell where the line is. I've decided that it doesn't matter a whole lot which came first as long as I try to maintain my health in all the ways I know how to.

Meg

[Ernie]

Hi,

For me I got the opposite diagnosis. Conversion disorder based on the fact that when I fainted I did not have anxiety or panic feeling. I had so many syncopes in my life that I don't panic and the doctors thought that I have what is called in psychiatry ?La belle indiff?rente? which means that you just don't care. It's not that I did not care, it's that I had learned that the more I stressed myself the worst I made myself so I learned to stay calm even when I fainted (even on the TTTs).

So this goes to show that doctors always find a theory to put some emotional or psychological diagnosis on our physical disorder.

[juliegee]

I can relate to Ernie & Tearose. I also (very rarely!) get anaphylaxis with my POTS symptoms. When things start to flare, I'm very calm. I start taking inventory...."OK, my throat's tight, but I'm still able to breathe...HR's up, but no lightheadedness...locate benadryl, locate epi-pen." Very methodical. I have let myself panic in the past and it makes things so much worse. I also use tricks, like lying down (blood to brain), massaging my cartoid artery, square breathing, etc. Anything to feel in control of a basically uncontrollable situation :-)

Julie

[runningshoe]

This topic is fascinating and something I have been trying to "tease" apart in my own life. Typical situation: heavy feeling in my head, fading out, shot of adrenaline all within nanoseconds. Okay so was that a pots symptom triggering a pots reaction or was it just a funky feeling that I am afraid will be the start of an episode so I panic? My dr says it all is happening in your body and brain so don't try to figure out what comes first. COMPLICATED!!

[Deb]

I, too, find this topic fascinating. I started having anxiety attacks AFTER the POTS symptoms started but before I was diagnosed with POTS. I am such a laid back type person that I fought the doctors about having anxiety because in the beginning the doctors in the ER were trying to blame my POTS symptoms totally on anxiety. Sound familiar? With all the POTS symptoms it was hard to sort out which symptoms were from POTS, which were from the anxiety, and which were the side-effects from the medications!

I have never found a real connection with stress and my attacks. I know that stress can trigger them, but I think there is so much more that isn't known about anxiety. I saw a therapist for awhile, but none of the techniques worked for me. I have gotten to where I recognize the symptoms, but I still cannot stop them or even relieve them on my own.

Anyway, I agreed to try Paxil and then Zoloft but neither one helped me deal with the anxiety. I had so many horrible side-effects that I couldn't function. What finally did work for me is Lorazapam (generic of Atavan). I always have a couple with me, and when I start feeling the symptoms, I pop one and I feel better within minutes. Fortunately the attacks are not very frequent anymore.

[lotusflowersusan]

I suspect that I have had ANS dysfunction symptoms most of my life. I was diagnosed with PTSD in my late twenties. I can totally relate to the frustration of having symptoms attributed to anxiety, especially if you have a history of a diagnosis like PTSD. This has been a topic that interests my therapist and we have discussed the possibility that my (suspected) ANS issues actually made me more susceptible to the anxiety response in PTSD. The mind and body really can't be easily separated, though many in the medical community would like to think so. What happens in the body effects the mind and vice/versa. To me, a holistic approach, where the mind and body are seen as part of a whole, would do us more good than trying to always pass us off as 'crazy'.