Anxiety Vs. Pots

[all4family]

Hi Everyone,

I have seen a lot of discussion on this subject lately, and just thought I'd chime in. I did a google search of POTS symptoms, and Panic attack symptoms. The first thing I noted on the search was that by the time I had entered "symptoms of PO" there was no matching results. You know what I mean? The suggestion the computer gives you for things common to find. Then I looked up "symptoms of p" there already on the list was panic attacks. As I continued to type, "pani" I had a list over 10 long of things to search for. Here are my results...If you notice I did them both from wikipedia, so that the results would be from the same source.

DSM-IV Diagnostic Criteria for Panic Attack

A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:

1) palpitations, pounding heart, or accelerated heart rate

2) sweating

3) trembling or shaking

4) sensations of shortness of breath or smothering

5) feeling of choking

6) chest pain or discomfort

7) nausea or abdominal distress

8) feeling dizzy, unsteady, lightheaded, or faint

9) derealization (feelings of unreality) or depersonalization (being detached from oneself)

10) fear of losing control or going crazy

11) fear of dying

12) paresthesias (numbness or tingling sensations)

13) chills or hot flushes

The hallmark symptom of POTS is an increase in heart rate from the supine to upright position of more than 30 beats per minute or to a heart rate greater than 120 beats per minute within 10 minutes of head-up tilt. This tachycardic response is often accompanied by a profound decrease in blood pressure and a wide variety of symptoms associated with hypotension including:[4]

lightheadedness, sometimes called pre-syncope (pre-fainting) dizziness (but not vertigo, which is also called dizziness)[5]

exercise intolerance

extreme fatigue

syncope (fainting)

Chronic or acute hypoperfusion of tissues and organs in the upper parts of the body are thought to cause the following symptoms:

cold extremities

chest pain and discomfort

disorientation

dyspnea

headache

muscle weakness

tremulousness

visual disturbances

Autonomic dysfunction is thought to cause additional gastrointestinal symptoms:

abdominal pain or discomfort

bloating[6]

constipation

diarrhea

nausea

vomiting

Cerebral hypoperfusion can cause cognitive and emotive difficulties:

brain fog

burnout

decreased mental stamina

depression

difficulty finding the right word

impaired concentration

sleep disorders

Inappropriate levels of epinephrine and norepinephrine lead to anxiety-like symptoms:

chills

feelings of fear

flushing

overheating

nervousness

over-stimulation

Symptoms of POTS overlap considerably with those of generalized anxiety disorder, and a misdiagnosis of an anxiety disorder is not uncommon.

Ok. first, like I said above there is plenty to look up about panic attacks. Why because it is easier to diagnose, rather then to look for something esle that could be causing the problem. Yet there is nothing that comes up on my suggestiong list for POTS.

If you look at the symptoms from the panic attacks almost every one of them is in the symptoms of POTS. Though worded differently. Like for example in the Panic attack one it says "fear of dying." (blame the patient they are afraid to die. (who isn't?!)). Under symptoms of POTS you will find "feelings of fear". (saying there is a feeling of fear there, but it is not because you are just afraid of something.

The second thing that strikes me is the heading before panic attacks. It says "DSM-IV Diagnostic Criteria for Panic Attack" the reason for this heading is because to diagnose a panic attack the only diagnostic criterea you need is if my memory is correct, is 6 of the symptoms on the list. (I could be wrong on this number) If you look above POTS it does not say the same thing. This is because there are diagnostic tests to diagnose POTS. TTT, blood tests, etc etc. etc. I also like the statement on the bottom that says "Symptoms of POTS overlap considerably with those of generalized anxiety disorder, and a misdiagnosis of an anxiety disorder is not uncommon."

So we have one diagnoses that is based on symptoms alone, (and you can ask any therapist, or psychologist) there is no blood test, or other scientific test to prove the dignoses of anxiety, or panic. Yet there is sicentific tests to prove POTS. And really if you think about it, it would seem silly to say that someone is being anxious about being upright. (although my doctors did!)

I am certainly not saying that someone does not have feelings of anxiety, or even depression. I am simply saying that it is not a disease to have feelings. ANYONE suffering the severity of this or any other chronic illness is bound to feel anxious or depressed. And these feelings are made worse when well meaning doctors tell us that we are creating these symptoms in our head because we fear something, or whatever their reason is. I KNEW that I was getting sick on the medications given to me, but I was told that I was AFRAID to take medication. (Then why was I on 4 at one time?!?)

And if someone IS feeling anxious or depressed, it sure is a good idea to talk about how they are feeling...but to worry about being labeled with some disease that can only be measured by symptoms I just personally wouldn't do. I think it is natural for any of us going through this to feel this way at times. And even harder to tell why we are feeling the way we are. Is it a physical symptom? is it a mental one? If I just stopped thinking about it would I feel better? I think we should really stop beating ourselves up! It is what it is, and all we can do is deal with the symptoms we have one day at a time. And if you feel sad, or anxious, tell someone. Even if you gotta find someone on the street to talk to, talk. I talk to God. You can talk to your dog, or cat, or your wall, but it feels good just to say "IT STINKS TO FEEL THIS WAY, AND I DON'T LIKE IT!!!"

OK. This was just my 2 cents, and I hope it helps someone. I hope no one will take offense to anything I have said because this is just being offered as support. If you feel you have anxiety causing your symptoms, that is fine too. You know your body best, is all I am trying to say. I wanted to believe in the begining that it was anxiety. (then I could feel better!) But no amount of blaming my mother, my father, my childhood, anything that I could of ever thought of in life that ever made me upset in any way, made me feel better.

Take care everyone, and I hope you all have a happy symptome free day! (we can hope anyways!)

[carinara]

like it was mentioned before when people with POTS lay down, their HR goes down. When people with panic attacks lay down, their HR doesnt change.

People who suffer from panick attacks learn in their therapies, that they should stay in the situation that frighten them until their panic goes away. For example: if somebody has a panic attack standing in line in a supermarket this person should stay in this situation until the panicky feeling goes away and then leave the situation.

For people with POTS its recomended to avoid standing in long lines, because of the blood pooling and so on. So if somebody with POTS tries to stay in this kind of situation it would never get better. It would get worse and worse.

For people with panick attacks its also recomended to keep putting themselves in situation that cause their panick to come up, the theorie behind is, that as more often as they experience that nothing bad will happen to them, the easier these situations get.

If you tell somebody with POTS to expose yourself to situations like, standing in line, going to the sauna, and so on on a daily bases to overcome the panicky feeling, this will never happen.

[Guest GaryRN]

You guys might want to get your Potassium and Magnesium levels checked. POTS has been associated with both hypokalemia & hypomagnesemia.

I have noticed in my own disorder that using Magnesium supplementation helps with not only anxiety, but also body aches, fatigue, headaches, stiff neck, muscle twitching, nausea, etc.

Symptoms of Hypomagnesiumia: Muscle weakness, confusion, and decreased reflexes with severely low blood magnesium levels. You may also notice "jerky" movements, high blood pressure, and irregular heart rhythms with severely low blood magnesium levels.

It is a known fact in Lyme disease, that the Lyme lives off and deplete magnesium levels. I actually have a magnesium level pending and will let you guys know what it is when I get it, but even so, it can't hurt to supplement.

You might want to try this instead of your Benzos or Antihistamines. This is something new that I am doing and getting positive results in all the areas above.

This is yet another correlation I make in my own case between POTS and LYME in that my POTS is secondary to my Lyme.

Gary

[mjan]

So what you're saying is that many of the signs and symptoms match..but the origin of WHY they occur and HOW they manifest do not.

I am a theapist. AND I know that panic and anxiety attacks.. often associated with a trauma or reaction to something unpleasant ..does cause an altering of the brain chemicals enough to warrant such symptoms. PANIC/Anxiety ATTACKS originate from the rush of adrenaline. Did they ASK for their adrenals to produce such a reaction??? No it was involuntary.. Could it be a medical condition...YES. Is it treated as such.. NO.

When a professional tells YOU/US its all in our heads.. in a way they are right!! (I know.. its not what they mean though).

I worked for years in chemical dependencies.. a very JUDGMENTAL field. It has taken a long long time for anyone to research that YES something IS going wrong in their brains chemically..causing cravings..then the inability to stop once they start. Its NOT as simple as justs saying NO.

MANY professionals..esp MDs.. need some education on what is happening in our brains and systems that cause these reactions (signs and symptoms) and find ways to treat it rather than judge and dismiss only...

AND for women.. its been worse. A longtime belief is: Women are hysterical..give then a sedative..they are irrational..lots and lots of judgments in MY lifetime without really knowing... and never bothering to know. It was not that many years ago that schizophrenia was blamed on the mother. I read that in MY training. MANY mothers took blame for illnesses and problems that were MEDICAL.

Ok.. my 2 cents..

Jan

[Guest GaryRN]

Other than playing into the "Fear of Fear", I honestly believe the causes of both anxiety and panic are from some other means.

Many many things can cause this. God did not intend for our bodies to have the "fight or flight" response unless we were physically threatened.

So when it occurs in situations where it is not warranted, than I say there has to be another cause.

What that cause is, can not be explained in most circumstances, so we are given tranquilizers to calm us down. All I know is that both anxiety and panic attacks are both terrible conditions that I would not wish on anyone. It's bad enough going through them, but then being worn out for a good part of the day after an attack or the onset of more attacks is just ridiculous.

[all4family]

Hi,

All I was trying to say by this is that I have seen a lot of people on here, (and I'm sure there are a lot more that aren't posting about it) recently worrying about weather they have anxiety, and or depression. I hate to see people worrying themselves about this, when they have enough to worry about with dysautonomia. I am saying we know our bodies best, and I personally wish I hadn't worried so much of my time away about if I had a "mental" issue or not. Maybe I wouldn't have sat in silence about the pain and illness I was feeling, because I didn't want to hear one more person imply that if I wanted to feel better all I had to do was change my thinking. Maybe I wouldn't have lost a great deal of my self confidence, and I could have focused on something more important like getting a diagnoses for what was really making me sick, then finding a plan to improve my life. Maybe I wouldn't have kept taking pills that were making me sick, that I was told I was just "afraid" of. Maybe just maybe I would have said no, then I wouldn't have gotten as sick as I did trying to treat a mental illness that didn't exist. Maybe I wouldn't worry about going to doctors now, because why should I bother, they didn't believe me, or help me when I needed it.

I am trying to say that if we could just have some compassion for our OWN selves for what we are going through, and understand that what we are going through will cause feelings of anxiety, and depression, but that does not mean we have a mental disease. It means we have some very normal feelings to feeling sick all the time. And to be good to ourselves, instead of thinking we should be happy all the time. (which by the way would be considered a mental disorder too!)

take care,

Suzy

[Angelika_23]

like it was mentioned before when people with POTS lay down, their HR goes down. When people with panic attacks lay down, their HR doesnt change.

Not necessarily, I have POTS AND IST. My HR doesn't always go back down when I lie down...

Just a thought,

Angela

[mjan]

Hey there Suzy girl.. so PROUD of you.. processing the terrible times.. the misdiagnoses..the non belief..the lack of advocacy..no one to fight for you.. for us.

After many many years of working with the mentally ill and drug and alcohol (my favorite people) still its misunderstood.. JUDGED..labeled..JUDGED..even by themselves.

My heart goes out to any and all who have a chronic disease..disorder..especially who lack the advocate..the one who supports without judgment..who helps without their own time table..UNCONDITIONALLY...

Good job my sweet Suzy

Jan

[carinara]

like it was mentioned before when people with POTS lay down, their HR goes down. When people with panic attacks lay down, their HR doesnt change.

Not necessarily, I have POTS AND IST. My HR doesn't always go back down when I lie down...

Just a thought,

Angela

Hi Angela,

if you lay down for a while, eventually your HR would go down. But if you would keep standing (without sitting down) the HR wouldnt go down.

A person with panic attacks would also get an attac laying down if he is confronted with something that creates panic within

himself it wouldnt make a difference if he would lay or stand.

[janiedelite]

Good thread! For me, one of my worst triggers for POTS flares is emotional stress, especially anxiety. Last year, when my POTS symptoms kept worsening and I went to over 40 Drs appointments in one year, I was doing my best to stay calm but I couldn't help but be anxious somewhat over my increasingly disabling symptoms! I went to Mayo a couple months ago, and implementing all their suggestions has helped, but I think it was also hugely helpful to finally be evaluated by docs who were able to tell me I wasn't dying, they knew what I had, and how to help me. Since I've been back from Mayo, my POTS symptoms are not as debilitating because I finally was able to get peace of mind and stop the adrenaline-producing cycle!

I've been under some stress lately with my mom's worsening health, and my anxiety over her health triggers worse symptoms than even over-exercising for me. And unfortunately, since our disorder involves the sympathetic nervous system, my body will overreact to normal anxiety triggers and send me into a vicious cycle of worse POTS, anxiety, etc. My lying norepinephrine (adrenaline) level is 250 and standing is 1089 and that's just doing daily activity without feeling anxious! What I'm trying to say is that I am normally a very calm person, but having POTS makes staying calm/peaceful all the more challenging. Just like we have to be more aware of cues from our bodies when they are stressed, we have to be more aware of our state of mind too.

My PCP recently suggested I try some meditation or yoga. She said she recommends it for patients who have essential hypertension that no meds can treat, just to try to calm their sympathetic nervous system. First, I was a little offended thinking she was telling me my problems were mostly in my head, but she reassured me that practicing relaxation would help reduce my abnormal physical responses to normal stress. I also practice daily prayer and scripture reading. Whatever I can do to maintain peace of mind.

Don't worry... be happy! (it's my new POTS treatment)

Janie

[Angelika_23]

Hi Angela,

if you lay down for a while, eventually your HR would go down. But if you would keep standing (without sitting down) the HR wouldnt go down.

A person with panic attacks would also get an attac laying down if he is confronted with something that creates panic within

himself it wouldnt make a difference if he would lay or stand.

Carinara,

As you should know, we are all different, therefore reacting differently to individual situations. My HR does not always come down when I lie down because of my IST. It is not because of anxiety. Sometimes I have to have medical intervention to bring it down.

Angela

[Sophia3]

Ok...I gotta be honest I did not read the first post on this as it's too long and I KNOW the diff between POTS and anxiety being disabled from full time work 19 years and part time 10.

I have florid POTS. USUALLY most all the time when I lie down my HR drops 50 points and gives me relief.

HOWEVER I did not have IST.

I ALSO know HORMONAL FLUCTUATIONS especially during menses can help KEEP HR high..it may drop when supine but still be over 100.

Also if you are DEHYDRATED the racing HR may take a while to drop after lying down. Sometimes IV's are needed or to push fluids orally.

Just to clarify things. You can't make blanket statements about what's anxiety on a message board, folks. Or you may cause anxiety.

@Angelika, I do not have IST but when severely dehydrated and or when I had sick periods- before my hyst, it would take a bit for my HR to level out but eventually it would. I understand though your situation, as I know others in a similar boat.

This is my two cents worth.

[all4family]

Well I am glad to see that the message I was tying to send hit it's desired target! The ones who needed it! We can spend all day and night arguing, and discussing weather the heart rate does this or that, or what conditions we have, but in the end, we all must feel bad, or we would certainly be somewhere else doing something else with our time. By the way I seen at the top that it only takes 4 of the symptoms to have a diagnoses of panic attacks. Jeez...I have most of those symptoms 24 hours a day!

Jan, thank you so much for your kind and caring words....they meant a lot to me. I hate to see people beat themselves up like this...I did it for way to long, and have no intention of doing it one second longer!! And you are so right we are judged way too much...even by ourselves, and others in the same boat..I hope things are going good for you too.....take care.

Janie, thank you for sharing so honestly! I fel the same way as you do about having peace of mind!! knowing that there was a explenation, and that I wasn't going to die, made a huge difference in how I handled what was happening to me. I'm sorry about your moms health. My moms health isn't good right now either. I will pray for her. I listen to some relaxation videos on you tube, that I really love. I don't have there url right now because I am on a different computer, but if you are interested pm me, and I can send you them (after I find them.) One puts me to sleep almost everytime! btw...I LOVE your POTS treatment!!!! I am beginging my treatment today!

I hope everyone will give themselves a lot of credit for what they are going through. This isn't easy for anyone!! And I think everyone just wants to do all that they can for themselves to feel better!

[mae]

Hi all 2nd post here and counting,

I 1st started off having anxiety attacks before the birth of my 1st child 7 years ago then actually DX with Generalized anxiety disorder after my second child was born. And with every child born I developed more and more symptoms which may have been a misdiagnoses and maybe I had POTS all along or anxiety was a clue of some other problem who knows... I have lived with the dizziness for 7 years it started immediately after my son was born and they docs never looked into it and always had lower BP and finally they just put it together. I think Low Blood vol. is causing my dysautonomia since it has gotten worse after every pregnancy, theres some type of link I believe. Maybe POTS caused anxiety or ANXIETY caused pots. Now I have anxiety attacks well they feel like it with no triggers actually looking over the list on DINET triggers eating,heat,menstrual,lack of sleep,day after drinking alcohol ----when it 1st started years ago those were my triggers. So I believe I have had this for 7-8 years and having more children made my symptoms way worse. Sorry to go off topic I got carried away.

Mae

[carinara]

Hi Angela, with my last post i didnt mean you personaly i meant people with POTS in general. I guess i didnt choose the right words. That was because i was at work when i wrote my post and i had to write quick plus english is not my native language, i guess i just got carried away and wrote without having the time to be more detailed about what i meant. Sorry if i offended you. All i wanted to say was that a difference of people with POTS and people with ONLY panick attacks (without POTS) is that the HR of people with POTS usually comes down after laying down where as the HR of people with ONLY panic attacks (without POTS) stays high no matter if they lay down or not. Their HR is not connected with their position.

carinara

Hi Angela,

if you lay down for a while, eventually your HR would go down. But if you would keep standing (without sitting down) the HR wouldnt go down.

A person with panic attacks would also get an attac laying down if he is confronted with something that creates panic within

himself it wouldnt make a difference if he would lay or stand.

Carinara,

As you should know, we are all different, therefore reacting differently to individual situations. My HR does not always come down when I lie down because of my IST. It is not because of anxiety. Sometimes I have to have medical intervention to bring it down.

Angela

[all4family]

Hi Mae,

I also thought back over my life after diagnoses, and I thought of what I had thought were anxiety attacks that I had had throughout my life, like when I was in a dressing room, at 18 years old, and had my hands over my head trying on clothes, and I suddenly felt my heart race, and thought I was going to faint. I later told a doctor about it, and they said that people my age don't have heart problems!!! So why are there so many pediatric heart doctors?? So I went about my life. Also when I was around 14 to 17, I just kept saying all the time that I don't feel right, I just feel like something is wrong. I felt spacey, and like I wasn't there most of the time. My mom was worried, and took me in to see a doctor who did some kind of test with these long metal probes, that had to be put down my nose, and go down my throat, and I was supposed to go to sleep...the outcome must have been fine, because I didn't go back. So I hear what you are saying. I never was afraid of anything I could think of, but usually thought of something that might have been scaring me from my past....But now I remember other things. Like the fact that just before that happened I had been accidentally poisoned with bug spray. Gosh maybe I was having anxiety that I was a bug!!! Just kidding....Anyways I think that physical problems get blamed (more often for women especially after having children!) on anxiety. You know...just an anxious woman! If it happens to a woman look for a mental problem first! I know not all doctors are like that, otherwise we wouldn't be here! But a LOT sure are! Anyways didn't mean to go on so much...just wanted to say I understand where you are coming from!!

Suzy