Is It My Pots Or Is It A Panic Disorder

[pinkbubbles1680]

Someone help .... I am having an awful time dealing with weird symptoms. My doctor thinks I may have hypo-adrenic POTS which I'm getting tested for next Friday. I'm also seeing a Psychologist and a Psychiatrist together and the psychologist thinks I have trouble dealing with anxiety which is why I'm getting panic attacks. My cardiologist the one who thinks I have hypo adrenic POTS said that its just my body secreting to much adrenaline

I'm so confused and I dont know what to do.

My symptoms were really bad about three months ago I would get palpitations and chest discomfort and really bad panic like three times a day. Since then I've been taking ativan drinking more water and I increased my dose of florinef my symptoms have improved a lot, but almost everynight I start getting weird panic symptoms like chest tightness, palpitations, and then I get a little panicky.

Does anyone else with hypoadrenic POTS get bad symptoms right around bedtime.

How do you know the difference between an anxiety disorder and POTS ??

[Brye]

I don't know what kind of POTS I have but at night when I lay down to go to bed it feels like my adrenaline won't shut off. I have this weird tremory chased by a bear feeling until I fall asleep. I take xanax at bedtime. It doesn't help the tremory feeling but it makes me sleepy so I at least fall asleep quicker. I never was an anxious person pre-POTS so I'm pretty sure it's an adrenaline surge for me!!

Brye

[erik]

The underlying process said to be involved isn't so different, plus POTS and anxiety can intertwine so it's hard to say how to distinguish a person with "just POTS", just "anxiety disorder", or both. They say stress is a trigger for most folks with POTS, so in a way we automatically have a certain sort of anxiety disorder built in... hyper-adrenergic or not.

Without personal insight into your situation, given that a cardio is suspecting hyper-adrenergic style POTS then I would lean that way just because it takes *a lot* to convince a doc to even suspect such things... meaning you've caught his eye with clear symptoms and some signs (hence POTS). Hopefully the upcoming test will give a little more insight. Even "regular POTS" tends to involve extra adrenaline (and friends), just less so than the H-POTS folks. It's also about "nerves firing" and not necessarily "serum blood levels"... though with adrenaline related measurements I guess those tend to correlate.

I mostly get things akin to panic style symptoms if upright too long, dehydrated, etc. Nonetheless, they can hit me at other times (middle of the night stuff is bad when it comes)... not to mention being tremulous on a pretty regular basis (not constant, I just mean daily). Despite POTS being defined by troubles with upright position, it's important to remember the problems/symptoms don't stop there.

It's also important to minimize any known triggers... and stress is a key trigger! So it isn't a bad option to entertain "both diagnoses" and tackle things from both fronts simultaneously... so long as the shrink doesn't try to supersede the physical findings and claim their world offers complete insight! Docs tend to think within their specialty, understandably. I suspect most advice from counseling will at least help endure, and not aggravate, a POTS based "physical" attack so it is hard to envision harm from counseling. I don't know what all they do though... but certainly deal in whatever way you can with any stressors in your life. That can only help.

[miranda]

I notised I get worse in the evening and then realised its after I eat a meal.

My heart starts racing. So now I eat a smaller evening meal and it seems to help.

[futurehope]

pinkbubbles1760,

When I was on a benzodiazepine like you are (ativan), I remember getting extremely nervous and anxious as they wore off to the point of, I needed to do something about it because it was so uncomfortable.

Is there a possibility that your "nighttime" attacks correlate with your Ativan wearing off? Just a thought.

[lieze]

I have this too.

I am just trying to stay as calm as possible and pace my day since too much activity also triggers it.

So what I feel like I have are almost activity induced panic attacks.

They vary in severity and basically I just feel crappy when they happen.

At first they were very scary with the full blown cardiac symptoms, chest pain, irregular heartbeat.

What I realized right after a bad attack where my throat had closed up on me and my heart was skipping all over the place and I ended up curled up in a fetal position on the floor in a spare bedroom holding my cell phone was that this only happens when I get really worked up.

I wasn't intentionally doing anything to bring it on but it was a process where I allowed it to escalate.

I did have the bad stuff at bedtime too and it just seemed to come out of the blue. Also the middle of the night stuff that wakes you up out of a dead sleep.

I'm not trying to say this is your fault or that you can control it.

Just saying that I am working to really focus on being calm staying calm.

I notice sometimes my entire body is tightened up and stiff and I don't know if this is subconscious or what? But I have to actively try to relax. To let those strained positions slowly release. I have no idea how this started for me? Why I began to do this to myself.

I have always had some anxiety but this is so much more intense and I may be pumping out way too much adrenaline.

Also I have to stay a bit active-go out-drive my car regular-if I don't huge panic.

So I have to try to stay calm upright and active in many ways so nothing shocks me then when I do it.

Strange I have to say-never imagined anything quite like this.

I think it's great that you are working with both the cardiologist and the psychiatrist.

Together maybe you'll be able to find a nice balance.

Let us know how things go for you-there are others experiencing the same thing and maybe our experiences can help one another.

lieze

[Noreen]

Wow- thanks for that 'chased by a bear' description.

I'm weird. I often need word pictures to understand myself.

[pinkbubbles1680]

thanks for all your help guys I'll let you know what the doctors find out with my POTS !

[tinkerbella]

Someone help .... I am having an awful time dealing with weird symptoms. My doctor thinks I may have hypo-adrenic POTS which I'm getting tested for next Friday. I'm also seeing a Psychologist and a Psychiatrist together and the psychologist thinks I have trouble dealing with anxiety which is why I'm getting panic attacks. My cardiologist the one who thinks I have hypo adrenic POTS said that its just my body secreting to much adrenaline

I'm so confused and I dont know what to do.

My symptoms were really bad about three months ago I would get palpitations and chest discomfort and really bad panic like three times a day. Since then I've been taking ativan drinking more water and I increased my dose of florinef my symptoms have improved a lot, but almost everynight I start getting weird panic symptoms like chest tightness, palpitations, and then I get a little panicky.

Does anyone else with hypoadrenic POTS get bad symptoms right around bedtime.

How do you know the difference between an anxiety disorder and POTS ??

Hi pinkbubbles,

I don't know what kind I have as my doc tells me they are all the same. But first, I thought I had asthma for 15 years and was taking all the wrong meds that were making me so anxious. After a severe reaction to a BB I was sent to a plummy dr who sent me for breathing tests where I found out Ididn't have asthma. So, I wondering when you take your inhaler.

Also when we lay down we all feel paps more because we are still and they seem scary. Caffeine is hidden in so many foods and meds. I posted a list in another post somewhere here recently. But just google foods and meds with caffine hidden in them, you may be ingesting some and that's the fist thing docs have you stop to see if the paps go away. Another thing you could try is taking your ativan under your tongue as it is absorbed into the bloodstream quickly and you may feel more relaxed and fall asleep easier if you take it at bedtimel Try to brush your teeth right after as your teeth being exposed to melting meds can become decayed quicker.

I found once on the right meds for pots I never really feel anxiety like I did before when I was on all the wrong med that only made me worse. I have a list of meds a mile long that I just can't take. All of that make sense now to me and my docs. I hope you find relief and feel better soon. I always google all my meds when I feel off and see if there is something there or a missed interaction with something else I'm taking.

Also, remember to include all herbs and vitamins with your meds as they effects us as well.

Take care,

Bellamia~

[ramakentesh]

No offense but this question has been answered numerous times. The literature is full of reports of POTs patients experiencing anxiety like symptoms and 'feelings of impending doom' - they are common in many cardiovascular illnesses and they dont automatically have a psychosomatic source.

The normal coping mechanism for reduced cerebral blood flow and cerebral hypoxia is release of adrenaline. Higher adrenaline all the time would make anyone juittery and more prone to panic attacks.

[Noreen]

No offense but this question has been answered numerous times. The literature is full of reports of POTs patients experiencing anxiety like symptoms and 'feelings of impending doom' - they are common in many cardiovascular illnesses and they dont automatically have a psychosomatic source.

The normal coping mechanism for reduced cerebral blood flow and cerebral hypoxia is release of adrenaline. Higher adrenaline all the time would make anyone juittery and more prone to panic attacks.

Yeah but Rama - it is hard to do research when you "feel like you are being chased by a bear." A quick question among friends shouldn't hurt. Your concise explanation of adrenaline release is great and much appreciated.

I absolutely love your gravity graphic. I started singing the song in my head which you so appropriately include in your signature line and became symptomatic. Boy that will come in handy at the doctor's.

Are you treating the AS with meds at this point or just with exercise? I'm curious about any inflammatory disease process and linkage with dysautonomia.

Tks,

Noreen

[pinkbubbles1680]

Someone help .... I am having an awful time dealing with weird symptoms. My doctor thinks I may have hypo-adrenic POTS which I'm getting tested for next Friday. I'm also seeing a Psychologist and a Psychiatrist together and the psychologist thinks I have trouble dealing with anxiety which is why I'm getting panic attacks. My cardiologist the one who thinks I have hypo adrenic POTS said that its just my body secreting to much adrenaline

I'm so confused and I dont know what to do.

My symptoms were really bad about three months ago I would get palpitations and chest discomfort and really bad panic like three times a day. Since then I've been taking ativan drinking more water and I increased my dose of florinef my symptoms have improved a lot, but almost everynight I start getting weird panic symptoms like chest tightness, palpitations, and then I get a little panicky.

Does anyone else with hypoadrenic POTS get bad symptoms right around bedtime.

How do you know the difference between an anxiety disorder and POTS ??

Hi pinkbubbles,

I don't know what kind I have as my doc tells me they are all the same. But first, I thought I had asthma for 15 years and was taking all the wrong meds that were making me so anxious. After a severe reaction to a BB I was sent to a plummy dr who sent me for breathing tests where I found out Ididn't have asthma. So, I wondering when you take your inhaler.

Also when we lay down we all feel paps more because we are still and they seem scary. Caffeine is hidden in so many foods and meds. I posted a list in another post somewhere here recently. But just google foods and meds with caffine hidden in them, you may be ingesting some and that's the fist thing docs have you stop to see if the paps go away. Another thing you could try is taking your ativan under your tongue as it is absorbed into the bloodstream quickly and you may feel more relaxed and fall asleep easier if you take it at bedtimel Try to brush your teeth right after as your teeth being exposed to melting meds can become decayed quicker.

I found once on the right meds for pots I never really feel anxiety like I did before when I was on all the wrong med that only made me worse. I have a list of meds a mile long that I just can't take. All of that make sense now to me and my docs. I hope you find relief and feel better soon. I always google all my meds when I feel off and see if there is something there or a missed interaction with something else I'm taking.

Also, remember to include all herbs and vitamins with your meds as they effects us as well.

Take care,

Bellamia~

thanks for your post bellamia, I am not currently on any regular inhalers for my asthma just once a day singulair

I haven't had too many asthma flare ups and I'm glad because I know my rescue inhaler can cause my heart rate to skyrocket.

I do try to avoid caffine but I'll look into foods that have it hidden in them

I also have heard that tip about putting ativan under your tongue it definitely does work a lot faster but I have not heard about brushing your teeth after it so thank you for that !

~alex