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Panic Vs. Pots


lieze
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Am I having POTS episodes or panic attacks?

I looked up the mechanism of a panic attack and it looks as if it's caused by an unbalanced ratio of DHEA to cortisol.

This may answer why I am okay for about 3 days after I take a Xanax-it is probably stimulating me to produce DHEA and helping me maintain a balance.

In fact Xanax seems to clear most of my POTS issues.

It eliminates brain fog for me and vertigo migraines and even gives me an appetite.

My only hangup for not taking it is the guilt i feel and fear of addiction.

I also on a general basis don't feel anxious, I seem to go right into waves of panic so maybe this makes sense if it is occuring from an imbalance of my DHEA/cortisol levels.

I searched the mechanism of a panic attack and this is what I found.

http://members.cox.net/jmhoward3/A%20Hypot...%20Disorder.htm

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Lieze,

In my experience, they often overlap. My son had NEVER experienced any anxiety prior to becoming ill. He was (and is) SUPER laid-back. However, when his dysautonomia hit, he became debilitated by waves of anxiety prior to measurable symptoms. He suffers from NMH, where his BP drops to an immeasurable level. About 30 mins. prior to a drop, he sense it is about to happen & adrenaline courses throughout his body. Hs doctor at Hopkins described this mechanism and was careful to explain to him that this in no way was indicative of an emotional weakness. This is a physiological occurrence as your article seems to also indicate.

It sounds to me like your sympathetic nervous system is in overdrive and that's why the Xanax helps. Some use klonopin for the same reason on a long term basis. I know you've considered Lexapro, which aside from florinef, has been the most helpful med for my son. However, as Nina (I think) mentioned in another post it is sometimes hard to tolerate initially. Ask your doctor for the smallest dose possible & even consider cutting that into halves or quarters and working your way up to a therapeutic dose.

If you experience a 28-30 BPM HR increase, you have POTS. Anxiety often accompanies it for physiological reasons.

I know that you'll find a med/lifestyle regimen that will help you feel more control soon.

Hugs-

Julie

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Am I having POTS episodes or panic attacks?

I looked up the mechanism of a panic attack and it looks as if it's caused by an unbalanced ratio of DHEA to cortisol.

This may answer why I am okay for about 3 days after I take a Xanax-it is probably stimulating me to produce DHEA and helping me maintain a balance.

In fact Xanax seems to clear most of my POTS issues.

It eliminates brain fog for me and vertigo migraines and even gives me an appetite.

My only hangup for not taking it is the guilt i feel and fear of addiction.

I also on a general basis don't feel anxious, I seem to go right into waves of panic so maybe this makes sense if it is occuring from an imbalance of my DHEA/cortisol levels.

I searched the mechanism of a panic attack and this is what I found.

http://members.cox.net/jmhoward3/A%20Hypot...%20Disorder.htm

But, according to this study ---what causes the prolactin and CCK to be so high in the first place? Since one section showed it didn't matter what the level of cortisol is and in one part cortisol was low and there was a panic attack. It doesn't seem that the person analyzing it is proving his point.

If that were true, you could just take DHEA and you would always have your DHEA at a high level. But then, you would sleep all the time, if DHEA induces the phases of sleep. So, if you don't have low DHEA and you supplement -- seems like you would create a chronic fatigue issue in yourself.

I know, years ago, I was having what seemed to be panic attacks -- before my POTS diagnosis. I was shown to have low cortisol. So, I don't believe that high cortisol causes the surges. But, possibly high adrenaline instead. But, quite honestly - I think it was the undiagnosised POTS and the dysfunction of the autonomic system.

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I'm thinking the "panic" is actually part of the POTS-----or IS POTS............ :rolleyes:

That's one of the first symptoms I expereinced when I was younger.

When I get those attacks on occasion I feel helpless, and to me this is thw WORST part of POTS.

It's also the one symptom that if often misinterpreted as "anxiety", or having a "psychological" disorder.

I used to take xanax in the early 90s. I think I took it for about a year. Back then I just had the tachycardia whihc was mostly controlled with the beta blockers, and the xanax helped with the panic attacks. In fact I was able to lower the beta blocker dose when taking the xanax.

Now I take Klonopin which does the same.

I take a small dose of klonopin-----.50----usually only half though. I keep the other half on reserve for those occasions when my body is stressed more.

Don't feel guilty about the xanax. You need this to help with your POTS, just like someon needs insulin for diabetes. My PCP said not to worry about it. I don't take it to get high, I take it to be able to function in normal life.

That's an interesting article. ;)

Maxine :0)

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I think it mentioned that prolactin was released during the panic attack.

I know I've had times when I get so just out of it in my head that everything seems surreal.

At these times my body seems to function-I am able to walk and talk.

I don't seem to have any trouble with tachycardia or lack of oxygen.

One time just recently walking into a grocery and it totally distorts my thoughts.

I was sending myself the mental message that I was not going to make it out of that store alive.

It took all my energy to send positive messages do breathing exercises all the way through the store and complete my shopping. My symptoms did not worsen I did not feel normal though it was like I was walking around with not just a balloon head but more of a dirigible. It was like the boundary of my head and skull reached to the ceiling and everything in between was just air. It almost feels like an out of body experience as it's happening.

I guess this is one type of my episode where actual "vital signs" are not affected it is just a strange feeling.

The next time I went into that store I was almost cracking up in disbelief that the last time I was there I didn't think I'd make it out alive.

Another trip was to my daughter's dance class I actually had myself believing the trip was going to kill me that I was going to die at some point during that outing.

Weird I tell you weird.

Such strange messages and sensations I have had with this and I have to consciously override it and keep repeating different messages to try to fight it.

If you didn't know better you would think I was going into a type of psychosis or schizophrenia.

The thing is it doesn't last and I return to "normal' and can even laugh about how out there I was.

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Lieze

Thank you for sharing your experience with panic attacks - I'm so sorry this is happening to you. I've been having panic attacks for the past ten years, always connected with my speech (which goes awry when my illness is very active) and always at work (where I'm supposed to appear business-like and competent). I've hyperventilated in meetings, in teleconferences and on the phone. In a business environment, even dealing with doctors and doctor-academics, it seems to be very confronting for people looking on - no-one really knows what to do, and everyone seems to think I'm a lunatic. Its been the most humbling part of my illness, although these days I tend to think that humility is not such a bad thing. I also think that, more than any other experience, my panic attacks have taught me endurance and broken me of the need for approval.

I've tried really hard to stop them - meditation, hypnosis, self-hypnosis, desensitisation (I hyperventilated and cried delivering my first speech at Toastmasters - it seemed very bizarre that I still got a round of applause). I saw a psychologist who helped me work through a program (titled Overcoming Panic) and some of the medication I've tried was supposed to help (it didn't, and I didn't tolerate it). I also faced my fear - I didn't avoid situations that would make me panic (this mean't that I panicked regularly). None of these things either fixed or reduced my panic attacks. The only thing that has helped is overall management of my illness - as long as I'm managing my illness well, as long as most of my symptoms are sleeping and I'm well-rested, there is much less chance that I'll panic.

I now have an agreement at work that I will focus on doing the things I can (critical analysis and writing, mostly).

So I guess, for me, my panic attacks are firmly linked to my illness.

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Wow Dianne thank you so much for sharing your story.

I know what you mean about the humility thing.

I really don't care if I go down in public.

I mean I don't want it to happen or enjoy it but I am only human and the people that have stopped are very understanding.

It's just our reality I guess.

I notice too every once in a while if I try to speak during one my speech will sound a bit slurred.

I felt really worried because my boss called right after an episode and I was still in panic mode.

She kept asking are you sure you're okay because your voice sounds as if you've been asleep.

I did confess to her at that moment what was going on and she basically talked me through it.

I did as I said sound slurred to me for one sentence and then thank goodness my speech cleared up.

I'm sure she was assessing me the entire time for my cognitive level since she is a nurse and I hope I passed.

I also did the thing where the wave passes through me where i feel like bursting out crying but I was just very honest about it. She just agreed that was an indicator to her that probably a very low dose of an SSRI could potentially help me.

And above all she said her concern was my quality of life-she said she didn't want me to be fearful of doing things.

So I guess my experiences while humbling have been positive-thank God for that.

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Panic attack was one of the first symptoms of my POTS, Out of no where it would just begin and escalate to the point I though I was dieing, hyperventalation, cold sweats, Very intense fear, heart racing....When finally I had my POTS diagnosis the Dr at the autonomic clinic at the Cleveland clinic explained it to me as my body reacting to the drop in my blood pressure in a very dramatic way that too much adrenaline was being released because it sensed I needed it NOW, causing the symptoms of my panic. They tried Xanax and was a life saver, I put one under my tongue and I could have almost immediate relief of the attack. But it did not seem to help stoping them from comming and the attacks were affecting my quality of life, I was almost housebound out of fear one would happen while I was out. When I became a patient of Dr Grubb he suggested we try Celexa as it would help curb the attacks. I started out with a very baby dose and worked up over time to 20 mg a day. I used my Xanax in the beginning if I had an attack while waiting for Celexa to kick in. It took a few months but it really did work. I have not had a full blown panic attack in so long. I still can feel some of the wierd feelings when my pressure drops but It doesnot grow into an attack. Everyone is different and I am no expert, but this is my experience with Panic. I hope you can find an answer to helping yours, I know how horrible it feels. Another thing that helped that I found on my own was some tapes by a woman named Clair Weakes, spelling?, she explains the whole process of panic and attacks and helps in a very calming way discribe how your body is reacting and how best the understand the process and help calm yourself. They really helped on bad days.

Kim

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Panic attack was one of the first symptoms of my POTS, Out of no where it would just begin and escalate to the point I though I was dieing, hyperventalation, cold sweats, Very intense fear, heart racing....When finally I had my POTS diagnosis the Dr at the autonomic clinic at the Cleveland clinic explained it to me as my body reacting to the drop in my blood pressure in a very dramatic way that too much adrenaline was being released because it sensed I needed it NOW, causing the symptoms of my panic. They tried Xanax and was a life saver, I put one under my tongue and I could have almost immediate relief of the attack. But it did not seem to help stoping them from comming and the attacks were affecting my quality of life, I was almost housebound out of fear one would happen while I was out. When I became a patient of Dr Grubb he suggested we try Celexa as it would help curb the attacks. I started out with a very baby dose and worked up over time to 20 mg a day. I used my Xanax in the beginning if I had an attack while waiting for Celexa to kick in. It took a few months but it really did work. I have not had a full blown panic attack in so long. I still can feel some of the wierd feelings when my pressure drops but It doesnot grow into an attack. Everyone is different and I am no expert, but this is my experience with Panic. I hope you can find an answer to helping yours, I know how horrible it feels. Another thing that helped that I found on my own was some tapes by a woman named Clair Weakes, spelling?, she explains the whole process of panic and attacks and helps in a very calming way discribe how your body is reacting and how best the understand the process and help calm yourself. They really helped on bad days.

Kim

This is the exact same explanation that my son's doc gave and same basic treatment SSRI: started VERY gradually. So happy you got yours under control, Kim. Worked for my son too!

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