Post Tramatic Stress

[issie]

Have any of you connected your POTS to Post Tramatic Stress? Was something going on in your life that was very stressful or tramatic and at the time or months later, you develop symptoms of POTS. Since our Autonomic Systems are so sensitive, wondering if it could be caused to malfunction due to a nervous system overload. (Question brought up from another discussion. Thought I'd throw it out to everyone.)

[lieze]

Yes I think I have it.

It's related to the behavior I deal with my husband with his bipolar disorder.

What makes it worse is I think I have a bad case of anxiety and even some OCD where I obsess on the things that aren't right in our life or the things he has said and it quadruples what we are actually going through at any point and time so it is a toxic situation.

It almost seems when I get stressed now it comes straight out in physical symptoms.

I no longer feel the anxiety it just manifests itself physically.

I have asked for Lexapro and I think it can help me since my anxiety is really bad but I now have to work up the nerve to start taking it.

Xanax many days has taken away all the weird sensations I get and I start to feel normal-get an appetite etc etc.

[lieze]

It's very interesting because this anxiety type problem runs in my dad's side of the family.

My mom claims all of his sister's went nuts at 40 but it manifests through over concern with health issues so it makes me wonder if they've gotten similar feelings that I do.

For instance my dad's sister had the same problem with feeling like if she fell asleep her heart would stop. Good news is she has lived with this for a very long time and they all seem physically healthy despite their worries.

[firewatcher]

There is research out there that prolonged stress, particularly during the developmental phase of childhood or even later, causes such a sustained cortisol response that it changes the autonomic nervous system's pathways. It is quite possible that post traumatic stress could cause POTS. This is not the case for everyone, but certain people are more susceptible to these changes.

[lieze]

Oh something else really strange happened right before I started having the POTS symptoms was I started speeding in the car but had no idea I was doing it. I got stopped like 4 or 5 times? And I honestly had no clue I was driving that fast. It's like my bearing were off and I was just going at life full speed ahead. Compared to now I can't even hardly drive at all and everything feels like it's coming at me too fast.

Also I had the pupil thing happen twice? I think before the other POTS symptoms where one pupil was dilated and one constricted. I was really stressed the one day at work when this ahppened and I freaked out left work and went straight to ER. They couldn't find anything wrong with me but sent me on to a ophthalmologist who also could not find anything wrong.

So it's like my POTS does show up in physical ways but nothing that seems to be life threatening even though at the time it's really scary.

[issie]

Firewatchaer,

Is it possible for you to find the references to this research? I find this very interesting.

[nforste]

It's interesting you say that firewatcher - I was talking to a woman the other day and she was saying that there's a correlation between kids who experience some type of stress pre-18months or so and fear of heights. What that fear relates to though is a reflex that hasn't been switched off due to that stress during development. She said that people who are afraid of heights, jump when they're startled and kind of go in on themselves (like shoulders go forward, towards foetal position etc) haven't had that reflex turned off. She does a series of exercises with kids to reverse this - essentially they get used to being startled/scared. I haven't looked into it any further, but thought it was interesting

[firewatcher]

This is simply the most recent, but there have been several that I have come across:

J Psychopharmacol. 2010 Jan 21. [Epub ahead of print]

Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma.

Corrigan FM, Fisher JJ, Nutt DJ.

Argyll & Bute Hospital.

Abstract

This paper reviews the Window of Tolerance model of the long-term effects of the severe emotional trauma associated with childhood abuse, a model which can also be applied to adult trauma of sufficient severity to cause post-traumatic stress disorder, chronic dysthymic disorders and chronic anxiety disorders. Dysfunctional behaviours such as deliberate self-harm and substance abuse are seen as efforts to regulate an autonomic nervous system which is readily triggered into extreme states by reminders of the original traumatic events. While midbrain areas such as the periaqueductal gray mediate instant defence responses to traumatic events and their memory triggers it is proposed that ascending monoaminergic tracts are implicated in longer-term changes in mood and arousal. An imbalance of ascending dopaminergic tracts may drive rapid fluctuations in level of arousal and in the associated mood, drive and motivation. Animal models of depression frequently use traumatic experiences of pain, isolation or social defeat to induce changes in mesolimbic and mesocortical dopamine systems which may alter prefrontal cortical control of midbrain defence responses. A focus on the pharmacology of the Window of Tolerance could provide advances in drug treatments for promoting emotional regulation in those who are suffering from the chronic sequelae of traumatic experiences.

PMID: 20093318

J Natl Med Assoc. 2007 Jun;99(6):642-9.

Cardiovascular manifestations of posttraumatic stress disorder.

Bedi US, Arora R.

Department of Internal Medicine, Rosalind Franklin University of Medicine & Science/Chicago Medical School, IL, USA.

Abstract

Posttraumatic stress disorder (PTSD) involves the onset of psychiatric symptoms after exposure to a traumatic event. PTSD has an estimated lifetime prevalence of 7.8% among adult Americans, and about 15.2% of the men and 8.5% of the women who served in Vietnam suffered from posttraumatic stress disorder (PTSD) > or =15 years after their military service. Physiological responses (increase in heart rate, blood pressure, tremor and other symptoms of autonomic arousal) to reminders of the trauma are a part of the DSM-IV definition of PTSD. Multiple studies have shown that patients suffering from PTSD have increased resting heart rate, increased startle reaction, and increased heart rate and blood pressure as responses to traumatic slides, sounds and scripts. Some researchers have studied the sympathetic nervous system even further by looking at plasma norepinephrine and 24-hour urinary norepinephrine and found them to be elevated in veterans with PTSD as compared to those without PTSD. PTSD is associated with hyperfunctioning of the central noradrenergic system. Hyperactivity of the sympathoadrenal axis might contribute to cardiovascular disease through the effects of the catecholamines on the heart, the vasculature and platelet function. A psychobiological model based on allostatic load has also been proposed and states that chronic stressors over long durations of time lead to increased neuroendocrine responses, which have adverse effects on the body. PTSD has also been shown to be associated with an increased prevalence of substance abuse. With this review, we have discussed the effects of PTSD on the cardiovascular system.

PMID: 17595933

Edited July 10, 2010 by firewatcher

[tommykazim]

Interesting topic. I first became ill many years back with a sudden bout of tachycardia, dizziness and chills which became episodic, weekly or monthly and still to this day, mostly waking me up at night. Not knowing what was causing it I became extremely anxious and wonder if the years of worry took its toll on my autonomic function. Citalopram has been the only drug to have helped my symptoms interestingly as is used in anxiety however it seems to have lost its effect recently. I do wonder though if the condition causes anxiety perhaps by a reduced blood flow to that specific part of the brain or the anxiety then exacerbates other symptoms...Related or not has anyone been found to have low levels or norepinephrine on catecholamine testing? Mine strangely was, would have expected it to have been raised...

This is simply the most recent, but there have been several that I have come across:

J Psychopharmacol. 2010 Jan 21. [Epub ahead of print]

Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma.

Corrigan FM, Fisher JJ, Nutt DJ.

Argyll & Bute Hospital.

Abstract

This paper reviews the Window of Tolerance model of the long-term effects of the severe emotional trauma associated with childhood abuse, a model which can also be applied to adult trauma of sufficient severity to cause post-traumatic stress disorder, chronic dysthymic disorders and chronic anxiety disorders. Dysfunctional behaviours such as deliberate self-harm and substance abuse are seen as efforts to regulate an autonomic nervous system which is readily triggered into extreme states by reminders of the original traumatic events. While midbrain areas such as the periaqueductal gray mediate instant defence responses to traumatic events and their memory triggers it is proposed that ascending monoaminergic tracts are implicated in longer-term changes in mood and arousal. An imbalance of ascending dopaminergic tracts may drive rapid fluctuations in level of arousal and in the associated mood, drive and motivation. Animal models of depression frequently use traumatic experiences of pain, isolation or social defeat to induce changes in mesolimbic and mesocortical dopamine systems which may alter prefrontal cortical control of midbrain defence responses. A focus on the pharmacology of the Window of Tolerance could provide advances in drug treatments for promoting emotional regulation in those who are suffering from the chronic sequelae of traumatic experiences.

PMID: 20093318

J Natl Med Assoc. 2007 Jun;99(6):642-9.

Cardiovascular manifestations of posttraumatic stress disorder.

Bedi US, Arora R.

Department of Internal Medicine, Rosalind Franklin University of Medicine & Science/Chicago Medical School, IL, USA.

Abstract

Posttraumatic stress disorder (PTSD) involves the onset of psychiatric symptoms after exposure to a traumatic event. PTSD has an estimated lifetime prevalence of 7.8% among adult Americans, and about 15.2% of the men and 8.5% of the women who served in Vietnam suffered from posttraumatic stress disorder (PTSD) > or =15 years after their military service. Physiological responses (increase in heart rate, blood pressure, tremor and other symptoms of autonomic arousal) to reminders of the trauma are a part of the DSM-IV definition of PTSD. Multiple studies have shown that patients suffering from PTSD have increased resting heart rate, increased startle reaction, and increased heart rate and blood pressure as responses to traumatic slides, sounds and scripts. Some researchers have studied the sympathetic nervous system even further by looking at plasma norepinephrine and 24-hour urinary norepinephrine and found them to be elevated in veterans with PTSD as compared to those without PTSD. PTSD is associated with hyperfunctioning of the central noradrenergic system. Hyperactivity of the sympathoadrenal axis might contribute to cardiovascular disease through the effects of the catecholamines on the heart, the vasculature and platelet function. A psychobiological model based on allostatic load has also been proposed and states that chronic stressors over long durations of time lead to increased neuroendocrine responses, which have adverse effects on the body. PTSD has also been shown to be associated with an increased prevalence of substance abuse. With this review, we have discussed the effects of PTSD on the cardiovascular system.

PMID: 17595933

[Guest tearose]

I don't think so...

I think I had a predisposition to ANS sensitivity and a lyme bite that caused lymphedema and dysautonomia pushed my immune system and ANS over the limit of balance.

I got "stressed" from defending myself and having to explain that I was not anxious or depressed, I looked good because I took time to care for myself even though inside my body was struggling.

Now that I am advocating for myself again, I am not getting stressed over explaining dysautonomia over and over and over again. I believe with every cell of my body that I was born "sensitive" in a good way and am finally learning how to use this as a gift.

[comfortzone]

There is research out there that prolonged stress, particularly during the developmental phase of childhood or even later, causes such a sustained cortisol response that it changes the autonomic nervous system's pathways. It is quite possible that post traumatic stress could cause POTS. This is not the case for everyone, but certain people are more susceptible to these changes.

For many years I have been looking into just such things such as prolonged trauma ~ and health. The group/s that I've studied are those that have been recruited into destructive/damaging cults. Cult members can sustain several multi-faceted injuries over the course of the years they are involoved -- of varying types and severity & it's disheartening to read that those that escape and achieve freedom -- have to deal with the fallout in their bodies/minds. The fact that there is much ignorance in the medical and mental health community about cults and the effects of cult involvement.......only makes the escapee's recovery more difficult if downright convoluted or damaging -- though it's assumed the helping professions desire to help. You could include in this any person involved in a high demand group or even in a one to one domestically violent relationship.

Yet even in working with the world's best scholars about this I have yet to find available studies on the physical symptoms where the causation could be related to sustained abuse or abnormal stress over years and years.....Proven out in scientific research. In fact I may see what I can do to get more involved -- in learning about post-trauma effects on the ANS......and things such as this. I'll fire off a few emails & see if I can find something out -- that I can share :-)