POTS and the Brain

[guvna2004]

Hi all.

I was sitting here the other day thinking to myself, could POTS be started by ourselves? What i mean is all the anxiety and damage we put our bodys through could we be damaging our own nerves? Its just a thought that probably sounds stupid, but my pots symptoms started after i choked on a sweet, from then on i was paranoid about eating, i was paranoid about death, and life, and soon after i began developing minute pots symptoms which gradually got worse as time went on. Ive always been a paranoid person, every scince i could remember, i used to get a splinter in my finger and always thought id have to amputate my finger, i was always scared to eat after i choked when i was 4 on some chicken, my moms literally forced food down my throat after i never ate for a week, she said i looked really ill. So could this be what starts POTS of? things in the past we do that eventually catch up with us. It might be nothing, but how many of you have always been CONCIOUS of your lifes and the goings on?

[MomtoGiuliana]

I think it is pretty well established that anxiety does not cause POTS. It's the other way around--anxiety is often a POTS symptom. While in general it is also true that stress can exaccerbate illness, I think there is no evidence out there in research land that shows that stress itself definitely *causes* particular illnesses.

Sadly, I think some doctors talk us into thinking that our POTS symptoms are caused by stress. I was told I was stressed out and depressed for months prior to my accurate diagnosis.

Anyway, if you are interested, here's a web site (the about.com pages) that I find helpful and accurate for answering basic questions, like this:

http://stress.about.com/od/chronicconditions/

I would also add, that working to reduce stress in your life can only be helpful to your health. Meditation, yoga and other practices can really help. If you are still feeling anxious on a regular basis, it would be worth discussing this with your doctor. I saw a psychologist for awhile when I was quite sick for the sole purpose of learning relaxation techniques through biofeedback. It helped me tremendously.

Some additional thoughts--Do you think it is possible that, rather than being anxious for no reason, that your anxiety that started as a child was actually caused or greatly exaccerbated by having undiagnosed POTS? Also, POTS patients can have trouble swallowing--as the autonomic nervous system plays a role in that.

In any case, please don't feel that you brought POTS upon yourself. Besides the fact that this is not likely, you can't change the past, you can only start to work on changing your approach to life now.

Take care, Katherine

[guvna2004]

Maybee i have had pots for a long time but never knew about it. I have always had trouble swallowing, i always need to drink water with meals and sometimes it feels like my throat opens wide at the back for no reason. Try it, open ur throat , it feels like that for no reason. I also feel like i want to heve alot , like im about to be sick but without hte stomach pains. Im gonna go to the gym and start doing yoga and do some relaxation. Thanx

[geneva]

Just a personal note about whether anxiety is a cause of POTS. I also think not...when I was diagnosed the doctor said to me that he knew I had been told that I was probably suffering from anxiety for several months by different doctors. He told me never to accept this explanation for my symptoms and to have any doctors contact him if they thought so. His reason was that while I was in the hospital and on the cardiac ward, he watched as my stats were perfectly normal lying down but when I stood up my bp held and my HR soared. He said "no amount of anxiety can cause you to only have a rapid heart rate just when standing." That reassured me.

Like Katherine I have found yoga to be helpful in my life. good luck finding what helps you.

[calypso]

I have a bit of a different opinion on this subject. I was diagnosed with panic disorder with features of generalized anxiety disorder at age 18. It was very well controlled with meds and psychotherapy from a few months after diagnosis until I developed POTS at age 27. I think that perhaps the same reasons that cause us to be biologically prone to anxiety are the same ones that may be responsible for the development of POTS.

Autonomic sensitivity has been well documented to be a genetic issue that is exacerbated by environmental factors (stress/trauma, especially in early childhood; toxins, such as chemicals or pollution; etc.). For instance, you may have always had a tendency toward and overactive sympathetic nervous system, but it didn't show up because you had no event to bring it out (such as stress, trauma or illness). Autonomic sensitivity is thought to be the reason why some people develop panic attacks and POTS. Many of us, now that we think back on it. saw signs of autonomic sensitivity in our childhood or teen years -- tachycardia, fainting, low BP, dizziness, tremors, etc.

Yes, it is true that we have SOME control over our autonomic nervous system, but it's more immediate. For instance, after doing 1 hour of yoga or meditation, many people will experience a clinically significant drop in BP or heart rate. But it doesn't last very long. If you become a regular practitioner of yoga or meditation, it is said that after many months of doing it, you can "reprogram" your nervous system to make those effects of lowered BP and heart rate become more constant. For some of us, we can meditate all day long, but the biological sensitivities are too strong for us to change the autonomic nervous system permanently. I figure it's worth trying.

Amy

[DawnA]

I like what calypso had to say. We are predisposed to having autonomic problems/ anxiety and stress/trauma can trigger POTS. I do not believe anxiety causes our POTS. But it does play a role in our symptoms. Stress and uncontroled anxiety can definitely exascerbate out symptoms. I believe their is a major mind body connection.

My daughter had the same issue after she choked on a butterscotch Candy at age four. It took her a long time to get over it. I never forced her to eat, because I feel it would of make it worse. I just encouraged her that she was OK everytime she panicked that she would choke. I also gave her a lot of easy foods to swallow. By the way she has POTS also. I feel she has had autonomic problems since she was born. Interesting!!

Dawn A

[DawnA]

We are not in full control. But we do have some control with our state of mind. It doesnt hurt to be calm and positive when you have an autonomic problem, but this is difficult to do. We do not have total control of our moods either.

Dawn A

[Gena]

Amy,

I agree with your line of thinking. I don't think anxiety causes POTS, but I know that stress and other outside and internal mechanisms can trigger certain illnesses or characteristics or disease traits. For example, if we have genetically inherited the trait for diabetes from a parent, science shows we can often significantly delay the onset of the diabetes by eating properly, exercising, etc. Whereas, another individual with the same inherited trait may develop diabetes early in life due to maintaining poor health habits.

I inherited celiac (autoimmune disorder of the small intestine) from my father's side, but never had any symptoms until I was 32 years old. It suddenly started to manifest itself during one of the most stressful times in my life.

My POTS symptoms came out of no where during another stressful time in my life. For me, I think my POTS is definitely autoimmune related. Maybe my stress triggered an abnormal gene trait to cause my autonomic nervous system to go haywire. Whether it's caused by stress, nutrition, another illness, etc. I don't know. But I don't think we should beat ourselves up over it or blame ourselves. I never had heart racing, or anxiety attacks until I got celiac. And that went completely away after going gluten free, but came back when I got POTS.

We remain a mystery wrapped up in an enigma!

[dawn]

Hi,

Interesting posts. I was told I had an anxiety disorder, before I was diagnosed with pots. I have always thought of myself as being adrenaline sensitive due to the fact of fearing my alcoholic father as a child. When he would come home I remember how hard and fast my heart would beat.(at age 5) As an adult it seems like my startle reflex is so much more exaggerated than others. To others I seem very calm and laid back.When I tell them on the inside I feel like I'm coming out of my skin they can't believe it.

My 24 year old son says I live 90% of my time thinking about my symptoms-he's probably right. It's a hard cycle to break. It's hard to let go of the "what if's" and just live.

Dawn

[TexasGrrl]

Indeed an interesting thread. I view this as a POTS sufferer (due to EDS), but my sister (who probably also has EDS) suffers from extreme anxiety and panic attacks. She has been diagnosed with manic disorder. I am half of her support system when she has her bad times (her husband is the other half). Recently we both began to make connections between anxiety and my own symptoms, and we're wondering if her symptoms are just manifested in anxiety instead of just a racing heartbeat and low blood pressure. It would be interesting to put us side by side in a lab and run the same tests on both of us to see what turns up.

In any case, I listen to her fears and feelings, and particularly when she is in a manic phase, she fears everything. But also, all the time, she focuses mightily on her symptoms and finds it hard to concentrate on solutions instead of the problem. It is, indeed, a tough cycle to break. WHile I can't empathize (I'm not in her skin), I can sympathize with what she goes through. She relies on me to give her building blocks to help her get through the rough times, and to tell her when she's overreacting or focusing too much on the problem.

What I tell her is that every time she starts thinking about how bad it is, she gets scared of having another panic attack. That, in and of itself, propagates the cycle and brings on another panic attack. The only way to break the cycle is to notice when she's thinking about the negatives, and focus on the solutions.

For example:

She thinks "Oh man, yesterday was so awful! I couldn't get out of bed all day! I knew I was supposed to get up and take my meds so I could function and go to work, but I was too scared!! This is so terrible.. what if it happens tomorrow?"

IF she continues on that train of thought, she will almost definitely have another panic attack and be unable to function again.

However, if she grasps that one sentence "I am supposed to get up and take my meds so I can function" and holds onto it for dear life, then she can force herself to fight the fear and go take her meds, and then function. Once she's on the meds and stabilizes, she improves fairly quickly.

I think the key is understanding that only YOU can break the cycle. You CAN choose to focus on the fear, the symptoms, what it's doing to your life... or you can choose to focus on what you KNOW you can do to get some relief, even if it's minor. Focusing on problems causes anxiety, but focusing on solutions brings some sense of control and calmness.

I am not in any way saying that we CAUSE our problems, but we definitely can make them worse just by what we think.

[vemee]

I've been treated for depression for many years. Everytime I got off the antidepressants I would get strong anxiety at night when I was trying to sleep. This summer when I started having paresthesia I got off all meds and the anxiety at night returned only this time I had my trusty little blood pressure monitor and found that when I was having the anxiety my bp had dropped below the shocky level usually with a systolic in the 80s or even the 70s. So the anxiety was due to hypocerebralperfusion.

I guess the antidepressants are helping control some of my pots symptoms.

[EarthMother]

No blame. No judgement. I firmly agree we do not "bring on pots".

I also have history of panic disorder -- but I have long history of what they called 20 years ago "tachycardia on mild excersion" -- I get it now that this was POTS.

Is it a chicken and an egg thing? Does the body control the mind? Does the mind control the body? Is there really a separation of mind and body at all? I am likely to believe there is not. After returning from work from one of my long POTS spells and being out on disability for a number of weeks (or months) one of my staff came to me and said that "people were talking". They wondered if I was "mentally sick" or "physically sick". I didn't miss a beat and turned to him and asked "Is there a difference?" And then I smiled warmly. Nothing more ever needed to be said.

However I have really been thinking alot about a the origin of POTS and while I know it is different for each of us, I wonder if many of us share a common thread of Trauma. I've been doing some work on trauma and the biological nature of what animals do and how they "shake it off" in many ways better than we do as humans. The work of Peter Levine talks about the autonomic nervous system getting stuck in a freeze response and then charging with bound up energy. For Levine it is all about "uncompleted movements" that we didn't make when expossed to some initial (or repeated stressor) and then what happens after a lifetime of re-traumatization.

We all have faced so many years of trauma going through the medical system and being told time and time again -- we are crazy. Does this impact our current state now? I think it does. I mean even though I have a great doctor now, I have to think that somewhere in my body, I still have physical memories of the storms that I didn't understand and that maybe there is a way I can let my body explore ways to "complete" the trauma response. And in the end, if I can't reduce the POTS symptoms, maybe learn to live a bit more at peace with them.

Thanks for bringing up the thread. It gives me more to think about. Good luck to all on your healing journey.

EM

[MightyMouse]

I would like to add my own piece on this topic. I have never had any problems with anxiety or anxiety attacks-- other than the normal stuff, like butterlies in my tummy before a big exam, right before surgery, etc... Additionally, I was told a psychiatrist (that my stupid general practitioner of 10 years ago made me go see because he apparently didn't have enough neurons to figure out what was wrong with me) that I was one of the most hopeful and well adjusted people she'd ever seen.

Yes, depression and anxiety can add to the problems those with ANS issues have, but I want to make it expecptionally clear: THESE DISORDERS ARE NOT CAUSED BY MENTAL STRESSORS such as depression or anxiety. They are their own medical domain. They can be worsened by mental stressors. I caution our members to remember that ANS disorders and mental health problems are not the same thing--and that even with biofeedback and relaxation techiques, most people with autonomic system disorders still need other treatments in order to be functional.

Nina

[RunnerGirl]

I think we are not yet at a stage where we can make definitive, bold assertions such as ANS disorders ARE or are NOT caused by mental stressors. The truth is that the etiology of ANS dyfunction remains largely unknown.

Likewise, the connection between the mind and the body is also poorly understood. The psychiastrist I consulted during my most symptomatic time was troubled when I tried to make a distinction between physical and mental illness. What he told me is this: The latter is, in fact, a physical illness, different from, say, diabetes only in the fact that the organ involved is the brain and not the pancreas. The brain is arguably the most complex and also perhaps the least understood organ in the body. Why, when the brain ultimately controls the ANS, is it not possible that the same brain chemical changes or disruptions that cause panic and anxiety disorders, or depression, could also manifest themselves in other, purely physical ways - such as disruption of the ANS? I think we do ourselves a disservice in the quest to understand our condition if we completely dismiss this possibility.

I, personally, am struck by the similarity between true anxiety and panic disorders (I'm not talking about butterflies before an exam, but rather dibilitating misfirings of the 'fight or flight" response that can and do occur in otherwise normal, hopeful, well-adjusted people) and the hyperadrenergic forms of ANS dysfunction, in particular. I often wonder if the two aren't on the same spectrum of brain chemistry disruption or imbalance.

Earthmother raises something about trauma, and what role it may play in our physical health. Again, this gets back to a mind-body connection. I consulted with a hypertension expert a couple of years ago by the name of Dr. Samuel Mann. Dr. Mann is NOT a touchy-feely alternative medicine guy. His background is about as mainstream and conventional as you can get. But in his book, "Healing Hypertension, " he documents patients with severe episodic hypertension, where pheo had been ruled out and panic attack was also excluded. What was similar about these patients: they all had some sort of trauma in their past, and they had repressed emotions surrounding that trauma to become otherwise productive, happy, successful people. In short, Dr. Mann suggests that hidden or repressed emotions can have a profound impact on our physical health - even moreso than the the stressors and emotions we actually acknowledge and feel.

Anyway, just more food for thought. I would encourage everyone to keep an open mind about the topic. It's easy to get defensive when someone suggests anxiety could play a role in our illness, as too many of us were 'brushed off" with "it's JUST anxiety" when we sought help for our symptoms. This not only demeans people suffering with ANS disorders, but also those with anxiety (the disease, not the symptom). They may or may not be related to each other, but they are both true conditions that can greatly disrupt our lives.

RG

[MightyMouse]

This discussion topic has come up inumerable times on this forum and on others I belong to. I find that as I'm getting older, I'm a bit less tolerant of enteraining the discussion of whether or not mental trauma is strongly related to the eitiology of ANS disorders (sorry EM, you and I are on opposite sides of the fence on that one). I'm not saying it doesn't have an effect on physical health. RG, I don't disagree with what your saying. I'm not completely dismissing the idea that there may be relationship--but I also think one must be clear that ANS disorders, according the the current understanding, is it's own group of medical disorders.

In all likelihood, there are many, many ways that ANS problems can occur--disruption ANYWHERE in the pathways of input and output could produce the symptoms that lead to a dx of POTS, NCS, OI, PAF, etc.. with input being such things as sensations, perceptions, emotions, physical activity, interactions of one bodily system with another, ingestion of food, medications, etc.... output being such things as neurochemical release, neural response, muscular response, on and on...and on....

Anxiety, panic and/or depression, alone, are not sufficient explanations for the symptoms that those with ANS problems have. Certainly, the body isn't disconnected from emotions, and each human being is an intricate, complicated dynamic system. Dynamic, meaning, all environmental factors, internal and external have an impact on a human in one way or another. Mental trauma does have an impact--but one must be cautious in drawing a conclusion of a causal relationship for the entire ANS disorder or being the setting event for ANS disturbance. That's a question that needs to be answered by science. Perhaps they will find a relationship or correllation some day. Who knows? No one yet. I'll gladly eat crow if science shows me empirical evidence to the contrary.

Until then, I reserve the right to get irritated whenever this discussion comes up because ...well... mostly it reminds me how doctors mostly DO brush off patients as "hysterical" or "depressed" and fail to investigate further. And, it reminds me how few doctors are actually doing research in ANS function. While the chemicals released in fight/flight responses are the same for some one having a panic attack and someone having an autonomic storm, what we don't understand is the whole process of how the ANS works in normal people and what's going wrong with those of us who don't respond normally. I'm sure the topic come up again, and I'll probably rant and rave then too. Probably will rant slightly less in the future as I'm currently full of steriods from those darned spinal shots and my fuse is about this big - .

I hope I didn't offend anyone. I respect your viewpoints even though I hold a different view.

Nina

[Guest tearose]

This topic can push my buttons!

I suppose it is because of the many years and may doctors and many tests that led nowhere...

It took me from 1991 till 2003 to finally get a complete diagnosis...

First, my disclaimer... It is not that my opinion is right or wrong, It is what I believe from my experience and understanding.

I am glad that I have never "allowed" myself to be labeled with a label of anxiety or panic disorder because it was never the correct label!

I do not believe that my emotions have given me POTS. If anything, because I am emotionally healthy, I can better deal with my physical challenges.

Even when my POTS symptoms have been my worst, I have not had the experience that I "don't want to get out of bed" I have had the experience that "I can't get out of bed". This has had nothing to do with my will or my disposition or my level of stress or anxiety. If I haven't been able to get out of bed there has always been a physical documentable reason! Then, eventually, I treat the physical problem and I can resume more activity.

I do think there are those people who become so frozen in the "fear and anxiety" of emotional challenges that they trigger physical manifestations. I believe that this falls into a psychological or psychiatric area.

I will "fight" to keep the two separate!

I refuse to have anyone treat my physical limitations/disorder as a psychological or psychiatric problem! It just isn't the right fix!

tearose

[EarthMother]

A good friend told me the other day .... when we feel we are "right" then we have to make the other person "wrong". I sincerely hope I didn't make anyone feel wrong about their opinion. I really don't see a fence on this issue to be on one side or the other. We are exploring possibilities. I don't believe there is a one-size-fits-all-truth to be found.

In chronic fatigue syndrome many people believe that there are a host of different "causes" that may lead to a similar expression of what we call CFS. Perhaps this is true for POTS -- some of us come down path X, some of us down path Y and we find ourselves together in this meadow of shared experiences with orthostatic intollerance. Which is unquestionably REAL -- we don't make up the drop in BP and the heart rate rising. When we stand it isn't a panic attack. (Otherwise it wouldn't go right back down again when we lie down.)

I also did the "go see this psychiatrist" request on behalf of one of my "specialists" back when I was in a really deep and yet undiagnosed POTS-HOLE. And I crept in there in my slippers and sweats (because it was really a challange for me to be upright at the time.) And I had the same experience as Nina. The doctor told me (and I firmly agreed) that I was mentally fine and in no need of psychiatric care. I have no signs of depression and my anxiety stemmed from the fact that I had an undiagnosed illness that no one was able to identify and treat. His recommendation -- FIND ANOTHER DOCTOR! Which I did and eventually came upon POTS. Now that doesn't mean that I still don't have panic issues to address -- I think in large part because I didn't process these body sensations 20 years ago.

I know this struggle. I would often have tears in my eyes in the parking lot with my husband if I was having a bad POTS episode and had to meet a new doctor. I'd confess to my husband ... I don't want the doctor to see this as anxiety ... it isn't. I can handle the anxiety part ... but I know deep down that this isn't anxiety there is something WRONG. And ofcourse we all now know there was. There is. I have POTS. I didn't make it up. And I can't meditate my way out of it.

However. I do believe -- ok I still hope -- that someday my body will find a way to work through this and correct itself. The body is an amazing thing. It can make it's own powerful drugs like morphene to stop pain, it can develop it's own killer cells to destroy invadors (or unfortunately to attack itself at times.) So I hold out that my body can find a way to remap the neural networks and begin to produce on it's own the "right" combination of chemical responses to heal whatever it is that has gone terribly wrong. Meanwhile, I'll continue to work with my doctor, my zen master and my therapist to achieve the most I can.

My deep thanks to everyone. If we were all identical, we would become bored rather quickly.

Salubrious!

EM

[MightyMouse]

EM, maybe fence was the wrong metaphor--sorry it was in the wee hours of the night and I was cranky to boot. A better metaphor:

we're both looking at the same ocean from different vantage points.

There's no right or wrong answers (yet) with regard to the answer to the original question. Everytime this topic comes up, it's been intense... and that's fine... that's part of what this forum is here for.

I think the question, itself, is a touchstone for many of us who've been dismissed by the medical community as simply anxious. Yes, EM, you and I share the same history with avoiding going to new doctors. I even got to the point, prior to diagnosis, where I wouldn't go AT ALL. I'd stopped going to the doctor for about 2 years, despite being terribly symptomatic. That ended when my gall bladder gave out and I had to get help. At that point, I'd just met Teri (days before) and had gained a great health care advocate--and finally got closer to ending my journey to an accurate diagnosis. I was almost 30 at that point and had been sympomatic since childhood, so perhaps that long, long road has amplified my opinionated rantings on this topic--like I said, no right or wrong answers as yet, but there sure are lots of opinions...and not just mine

Nina

Edited March 13, 2005 by MightyMouse

[RunnerGirl]

I love that we can challenge each other (and ourselves) with this thoughtful exchange of ideas and perspectives. Far from being offended, I am in fact extremely impressed by the impassioned and articulate discussion of divergent views expressed here. In less "mature" forums, this could have degenerated into a series of personal attacks, yet instead we show each other respect by sticking to the arguing of ideas.

Thank you to everyone here for your perspective!

RG

[Michelle Sawicki]

I can only share from my own personal experiences on this one, and from those experiences I do not believe my POTS is related to anxiety. I do not suffer from undue anxiety and I never have, not even when my POTS was at its worst. In fact, there have been times in the last 6 years that I've had POTS where I've gone through stressful periods and wondered if I would become worse. In truth, I've found that sometimes I actually feel better when I'm going through stressful periods, and my guess is that it may be because my blood pressure is actually a little higher during these times. Other times everything in my life is just peachy but the POTS is acting up. I have not found a conection in my own life between the two. That's not to say that there isn't a connection between the two in some of your lives.

I hope those of you with anxiety troubles do seek appropriate treatment.

Michelle

[avais1]

I am not going to get into this "chicken or the egg" discussion , This subject is way beyond me. I just want to make one comment: I am not comfortable with making the word "anxiety" a bad word. It is a condition, it is a legitimate condtion, just as legitimate as POTS.

My suggestion is for each of us to do our own research (and I see that many of us have) and form our own viewpoints. There are wonderful books and articles about the "mind/body" connection. There was one in particular that I read written by a Harvard Nuerologist called "Mind/Body Deceptions" that I felt was absolutely excellent. It discusses how Neurology and Psychiatry fields split apart in the early 1900's, and how recently, the two fileds have converged together again - PRCISELY FOR THE REASONS DISCUSSED IN THIS THREAD. Nuerology and Psychiatry can overlap.

The other thing that concerns me, is that I see some hostility in this thread. I do not feel that we need to do this to each other. In the end, we all want the same goal: a cure for dysautonomia!!! We are here to help each other, and that being said, let's do our very best to be aware of each others feelings.

Warm thoughts, and happy research to you all!

[guvna2004]

Im glad to see you all have fair views on this. Because of lack of understanding about POTS we are unable to say whos right and whos wrong. It seems from reading that a number of people do have anxiety issuses and have done befor they were labeled with POTS. The pattern im seeing here is either Anxiety CAN cause POTS or we had POTS but never knew, and was being labeled with anxiety. Im not a doctor but the brain controls your nervous system right? So if your brains going through a state of shock or fear or anxitey its obvious that only one part of your brain is being focuesd on, so the part that controls your breathing and heart rate is being deprived of electrodes because there going to the part of the brain thats making you fear. If people have constant panic attacks then the nervous system is going to get damaged, not in a fatal way but you may get broken nerves or something ( like i said im not a doctor im just explaining the obvious ). So maybee our nervous system is damaged. Thats why we get what we get. Im prolly wrong, but what im saying must have some sense.

[danish]

Hi,

I have to say that I very much disagree with the theory that anxiety or stressors cause POTS. I have never had problems with anxiety or panic attacks, and know that this is true of many other POTS patients. For a long time I was labelled as having an eating disorder and passing out for attention, but at least for me, I know that I'm not in control of my symptoms. I've never heard of panic attacks causing nerve damage, but like you, I'm not a doctor.

I do understand why having POTS could cause someone to be paranoid or depressed. After having quite a few seizures in the shower, I was scared and paranoid to have them, and I do get down by not being able to be in school or do things with my friends. However, I think that all of that is situational, and a natural human response to specific situations.

The ANS controls many functions of the body, and like other people here, lots of things have been affected. I respect other peoples opinions on this matter, but I feel strongly that we do not bring POTS/ autonomic dysfunction on ourselves.

~Sarina

[MomtoGiuliana]

This is a complicated and sensitive subject and this has been such an interesting discussion.

In my opinion, the bottom line is that if you have POTS it MAY be difficult to separate at times whether the anxiety you are experiencing stems from POTS or from another source of dysfunction. But, regardless, it is good to recognize that you do indeed have this symptom (as avais1 says--let's not make "anxiety" a bad word--I do so agree). If it continues to be a problematic symptom--seeking medical treatment is a prudent step. It may be that POTS meds alone, that aren't per se, for treatment of anxiety, may help relieve the symptom for you (in the long-term, that was the case for me, I believe). There are also drugs that are safe and effective for treatment of anxiety. I used Xanax (and many of us have) when my POTS was very bad, for short-term relief. I also know from my personal experience that certain lifestyle changes and habits--e.g., meditation, exercise/yoga, learning breathing exercises. biofeedback training--can help, at least to some degree, over time. There may be other meds/treatments that will help you, and a doctor should be able to help.

This has really already been said, but I'll just add that I know that when I was really sick, and didn't know what was wrong, the last symptom I wanted to describe to any doctor was anxiety. I believed that if I did that, my other symptoms would be discounted. I think a good number of us went through this and became programmed to deny this symptom for the pure reason that we wanted a proper diagnosis and that the medical community seems so quick to diagnose women in particular with anxiety disorder/depression. Thus, one reason it is a sensitive and difficult subject for some of us. It's also sensitive b/c in our culture, although attitudes are changing, we tend to believe that mental conditions are ones we bring upon ourselves--the patient is more likely to feel at fault for their symptoms/condition--which of course is completely unfair. But, importantly, as some others have pointed out, not all POTS patients have anxiety as a symptom.

Unfortunately, as POTS patients in particular, we have to learn to accept so many unknowns and things barely understood. This is a hard skill to master. Faced with that, though, it is probably best to take care of ourselves by addressing our current symptoms in whatever ways end up being most helpful, and not to dwell too much on the past or worry about what we might have done differently to avoid developing this condition.

Katherine

[guvna2004]

Ok. I can understand you all and i agree. Maybee im wrong then :], but at least i gave it a go. Its just that ive always been a paranoid person and ive always been Fully consious of wahts going on in my body, ever scince i could remember. But the discussion has been a rewarding one, and i have learn many new things. Thanx, i hope we can have more discussions in the future.