Where Does Pots End And Anxiety Begin?

[boymommy3]

Hi!

Just wondering if others could share their struggles with POTS and anxiety.

I have dealt with anxiety for years (before POTS). Now that my body seems to be freaking out with POTS symptoms I can't decide if I'm having terrible anxiety or terrible POTS symptoms sometimes. I just know that on days that I feel really bad from POTS symptoms I seem to spend a lot of time worrying or feeling anxious.

Do the two just seem to go hand-in-hand?

Thanks!

[Statix]

I think I have similar things. Although I am not diagnosed with anything yet as I have only been having tachy with standing for a month, once I noticed this, it freaked me out. I even went to the ER. I have had anxiety problems since I can remember, and I think people with anxiety are just more in-tuned with their body. The slightest change with our body can make us THINK something bad is happening. We start "catastrophizing" which in turn makes our anxieties worse. I know how hard it is to calm down, but if you start feeling anxious, sit down, lay down, do what ever you need to do and try to get your mind off of the symptoms you are experiencing.

I don't think my POTS problems are as bad as a lot of people on here, as I only get tachy, but I remember reading that POTS anxiety feels like an anxiety attack without the mental thoughts, while an anxiety attack is when our thoughts are rushing and we start feeling that something terrible is about to happen.

[Relax86]

One time over the summer my husband and I were in a restaurant having dinner. I felt a little Potsy before we went in and earlier that day. Once seated I started to feel much worse. I was feeling like I might faint and really didn't want to slump over at my seat. I was trying to analyze my breathing, belly and lightheadedness symptoms. I told my husband I was just going to wait in the car. I apologized and told him to take his time and enjoy his dinner and I would be better off in the car. The entire time I walked to the car I prayed I would get there before dropping on the floor. I got in the car, and did a little breathing and within 5 minutes I was totally fine. I was like - holy sh*t!!! My very first anxiety attack. Felt very similar to pots, but completely went away once I got out of the restaurant. My POTs symptoms never go away until they are ready to go away. I guess the point to my story is that it's hard to differentiate, and besides trying to decide what you feel it just stinks to have this disorder which mounts the worry and frustration. For me, I try and keep in mind that neither will kill me. Good luck and be kind to yourself.

[bebe127]

Boymommy3,

Sounds all too familiar. So sorry you are dealing with this. Before being dx with POTS (just months earlier I had to call EMT's and had an ER visit with hospital stay) it was thought that I had severe anxiety (deduction from EMT). My story is too long to put on here, but if you go to my blog, you can read about it more there. Suffice it to say, I deal with anxiety on a daily basis now.

The only other experience remotely the same was back in 1992 after hurricane Andrew struck South Florida, to be more precise, my house. I didn't experience anxiety during the storm. It was three weeks after when we were finally able to get out and drive any distance. Since phone lines were down and we didn't have cells back then, I hadn't spoken to my parents who lived 20 minutes north of us. They didn't know if we were alive or otherwise. In terms of anxiety, I recall quite vividly driving with my husband up to see my parents for the first time since the storm. Remember, we hadn't spoken and they didn't know how bad it was where we lived other than to see TV reports. Our area looked as if a bomb had hit. As we were getting closer and closer to my parent's house I could feel my heart racing, and tingling all over that seemed to be climbing up my extremities and I was shaking uncontrollably. I only relay this experience because this is exactly the same feeling I had years later in 2009 right before I was diagnosed with POTS, however I had never experienced this before.

Through my reading and such, my understanding is that since our ANS is out of whack, we seem to be kind of stuck in a fight or flight response. I don't think POTS gives us anxiety although it does exaserbate it. I don't think one even has to be an anxious person, so to speak to experience anxiety once dx with any form of dysautonomia. With any dx of a chronic illness, I think I'd be worried if one didn't experience some sort of anxiety. Just the fear of the unknown is enough to send me spiraling downward. I know for me, I experience this daily to varying degrees. Sometimes I still question whether I have POTS or if it is just anxiety.

I have suggested on here before that when I was going to a therapist for a short while, she referred me to a book called "The Anxiety and Phobia Workbook" by Bourne. I personally do not think that in my case, I have an anxiety disorder at all. I think that my POTS is the cause of it, not the other way around. Anywho, this book proved to be quite helpful and even though this therapist needed a therapist, in my opinion, I'm glad she directed me to this book. It has lots of information and tips on how to deal with anxiety. Hope this helps

Here is a link as well to an article written by a fellow potsie and former Neuropsychologist that you might find helpful as well: http://www.dysautonomiasos.com/#!psychology-and-dysautonomia/c20ox

Feel better

[Lemons2lemonade]

That is such a great question and i think they fall hand in hand. Anxiety feeds pots and pots feeds anxiety. Breaking the loop helped for me

[ramakentesh]

I used to get some postural anxiety and adrenaline surges when I first got POTS but if I take a volume expander like licorice or florinef completely got rid of this symptom. Infact I now notice that when i get dehydrated or low in blood volume the sympathetic symptoms start up again. its weird though because I still get dizzy but just no sympathetic symptoms.

I used to take inderal at times for this symptom. A herb called Eucommia was also very helpful for that wired tired feeling.

[peregrine]

(on reading the below, it's kind of disorganized, for which I apologize - not enough brain to reformat it, but hopefully it's helpful regardless)

These days I have less daily sympathetic activity (thank you, clonidine!) - I no longer get an adrenaline rush from things that shouldn't cause anxiety in the first place, like a bird flying nearby or someone walking past you on the sidewalk. I still have issues with things that are really hard on the body - pulmonary function testing (just resting, not exercise) flattened me for the day. So those things are clearly not anxiety, right? I got a very clear surge when I hit my head hard in lab on Wednesday - no anxiety that time (I knew I would be fine, was just bleeding a lot), but the starting/ending BP measurements at the ER (140/90 vs 112/69 over 75 minutes) were pretty impressive, as was the tremor and sweating and the usual sympathetic response. So that's clearly not anxiety, that's just POTS.

I have had anxiety (and corresponding POTS issues; when I have fight or flight issues these days they are absurdly strong, I just have them for more reasonable reasons than before) over reasonable stuff, like people trying to break into my lab late at night. I think pretty much anyone would have anxiety in that situation! If both anxiety and POTS are leading to a "fight or flight" response then they'll happily feed off of each other, which is why that particular issue was more of a problem for me than a standard panic attack, which would have made me a mess for about an hour, not for six hours.

The problem comes when there are things that are borderline - so, for example, last week my advisor told me in the middle of lab meeting that we had to have this paper in by Friday. Two days from the meeting. At that point I begin to have an adrenaline rush with the usual effects. The question is - why? How much of it is the sudden "oh crud gotta get this done let's load up the adrenaline to get it done" response and how much is the "oh crud there's no way I can get it done and now I'm scared of my advisor confronting me in front of five other people" response? Having had anxiety and intermittent panic attacks before the POTS began, this does feel different - part of me is going "it's my fault for not getting it done" and the other part is going "no, it's not your fault, your body is responding this way, it's not you freaking out." A good test for me is trying my cognitive-behavioral anxiety techniques - if I can't get myself to go "it would be okay to not feel this way, I am reacting to a thing that is not as bad as I think it is" and think it's true, it's probably the POTS and not anxiety, or there's less anxiety.

Like lemons says above, breaking the cycle can help - I'm certain that if I weren't already on edge about meeting with my advisor and having lung function testing later, I probably wouldn't have reacted that strongly, though I still would have reacted. So working on anxiety will probably help POTS - trying to figure out triggers (I have spoken with my advisor about not confronting me with no warning in front of others, since the resulting episode really decreases my productivity for the rest of the day) and learning to recognize when it's "just" POTS (i.e. there's nothing else anxiety-causing around) and when it's a combination of the two, where working on decreasing the anxiety might help reduce the POTS symptoms.

And keep in mind too that if you already have experience with anxiety, your brain will go "oh gosh this feels like an anxiety/panic attack" and will react accordingly even if it's just POTS - it still feels the same physically in many ways, and the near syncope experience often includes a feeling of impending doom even in people with no history of anxiety. You might benefit from sitting down and noting (perhaps in writing on a daily journal) when you have episodes and see if there are triggers that would have made you anxious in the past - perhaps note if there are different symptoms if you are anxious or not?