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Social phobia


calypso
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I am wondering if there is some sort of autonomic response that would predispose those of us with POTS to having signs of social phobia -- not in the emotional sense, but more in the physical sense. It seems that lately, when I have to talk in front of a large group or even in front of a small group of people at work, I have been turning red in the face for no apparent reason, feeling nauseous, becoming dizzy. I can't figure this out, because I have always been very social and don't seem to have this kind of problem. Plus, I am taking an antidepressant that is supposed to help anxiety and phobia, and I take clonazepam (which has sedative/tranquilizer effects).

Does anyone else here notice any problems in this department either pre-POTS or post-POTS? I am starting to become embarrassed about looking embarrassed!

Amy

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I think your symptoms are not unusual for POTS. Standing or sitting can cause symptoms, regardless of your fear or lack of fear for people or groups.

The only way around it is not to stand for long.

I've also noticed that if you are in a situation where you are more likely to be tense, the symptoms may surface sooner. So, at home, in your own environment, you may be able to last longer than out, in a social setting where your nervous system is more stimulated.

I'm sorry you are noticing these things. It can be disconcerting to find different aspects of your life impacted by your physical ailment.

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Are you sure it's not just from having to stand? As I've gotten older, it's gotten harder for me to do so even for short periods without moving about to keep my bp up. My coworkers have told me that they can actually see my cycles of highs and lows by the color of my skin--reddish vs. pale and white--with no real "medium" color. I often don't even notice that I'm vasodialated and in tachy b/c it happens so often, and I've had it all my life.

Nina

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yeah I thinking it is the standing too.. I get really red in the face when i stand or sit up. and have to stay that way.. then once the Bp and stuff start to drop.. I turn white.. and my lips get kinda purple looking.. a pasty purple loking.. and in the normal I look an unhealthy color of pasty/pale.. and an unhealthy looking pink.. my boyfriend says that he can tell how I feel by loking at my face.."he said it san unhealthy sickly loking color of pinky and pale..

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I also think since our autonomic systems are in charge of the "fught or flight" response that it could very well bring on a panic attack.... Thats just my personal opinion but Iwouldnt count it out.

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Hi, I think it is the added anxiety. I know when I am in a room full of people I get nervous thinking that something might happen (the near syncope, etc.). Also, if I get a symptom suddenly while I am standing among a group of people, I def. feel alot worse. SO basically I am trying to say maybe it's caused by the anticipation of a symptom...does that make any sense?? It does to me, LOL, but that's a hard one for me to explain! :)

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Amy

That is interesting and I agree with the others that the standing could be playing a large role. However, I have always had a problem with this--and I do pretty frequent public speaking in my job--presentations, etc.. It has always bothered me, too. People have always told me that I have an incredibly mellow personality, and YET, I often have this very anxious response to things like public speaking (that I generally manage to hide to a great degree), and conflict situations with other people. I do believe that my adrenaline response is on a hair-trigger and there is a connection to POTS as much as to any element of my personality.

I wish I knew what the answer was. Generally for me it has never been so bad that it becomes disabling, so I have never seriously tried to address it with medications or anything.

Take care,

Katherine

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Pre-pots I was fine speaking in front of big groups, now I avoid it if at all possible...and I work in public reations of all things!! :) Since having POTS, I have anxiety that I've never experienced; I get tachycardia, sweaty and nauseated.

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I personally don't have a problem with this, but i have heard of many POTS people that have. Like the others said, part of it is standing up. In my opinion, I think part of it is also based on catecholomine levels. Lots of people with POTS, including myself, have abnormally high levels of of catecholomines when standing. Norepinephrine is one type of catecholomine that is more commonly known as adrenaline, which is responsible for the "fight or flight" feeling that I think someone already mentioned. I think that if we produce too much norepi in normal situations, then even slight stresses that wouldn't normally bother people could trigger an even greater release of catecholomines, causing a feeling of anxiety. Thats really just my personal theory of why anxiety type symptoms can come with POTS.

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Thanks for all of the responses! This red-in-the-face thing occurs when I am sitting and talking to groups as well, so I don't believe it's the standing (although I do get a fair amount of symptoms from that, too). But I think some of you are right in that maybe I am anticipating symptoms and just am not realizing it. I guess this has always happened to me even before POTS but much more mildly. I just hate feeling uneasy, especially when there's absolutely nothing to fear from talking to a bunch of people who are no more or less important than I am. It is so irrational, yet my brain still makes it happen. Very strange. I guess I'll have to start going to Toastmasters or something!

Amy

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Hi, I have adrenergic POTS and I find that I'm not only avoiding social situations, I avoid even the telephone! I used to be a total people person, but now I get symptomatic just THINKING about interacting with people. It just sets me off.

My mother-in-law was visiting and she is very high energy (the way I USED to be!). I was gasping for air within 5 minutes and my heart was racing. It's like my body is trying to keep up with her, but over-shoots.

I totally understand what you mean about reacting in front of other people!

Diana

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