Panic Disorder?

[Mrs. Burschman]

Do any of you know if panic disorder could affect a tilt table test? Or cause orthostatic tachycardia?

I know Doctorguest has said anxiety won't cause it, but does that include panic disorder?

BTW, I didn't feel anxious when I had a positive TTT. I felt bored. Then sick.

Sorry to keep bringing up the psychological aspects. I'm having trouble dropping my belief that I'm just nuts.

Amy

[flop]

Hi,

as far as I know even a full blown panick attack whilst on the tilt table wouldn't put your heart rate up that much, and I think that the technician would have noticed you hyperventilating long before much showed on the recordings.

On my repeat tilt test I tried holding my breath and breathing heavily (not at the same time) to see if I could slow my pulse down at all (I was really bored) - didn't have any effect on my heart rate.

I very much doubt that anyone could fake a postive POTS response on a tilt test no matter how hard they tried, and I'm certain that you couldn'd accidentally "fake" it by panicking.

BTW panic disorder is part of "anxiety" in general.

Flop

[flop]

It really does sound like you have genuine POTS - have you read the information on the main part of the DINET website? I think you'll find quite a lot o stuff there that you can relate too and realise that the reason that we so often get misdiagnosed as mad or anxious is because on the surface the symptoms seem similar but there is a clear physiological abnormality in us to account for the symptoms.

Take care,

Flop

[Mrs. Burschman]

Thanks for your input, Flop.

I'm sorry to be a pain in the bum, as you folks would say.

I never heard of panic attacks causing blackouts walking up stairs, either.

Amy

[persephone]

Hyperventilation can raise heart rate- but part of autonomic testing that I had was to make you hyperventilate so they could see how high your heart rate went, and then compare it with the tilt table results...

Breathing patterns can affect the tilt test

[dezyrae2]

I totally understand how you feel maybe too well. I suffer from anxiety also. I am often confused also with if it is just anxiety or POTS. It is very frustrating because no doctors seem able to give sure answers on anything. It is very depressing. I hope you feel better and feel free to email me to talk anytime and I have instant messaging on aim and on msn if you ever want to chat. good luck

[cardiactec]

my input, i have seen patients with full blown anxiety/panic attacks with HR's that are super high -- have seen as high as 180 and that was their primary diagnoses after all testing to rule out other causes of anxiety/tachycardia/etc were evaluated.

I think with a tilt, anxiety can interfere with results to cause false positives. .......but generally, i would think that initially for upright tilt, your HR would go high (for being anxious in regard to the techs/docs moving the table/looking more in depth into things, etc) and then after a couple minutes the HR would go down after you "got used to" the tilt/you being in upright position. I have seen patients get very nerved up for tilt's and have a blunted HR response during the first part of tilt (first two or three minutes) and then they calm down and their rates drop to normal, all while still in upright position.....if the test had not been carried out long enough, these patients could have easily been misdiagnosed with pots/autonomic dysfunction, but waiting a little bit, 20 mins, to see if they calm or HR drops, is a good tool -- because generally someone who is "just nervous" will calm down after several minutes, and so will their HR response to their nervousness............... i was told HR must remain above a 30 point increase (sustained) from the time of supine to upright tilt to make a diagnoses of pots......

i think i've read in blair grubbs literature that the way they distinguish pots from anxiety/panic, is not only through tilt table testing, but also through other types of diagnostics (bloodwork/catechol levels/etc)............he also said in literature that people with anxiety are easy generally to point out than those with pots, because people with pots generally feel crumby while upright and then feel better after they go supine (less anxiety, shaky, nausea,etc) but people with anxiety dont feel any reduction in symptoms they might be feeling whether upright or supine.

[doctorguest]

There is a distinct tilt table test pattern consistent with POTS or NCS that a competent physician specializing in autonomic disorders should be able to recognize. A superimposed anxiety or a panic attack should not affect the POTS diagnosis if interpreted by a knowledgeable specialist.

[pastordari]

OK, Amy, you are not crazy!!!

I actually have difficulty distinguishing my depression/anxiety from POTS at times. The POTS is new to me and the other is just what I've been living with for years. It neer occurred to me there was a physical basis for my symptoms. Especially when some of my doctors were happy to send me on my way with an anxiety or hypochondriac diagnosis.

When I last saw my psychiatrist she took a bit of time to explain how to know the difference especially with the fatigue aspect. Thankfully, she does recognize MVP and POTS as real illnesses so that is very helpful!

I understand what a paradigm shift this is to think that we aren't crazy after people encouraging us to think we are!

But, sorry, we're perfectly sane and physically ill. Who knew?

At times I want to take my diagnosis sheet and share it with all those who thought I was "crazy" and wave it in their faces while singing "na-na-ne-boo-boo"!!!

Hang in there, Amy.

You'll get used to being sane!!!

Dari

[Sophia3]

Hmm...not sure how to word this response.

I ain't no doc but if one continues to focus/obsess on anxiety issues, perhaps a therapist would help?

While a message board is FANTASTIC for general support, the fact you keep bringing up the panic issue makes it impossible to know exactly what is going through your head or why you keep focusing on this issue.

Maybe a qualified counselor could help figure out if you have OCD on top of POTS. One CAN have gravity issues (ANS problems) AND psychological issues. But it is difficult to dx from a message board how you feel. Nor should we be trying to figure such a problem out.

I hope you will not be offended by my post but realize I am just trying to lead you to somebody who can help you COPE better.

Many adrenalin surges may be interpreted as panic attacks but after years of having POTS, that would mean just standing up would trigger 'panic attacks' or just bending over to clean something would trigger 'panic attacks' as the catecholamines scream through my system.

just my two pennies.

[cardiactec]

I second sophia. in other words, i think sometimes the best person to help sort out what could potentially be the underlying problem is the "doctor" right inside of you -- the patient, i believe always knows their body better than doctors do, so perhaps if you THINK it is anxiety as the underlying problem than perhaps that is what it is .......sometimes though it is difficult to sort these kinds of things out though because there are so many conditions that mimic OTHER conditions .....and anxiety sensations can be a symptom OF POTS, so, hard to sort out.....

...........I think there's a huge difference between "mental" or "thought" triggered anxiety and "body" triggered anxiety......with pots, i think the autonomic dysregulation brings on "body type sensations" of anxiety, but there isnt an associated thought process or mental component that triggers or starts such an event/symptoms..........with anxiety, generally there is something that provokes a thought process to trigger the anxious feelings -- ie: being scared of spiders, seeing a spider, psychologically processing that spider, thinking of your fears related to that spider, and thus causing you to go into panic mode. i think it is different with pots in that you dont think "oh im standing up, that is scary, getting anxious about it,etc. generally standing up isnt a "scary thought" to trigger thought provoking anxiety, atleast not for me ....i can see though how with some people, especially those that pass out, could get scared of standing up or prolonged standing, because of the sensations involved with passing out or feeling like your going to pass out .....once again, not necesarily easy stuff sometimes to sort out....

once again, i think the best person sometimes to try and sort out what the real issue is, and there COULD be many (POTS AND anxiety/panic disorder/etc) is YOU yourself. do you feel like you're constantly obsessing over this? do you feel yourself worrying about it alot ? does it make you anxious? are there many thought provoking anxiety related triggers in your life? are you consciously thinking about things that cause you a great deal of anxiety?

once again, i second sophia and hope i'm not coming across as being rude or insensitive. i just want you to start feeling better.

take care.

angela.

[Mrs. Burschman]

I think I have both. I hope that doesn't mean I'm not welcome here.

Amy

[cardiactec]

Hey Amy,

Of course your welcome here! I think there are probably some on this forum that also have both POTS/autonomic dysfunction and anxiety and/or panic disorder. ..I think the more you start to realize WHAT YOU THINK, or KNOW, could potentially be going on with you and aim to address such problems, the better you'll start feeling overall.

whether pots, anxiety, or both, this life is tough huh! ...but glad we have each other through it all!

take care.

cardiactec.

[Sophia3]

of course YOU are WELCOME here..the determining factor is if the ANXIETY is superseding the POTS symptoms, or you can't tell where one ends and the other begins, you OWE it to yourself to get therapy. And to learn coping tools to help YOURSELF feel less anxious.

Nothing to be ashamed of...I have been in moments of crisis and used a great therapist.

It's just that a message board is NOT a substitute for Face to Face, eye to eye contact..>AND a voice to re-assure you of what you are feeling.

I hope that makes sense. GOOD LUCK.

[flop]

I think that Cardiactec and Angela are both trying to help you to help yourself (after all supporting and helping each other is what the forum is all about). From your posts it is clear that anxiety and panic are topics that you frequently think about, which may reflect a genuine amount of anxiety alongside your POTS. Living with POTS is difficult, living with anxiety is difficult, living with both must be super difficult!

Have you tried counselling or therapy? You may find that some sessions face-to-face with an experienced professional may make a difference in the symptoms that you face. Controlling the anxiety may well make it much easier to cope with the POTS. However none of us should be trying to diagnose you over the internet, that needs someone to be able to sit and talk to you properly whilst observing your non-verbal communication at the same time.

I hope that the suggestions are helpful and not hurtful as I'm sure that none of us intended to make you feel uncomfortable. We all have POTS/ other dysautonomia but we need to realise that no two dysautonomia patients are the same and we all handle / cope with things differently and that there is no shame in seeking help to alter your coping stratergy.

Best wishes,

Flop

[Mrs. Burschman]

I've seen three therapists. I've been going to therapy for three years. And I'm still struggling with anxiety. Which is why it seems like there might be something physical (dysautonomia) driving it.

amy

[pat57]

I don't think I get TACHY so I don't know.

But I will say it was clear to me that Sophie , cardiactech and flop were trying to help you tease out the truth and there was nothing negative implied.

I am in the same boat as you with my fatique, Dr. says depression- therapist says physical. I would like to know which it is. Or maybe its both. Who knows??

[Mrs. Burschman]

I just wanted to thank everyone for trying to help and to apologize for my focus on anxiety or seeming short. I do appreciate your taking time to read my posts and responding.

I'm trying to figure out ways to reduce my anxiety without relying on posting threads so much. If you have any spiffy ideas, please send me a message!

Thanks again, and neurotically yours,

Amy