difference between POTs and anxiety?

[september1990]

can someone please describe to me the key differences between POTs and anxiety? i’m getting mixed diagnoses from my cardiologist, electrophysiologist, and neurologist. 2 out of the 3 are telling me its just anxiety and 1 of them are telling me its POTs. i’m so frustrated and confused. any advice would be appreciated. thank you.

[jeanjeannie50]

Have a look at this by Sanjay Gupta a cardiologist at York hospital in the UK:

drsanjayguptacardiologist.c...

Jean

[Bnicole28]

I am diagnosed with autonomic dysfunction, and more specifically, POTS. It was confirmed with a TTT. Not all doctors know about POTS and male doctors specifically liked telling me it was just anxiety. I saw an electrophysiologist who knew about POTS and received a diagnosis after 24 hour observation in the hospital. I cannot roll over without my HR spiking up to 100+ bpm. Nurses would rush in concerned and I was sitting there, half a sleep, like what is going on?

Any time I move/stand my HR spikes and I think my BP drops. My resting HR is in the 60s, but drops down to the 50s and when I move/stand it'll go up to the 140s and walking will put me in the 170s and above. Not just sometimes. Everytime. It freaks out the HR staff, but once I sit down and it goes down, they blame anxiety, because they're not familiar with autonomic dysfunction and see your symptoms change quickly.

See someone who knows what autonomic dysfunction is and can perform a TTT to confirm the diagnosis. Advocate for yourself. You know your body best!

[Blearyeyed in reply to Bnicole28]

Sorry you have POTS , and all its awful symptoms , but it is also nice to know I'm not alone in these symptoms .I've had the nurses rush for the ECG staff in hospital before because of my bleeping monitor convinced I was about to have a heart attack before I had my diagnosis.

I got a fitness watch recently and I noticed that , because all of these watches calculations are based on your pulse rate ( inc. blood pressure) it keeps saying my BP is really high when it isn't.

It also marks me as awake two hours before I am , because my heart rate has obviously started rising to wake me up.

[Blearyeyed]

Bicole 28 is completely right when they say most doctors , including Senior Consultants and even Cardiologists misunderstand what POTS is.And , more often than not , you can for years being diagnosed as having Anxiety , or being over anxious before anyone mentions POTS.

I am diagnosed with Dysautonomia ( autonomic dysfunction) my third Cardiologist found that I have a rare type of Tachycardia called Sinus Node Reentrant Tachycardia which has similar symptoms to POTS , but I also have POTs too and he still question marked it.

I'm on medications now so I couldn't prove it in the best test which is a Tilt Table Test ( TTT).

Even in the clinics , when they attempted the DIY tilt table test they often got the timings wrong , or my test results showed POTS but the doctors kept concentrating on my blood pressure results instead of my heart rate , and then got things wrong , as they were looking for Orthostatic Hypotension by mistake.

Simple terms , Anxiety disorders stem from psychological or brain activity and cause physical symptoms like palpitations , dizziness and nausea basically the feelings of Fear. Anxiety is a reaction to Stress.

Stress isn't just a negative thing , it's any activity , fun and good or bad and sad , that your brain or body can't cope with in their current state of Health.

Anxiety feelings or an anxiety attack can go on for a long time but the level of the symptoms stays pretty much the same after an initial spike until it wears off. Anxiety is basically your brain reacting too often with the ' Fight or Flight' response. If you are anxious all the time , you feel constantly nervous , jittery , sick and you can get headaches.

POTS on the other hand is a physical nervous system reaction because the autonomic system is dysfunctional in the messages between the brain and the body . The autonomic nervous system is in charge of your ' Fight or Flight' and ' Rest and Digest' activities so if it goes out of control your body doesn't respond properly to do basic tasks . Many people with chronic illnesses or people after a nasty infection have Dysautonomia for some time , Long COVID is likely to be a form of temporary Dysautonomia.

POTS is an over reaction to movement ( orthostatic change) it's often accompanied by other autonomic dysfunction that isn't actually caused by the POTS but doctors just link them together . These include lack of temperature control , problems with digestion , balance problems , insomnia and fatigue .

Your heart rate often doesn't drop to low levels even at rest which is why it stops you sleeping and makes your brain swim.

POTS also causes the dizziness , vertigo , nausea but also fainting or near fainting but usually on changing positions and the symptoms can spike and drop rapidly.

I have never understood why they have so much difficulty deciding upon POTS as the results of your heart and blood pressure changes to prove it a so simple.

I think it has more to do with them not be willing to ask for help or look it up when they need to in the consulting room.

You have POTS if your heart rate raises by 30 BPM within 1 minute of standing up ( your BP sometimes drops by 20 as well ) and your heart drops by 30bpm in a minute when you sit or lie down from a standing position.

You can be classed as having POTs if your heart rate does not make 30bpm swings but you are nearly always tachycardic ( have a 100bpm heart rate or more ) all the time you are standing , then the swings can take longer.

The DIY Tilt just takes a longer appointment as you lie down for 10 mins , have your heart / BP measured . Then you stand up and they test you at 1/2/5 / 10 mins . Then you lie down again and they test at 1 and 2 minutes. You can do it at home if you have a blood pressure cuff.

If you ask for a Holter Test done over 48 hours from your surgery , you can choose a specific time a couple of times a day to do the DIY tilt movements and mark down that time on the diary sheet they give you as ' DIY tilt test for Pots and the time you started and finished.

It will show if you have POTS , as long as the person reading the results know what they are looking for.

If you are sure you are not suffering from Anxiety and feel that your symptoms are more physical keep trying to get answers.

Ask for the Doctors that state that you have not go POTS to explain why based on their tests results , not just an opinion. You can get a download of POTS symptoms from the POTS charity website and ask them to confirm that that didn't happen , try to be as calm and polite as you can.

If you're still not sure , ask for a second opinion and to be referred to a Cardiologist with POTS as a specialism , even if they have to refer you to one outside your usual area and ask for a Tilt Table Test as most doctors won't believe you have it without one.

As I used to say , and sometimes still have to despite my various diagnoses , " I am not ill because I am Anxious , I am anxious because I am ill and not being treated yet."

Anxiety is just as important , and can have as serious an effect on your Life as any other illness , but if you are sure that isn't what you are experiencing it can be extremely frustrating when doctors with no experience of nerve related conditions always fall back on that as a diagnosis.

There is nothing that makes you feel more unwell than trying to get better when it is hard to find the right doctors to diagnose you.