Cooking up calm: POTS and panic attacks management. So what does POTS stand for?
It means postural orthostatic tachycardia syndrome. I’ve always delt with panic attacks and not POTS.
To tell you the truth, I’ve never heard of POTS until now. Learn something new everyday.
Consequently, POTS is a heterogeneous and often debilitating condition affecting the autonomic nervous system, estimated to affect between 0.3% and 1% of the U.S. population.
Its incidence is believed to be rising among people with a prior COVID-19 infection, as a likely component of so-called long COVID.
What is POTS?
Cooking up calm: POTS and panic attacks management is possible. Altogether, POTS is a common autonomic nervous system disorder characterized by an excessively fast heart rate and symptoms of lightheadedness upon standing.
The current diagnostic criteria for POTS is a heart rate increase of 30 beats per minute (bpm) or more, or over 120 bpm, within the first 10 minutes of standing.
What is the Poor Man’s POTS Test?
Many physicians do what is known as a “poor man’s POTS test.”
This test involves having the patient lie down and take their heart rate.
Then they wait two minutes and stand the patient up and take heart rates over a ten minute period of time to see if the criteria are met, that is a heart rate increase over 30 beats per minute.
Different Forms of POTS?
Neuropathic
- Firstly, decreased sympathetic innervation
- Pooling of blood
- Discoloration of extremities when standing or when warm
- Lastly, loss of sweat to extremities
Hyperadrenergic
- Firstly, increased levels of our stress hormone Norepinephrine
- Rises in systolic blood pressure when standing up
- Extreme Tachycardia / Heart Palpitations
- Nausea / Vomiting
- Lastly, Migraines / Headaches
Hypovolemic
- Low blood volume in plasma and red blood cells
- Decreased exercise tolerance
- Weakness
What is a Panic Attack?
Cooking up calm: POTS and panic attacks management is necessary medically.
Accordingly, a panic attack is a sudden, intense episode of fear that can trigger physical reactions, even when there’s no appatent danger.
Panic attacks can be very frightening and distressing, and can make you feel like you’re losing control, having a heart attack, or even dying.
Moreover, panic attacks can last between 5 to 20 minutes, with symptoms usually peaking within 10 minutes. As the attack fades, the symptoms slowly go away and are usually completely gone within 30 minutes.
Panic attacks can happen frequently and unexpectedly, and can occur at any time, from several times a day to a few times a year.
As a result, people with panic disorder may worry greatly about when and where the next attack may happen. Also, this can even keep them from leaving their home.
If you feel like you’re having a panic attack, you should see your doctor right away, as they aren’t dangerous but can get worse without treatment.
Cause of POTS and Panic Attacks
Cause of POTS
Cooking up calm: POTS and panic attacks management can be done. As a matter of fact, the exact cause of postural tachycardia syndrome (POTS) is unknown, but it can be caused by a number of factors, including:
- Autonomic nervous system problems. POTS is caused by an issue with the autonomic nervous system, which controls breathing and heart rate.
- Underlying health conditions. POTS can be associated with a number of diseases and conditions, including autoimmune diseases, diabetes, and Ehlers-Danlos syndrome.
- Genetic factors. POTS can run in families, but no single gene has been identified as the cause of most cases. However, there is a strong link between POTS and joint hypermobility disorders, such as Ehlers-Danlos syndrome.
- Other health events. POTS can develop after surgery, pregnancy, a head injury, or a viral illness.
Cause of Panic Attacks
Comparatively, panic attacks can have many causes, including physical, psychological, and environmental factors:
- Physical factors. Acute stress, such as a traumatic event, can cause the body to release large amounts of stress chemicals. Other physical factors include hyperventilation, intense exercise, illness, and sudden environmental changes.
- Psychological factors. Panic attacks can be Linking genetics, temperament, and brain function are possible factors. Therefore, people with low self-esteem or a history of mental health conditions like anxiety, depression, or PTSD may be more likely to experience panic attacks.
- Environmental factors. Panic attacks can be triggered by exposure to phobic objects or situations.
What are the Symptoms of Severe POTS and Panic Attacks?
Symptoms of Severe POTS
Cooking up calm: POTS and panic attacks management can be done. Postural orthostatic tachycardia syndrome (POTS) symptoms can vary from person to person and range from mild to severe.
At any rate, many symptoms occur when standing up or changing to a standing position, but some can happen without standing.
Symptoms that can be severe include:
- Lightheadedness: Can lead to fainting, especially after prolonged sitting or standing
- Heart palpitations: Chiefly, a feeling of the heart pounding or skipping a beat
- Intolerance of exercise: Symptoms can worsen after increased activity
Other symptoms of POTS include:
- Firstly, Brain fog
- Nausea and vomiting
- Headaches
- Fourthly, Excessive sweating
- Shakiness
- Chest pain
- Additionally, Shortness of breath
- Problems with digestion
- Problems with sight
- Lastly, Cold or painful extremities
Symptoms of Panic Attacks
Symptoms of a panic attack can include:
- Firstly, A racing heartbeat
- Shortness of breath
- Dizziness
- Fourthly, Trembling and muscle tension
- Feeling faint, dizzy, or light-headed
- Feeling very hot or very cold
- In Addition, Sweating, trembling, or shaking
- Nausea
- Pain in your chest or abdomen
- Feeling like your legs are shaky or are turning to jelly
- Lastly, Feeling disconnected from your mind, body, or surroundings
Can POTS Trigger Panic Attacks?
Cooking up calm: POTS and panic attacks management takes some work on your part.
At length, postural orthostatic tachycardia syndrome can cause some symptoms that are similar to panic attacks, such as a racing heart, sweating, chest pain, and brain fog.
However, POTS is not caused by anxiety, and patients with POTS are often misdiagnosed with anxiety or panic disorder.
POTS can cause blood flow changes that can lead to “panic attacks” that are more related to those changes than to actual psychological panic.
POTS patients may also be sensitive to norepinephrine, a chemical released into the bloodstream during anxiety and stress, which can cause anxiety-like symptoms.
Additionally, the parasympathetic nervous system, which helps calm people down, may not be functioning normally in people with POTS.
Telling the Difference Between POTS and Anxiety
Distinguishing between POTS and anxiety can be difficult, as some of the “hyper-adrenergic” symptoms of POTS — including tachycardia, palpitations, sweating and lightheadedness — can appear very similar to symptoms experienced by people with an anxiety disorder.
However, studies have demonstrated that the orthostatic tachycardia seen in POTS is not merely the somatization of anxiety.
“It’s possible that many of these patients have a high sympathetic response that may be labeled as anxiety when it’s really POTS,” senior investigator Robert Wilson, DO, a neurologist in Cleveland Clinic’s Neuromuscular Center.
What Happens During a POTS Episode?
Cooking up calm: POTS and panic attacks management is definitely possible. POTS is a chronic condition that causes an abnormal heart rate response due to standing up.
During a POTS episode, blood vessels don’t tighten properly in response to signals, causing blood to pool in the lower body.
Therefore, this can lead to a rapid increase in heart rate, or tachycardia, within 10 minutes of standing up.
The heart rate may exceed 120 beats per minute, and the nervous system releases epinephrine and norepinephrine to try to tighten blood vessels
Treatments For POTS and Panic Attacks?
Treatments for POTS
There’s no cure for postural orthostatic tachycardia syndrome (POTS), but there are treatments to help manage symptoms.
Hence, treatments can include lifestyle changes, medications, and other strategies.
- Lifestyle changes, these can include:
- Hydration: Drinking 2–2.5 liters of fluids a day, and eating salty foods like nuts, olives, and pickles
- Sodium: Particlularly, increasing sodium intake with salt tablets or the saltshaker, as sodium helps keep water in the bloodstream
- Avoiding stimulants: Alcohol and caffeine can divert blood from the center of circulation, so some people may need to avoid them
- Compression garments: Additionally, compression stockings that go up to the thighs or waist can help push blood from the legs to the heart
- Exercise: Gradual exercise can improve overall health
- Stress management: Trying to manage stress can be helpful
- Eating and drinking at regular times: In addition, eating and drinking at consistent times can be helpful
- Heat: Using a portable cooling device like a fan or air cooler on hot days can be helpful
- Standing: Lastly, using a stool while cooking or sitting down in the shower can help with prolonged standing
- Medications
- Firstly, Beta blockers
- Steroids
- Selective serotonin reuptake inhibitors (SSRIs)
- Antihistamines like cetirizine (Zyrtec), famotidine (Pepcid AC), and diphenhydramine (Benedryl)
- Lastly, Antidepressants like paroxetine (Paxil) or sertraline (Zoloft)
Treatment For Panic Attacks
Cooking up calm: POTS and panic attacks management with therapy is possible.
Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life.
Therefore, the main treatment options are psychotherapy and medications.
Psychotherapy
A form of psychotherapy called cognitive behavioral therapy (CBT) can help you learn, through your own experience, that panic symptoms are not dangerous.
Even more, your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner.
Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve.
Also, successful treatment can also help you overcome fears of situations that you’ve avoided because of panic attacks.
Medications
Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:
- Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs). Overall, these medications are another class of antidepressants. The SNRI venlafaxine (Effexor XR) is FDA approved for the treatment of panic disorder.
- Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence.
Or you could try 3-3-3 rule:
1. Look aroundName three things you can see, and take a moment to observe their details, colors, and shapes. You can try looking for things you’ve never noticed before, like different shades of blue or patterns.
2. Listen closelyName three sounds you can hear. Depending on your location, you might listen for things like a clock ticking, keys clacking, or someone sniffling. If you’re outdoors, you might hear leaves rustling, cars passing by, or dogs barking.
3. Move your bodyMove three parts of your body, like your ankle, fingers, or arm. You can also try identifying tangible items within your reach, like parts of your body.
Sum It All Up
Cooking up calm: POTS and panic attacks management is possible with treatments. Nonetheless, my experience is with panic attacks , but not POTS.
It sounds like POTS is a serious syndrome, not that panic attacks are any less.
Notwithstanding, having a panic attack is scary enough. When the panic rises up, you feel like you’re going to pass out. Everything seems so unreal.
But there are ways to bring you out of that. Focus on your 5 senses: touch , sound, taste, smell, and sight.
Sometimes, POTS gets diagnosed as an anxiety disorder. Hopefully, you’ll never have to experience either one. Until next time…
Articles About POTS and Panic Attacks
-IS IT POTS OR ANXIETY?
https://hopebraincenter.com/is-it-pots-or-anxiety
-19 Signs You Have POTS, Not ‘Just’ Anxiety
-Panic attack
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/panic-attack
-13 Ways to Stop a Panic Attack
Have a Good One,
Cindee Murphy, One Voice In The Vastness Of Emotions
“You are bigger than what is making you anxious.” – Unknown
“She was brave and strong and broken all at once.” – Anna Funder
“Feeling the need to be busy all the time is a trauma based response and fear-based distraction you’d be forced to acknowledge and feel if you slowed down.” – Tutu Mora
“I wondered how many people there were in the world who suffered, and continued to suffer, because they could not break out from their own web of shyness and reserve, and in their blindness and folly built up a great distorted wall in front of them that hid the truth.”— Daphne du Maurier
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