Which is it, POTS or Anxiety?

Very good video. I also add to the doctors: “ if you are saying I have anxiety, then why don’t I have anxiety when I am lying down.” For me is a big and frustrating misdiagnosed when they say you have anxiety but you still get no help and you can’t sit or stand. Treat the body as a whole connected system but don’t let doctors say this is anxiety when clearly is a physical disorder that many don’t even heard about. Keep fighting for your healing. Thanks Nathan 🙏

For those watching this, research vitamin b1 thiamine deficiency.

I was told it was anxiety in the ER. Funny thing...apparently I ONLY get "anxiety" when I stand up. It took a few years but was finally diagnosed with POTS, gastroparesis, ect. If you have anxiety...your heart rate would be high even when seated. Tachycardia that presents ONLY when you stand up is KEY to POTS.

I am 49 and have always been told my symptoms are from anxiety. I do have anxiety along with PTSD, ADHD, severe MDD. So I feel this always gave Dr.s an easy out every time I went to the ER for collapsing (usually 2-6 times per day during bad spells). I was always told it is my anxiety and I have vertigo. I just recently learned about POTS because for fear of a brain tumor or something else in that ball park, I have had MRIs EEGs and CT scans with nothing to show I started doing my own research. I relate to so many symptoms of POTS. I am dizzy all the time, My resting BPM is about average I think 80-90 but when I stand up it starts rapidly climbing to anywhere from 130 to 170 BPM and every once in a while, it will only rise to around 120 bpm. When I sit back down or lay down it starts going back down pretty fast. If I take a hot bath when I get out it shoots to 160-180 bpm and my heart feels like it is trying to beat its way out of my chest. I rarely think clear anymore. I can be asked the easiest of questions and just cannot figure out what I am being asked. It is so frustrating! I finally called my Dr. to schedule a POTS test and before we hung up I was asked "So to be clear, you are wanting a marijuana test?" LORD I hope it goes well when I go for the test in 13 days and they better not just hand me a cup and point to the restroom!.....

This is hands down the best explanation of differentiating between anxiety and POTS that I have seen. I’ve been telling my doctors for years that yes I do have anxiety but I have physiological symptoms that come on first and then the anxiety ramps up. In the past 6 months I went from being able to workout and push myself in the gym “except for cardio cause that has always fed my anxiety for high heart rate” to not being able to work out at all. They put me on klonopin 1mg a day with no resolve and then switched me to 10mg of Valium a day with no resolve. Tried taking beta blocker and it kept my heart rate from climbing but made my whole body feel tense like all the adrenaline was trying to go everywhere else. The only medication that has helped a little has been clonidine but that’s simply because it would sedate the hell out of me. Now they want to put me on diltiazem 120mg a day because I’m having resting heart rate of 52 average but then I stand and it stays at 85-100. My cardiologist and electrophysiologist have yet to do a tilt table test on me or other tests. They have just done EKG, Echo, and halter monitor and structurally the heart is fine. They did see some SVT in the halter monitor though. I was just in the ER the other day because my resting heart rate was 100 and then I stood up and it shot it to 160. It took an hour and a half of it going down to 90 or so sitting down and climbing back up rapidly before it finally stopped but stayed at a resting rate of 90 for a while. I decided to go to the ER anyways. Of course they said everything looked fine. I have a neurology appointing at UAB on Monday and I pray that they are able to help me with this. I’ve not been able to workout or do the things I love like boating and jet skiing without the fear of having some sort of issue.

Excellent. This is exactly how I feel. First symptoms then anxiety and they want to lanky me with anxiety as a source. I’m going crazy as I’m not receiving the care I should be receiving

This is by far one of the videos i have watched. I have been battling with a mirage of related POTS symptoms for 9 years. Sure wish i live close for a possible consult with you. I worked as Physical therapist assistant for 21 years and just recently took a leave of absence from my. As a therapist we statically stand alot, to assist patients or just communicate with them while doing exercises. All of my physiological symptoms manifest in standing. I am hopeful for a diagnosis soon and possibly treatment. Unfortunately tilt table tests through John Hopkins is not till the end of November. Please keep advocating for patients like me.

This resonates so much with me. It’s that constant battle of what came first; the chicken or the egg? Is the POTS causing my anxiety or is my anxiety fueling my POTS symptoms? Very tiring. 2:24

The hyperadrenergic form of POTS is the worst for getting misidentified as anxiety, due to overactive and exaggerated activity of the sympathetic nervous system (fight or flight response) being at the source of it. Thankfully medications like Guanfacine and Clonidine specifically target the sympathetic nervous system to calm it and prevent the wild swings that trigger this type of POTS. Interestingly enough, Guanfacine and Clonidine are sometimes prescribed to treat anxiety as well.

I wish you were my doctor... I started taking corlanor which lowered my heart rate but I’m still highly symptomatic...thank you for putting out content on this.

This is brilliant. As usual

I really appreciate this, because everyone is gaslighting me that it's anxiety. I have had anxiety & panic attacks before, I know what they feel like; heart palpatations when I stand & walk around slowly is not anxiety! lolsob I have a fitbit & I can see the spikes in my heartrate every time I stand up.

Very informative! I suspect I have hyperadregenic PoTs. My symptoms started 4 years ago after rounds of viruses my son brought home from daycare. Totally thought I was dying... Saw tons of doctors even herbalists and accupuncturists. Not completely recovered but let's say symptoms on and off with on being the majority. Then last Spring my mom was diagnosed with cancer while I was 1 month postpartum. A lot of emotional stress at that time for 3 plus months, then I definitely feel that the symptomatic days became more. Then I got covid, things became really bad. I am having borderline diagnostic heart rate and blood pressure increases upon standing. Numbers are not important. What's important is the symptoms are just Pots and other dysautonomia. And I also found that anxiety and emotional stress do also worsen the symptoms. For example I used a month of time to gradually decrease my daily symptomatic time. Then a week ago my mom was hospitalized again and was told the cancer relapsed. She was given months by the doctor AGAIN. I could definitely see all the symptoms worsened so noticeably. So for me I think yes it's a two way street. First I had symptoms unexplained and unmanaged by doctors after doctors. So my overall stress level is high. Then specific life events wrecked havoc on mental health status creating more stress hence more physical symptoms. For me, at this particular point of time, I personally think managing symptoms is the key. Because I can foresee that losing my mother is a thing with high possibility. Even if she survived anothet time like she did last year, it's not gonna be easy. It's gonna be rounds of emotional roller coaster rides.

I was told it was just "anxiety" for 30 yrs by MANY different doctors. With a new PPO health insurance plan, I was able to make an appointment with a neurologist without a referral. Tilt table test and examination positive for POTS.

My daughter has anxiety around being alone. She's 11 and still sleeps with me. She wants to sleep with her bestie when she sleeps over but she's terrified even to sleep in the next room with her friend or terrified for me to go outside when she's in the house alone. Otherwise, she is pretty balanced but this is starting to hold her back. I'm taking her to you in June and I hope this is 1 "symptom" we can help.

Anxiety doesn’t cause your heart rate to increase by 30 bpm or higher when you’re upright. I don’t understand how someone doctors were able to get their degree. Some of the things that come out of their mouths blows my mind. You’re so spot on! I have POTS. The only time I get anxious is when I’m about to pass out. Although, I think it’s my body reacting to what’s going on. The adrenaline seems to fix whatever was happening. After a huge adrenaline sure my body feels better. I don’t know if it’s a reaction to a drop in BP or not. When I did my autonomic testing they said my BP was fine. This condition can be so difficult to figure out. Maybe I need to come see you.

When you say anxiety, are we talking about emotional anxiety or the type of anxiety where one doesn't feel anxious at all but has physical symptoms of anxiety such as insomnia or shallow breathing but not feeling anxious for the most part. But my heart rate even when I'm very relaxed does goes up whenni stand up and stays up there.

What exercises did you give to this patient ?

The alpha-2 agonist medications Guanfacine or Clonidine are often prescribed off-label to treat hyperadrenergic POTS as well as anxiety. If you get a doctor that's stuck on the anxiety diagnosis, you can ask about one of those to treat the "anxiety" and end up possibly treating your POTS.

Thanks for this video. I can relate. Since Covid I think I have POTS though it hasn't been officially diagnosed. I'm being treated for Anxiety. I finally was able to get to see a cardiologist, I am under heart monitor for 30 days. I have Constant heart palpitations. I've counted 20 per minute when they get bad. Tachycardia up to 123bpm upon standing, average resting 85. I used to work out almost every day and can no longer do so. I can not do any heavy physical exertion without getting light headed. I can no longer mow the lawn and had to hire lawn service. My quality of life has decrease dramatically including mental health issues. Some days, like today I feel like absolute garbage. I have IBS. I get lightheaded when standing. I really wish I could find a Dr. like you in my area that is actually putting in research for this debilitating issue. All I'm getting right now is drink more fluids, intake more salt, take propranolol and "try to relax". How can I relax when I am constantly palpitating?