Dysautonomia and anxiety are connected in ways we don’t often realize. Recently, I was talking to my therapist about how my POTS was flaring and also my anxiety was high. I was talking about them as if they were separate issues. But my therapist surprised me by saying that maybe, because my heart rate was going up to 135 when I did things like walking up the stairs, I was feeling anxious because of my POTS.

Since that session, I’ve done some research, and I thought that this was probably something other people might not have thought about. So in this post, I talk about what dysautonomia and anxiety are exactly, how they are connected, and ways to deal with them.

As a reminder, I am not a medical professional. I share my experience and information I have gotten from reputable sources. These sources are always cited.

Additionally, this post contains affiliate links. Thank you for supporting Kate the (Almost) Great!

What Do These Terms Mean?

Dysautonomia is “a group of medical conditions caused by problems with the autonomic nervous system (ANS)” (x). The Cleveland Clinic says, “The ANS is the part of the nervous system that controls involuntary body functions (functions you don’t consciously control) like your heart rate, blood pressure, breathing, digestion, body and skin temperature, hormonal function, bladder function, sexual function and many other functions” (x).

This is a very large category of conditions!

It’s also relatively common; 70 million people world-wise have dysautonomia (x).

When dysautonomia is its own disorder, it’s called primary dysautonomia. If it’s as a condition within another disorder, it’s called secondary dysautonomia (x). For example, because rheumatoid arthritis causes inflammation when it shouldn’t, that’s an example of secondary dysautonomia (x).

When I talk about dysautonomia on this blog, it’s often when I’m talking about my POTS, or postural orthostatic tachycardia syndrome. POTS is a case of primary dysautonomia.

With POTS, blood pressure and heart rate are not working together as they should. “Heart rate and blood pressure work together to keep the blood flowing at a healthy pace, no matter what position the body is in,” the Cleveland Clinic says. “People with POTS cannot coordinate the balancing act of blood vessel squeeze and heart rate response. This means the blood pressure cannot be kept steady and stable” (x).

Learn more about my tips for living with POTS here.

So the symptoms of being lightheaded, fainting, and feeling nauseated, among others, are reactions to the heart rate and blood pressure acting incorrectly. When these symptoms happen frequently when going from sitting to standing, POTS is possibly to blame.

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Now that I’ve covered dysautonomia and POTS, let’s talk about the other element of this post: anxiety. Let’s talk about anxiety in general and anxiety disorders specifically.

Anxiety is a response to stress, and “It’s a feeling of fear or apprehension about what’s to come” (x). Healthline says, “But if your feelings of anxiety are extreme, last for longer than six months, and are interfering with your life, you may have an anxiety disorder” (x).

For example, I feel anxious basically every day, regardless of if there’s a reason for it. I’m able to deal with it because I’m in therapy and having coping techniques, and also because I can logically recognize that my anxiety is from an anxiety disorder. While that doesn’t stop me from feeling anxious, knowing that my anxiety is from a disorder helps me remember to do the things I need to in order to manage it all. (Some of those things are towards the end of this post!)

Heathline explains that anxiety can be a component of different disorders, including but not limited to: phobia, generalized anxiety disorder, OCD, and PTSD.

I personally have generalized anxiety disorder. I developed and was diagnosed with it years before I developed POTS.

The Anxiety & Depression Association of America says, “Generalized Anxiety Disorder (GAD) is characterized by persistent and excessive worry about a number of different things” (x).

If you have GAD, then you have 3 or more symptoms for at least 6 months (x). These symptoms include: feeling nervous, irritable, or on edge; having a sense of impending danger, panic or doom; having an increased heart rate; breathing rapidly (hyperventilation), sweating, and/or trembling; feeling weak or tired; difficulty concentrating; having trouble sleeping; and experiencing gastrointestinal (GI) problems (x).

Now that we’ve gone over what these things are individually, let’s talk about how dysautonomia and anxiety are connected.

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How Are Dysautonomia and Anxiety Connected?

Heart rate – Heart rate malfunction is a symptom of multiple forms of dysautonomia, including POTS, and heart rate also affects anxiety.

A 2020 article in the Journal of Atrial Fibrillation explains cardiac dysautonomia:

“ANS constantly controls the rate and force of heart contractions and the vascular tone with the aim to maintain the sufficient tissue perfusion with oxygenated blood and secure venous return to the heart. Dysautonomias, result of ANS malfunction, are often found in patients with cardiovascular symptoms. Apart from the most prevalent one, arterial hypertension, the cardiovascular dysautonomic continuum encompasses other important although less known conditions: postural orthostatic tachycardia syndrome, inappropriate sinus tachycardia, orthostatic hypotension and reflex syncope” (x).

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So what is the connection to anxiety?

Heathline explains that “anxiety’s impact isn’t just isolated to the mind. It’s a feeling that activates the body’s autonomic nervous system (ANS), also known as the ‘fight or flight response'” (x).

So if you have anxiety and dysautonomia, feeling anxious could trigger your ANS at a time when it might not otherwise.

Similarly, if your dysautonomia is flaring and it’s trigging your heart rate to rise, you might be anxious because the body associates increased heart rate with anxiety. Which is why Heathline says, “If you’re in a situation that is making you anxious, heart palpitations are just one sign that the ANS has kicked into gear” (x).

This is also what my therapist was talking about in the session I mention at the top.

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Trouble breathing – Breathing difficulties are symptoms of both dysautonomia and anxiety. One of the very annoying things about having dysautonomia, an anxiety disorder, and asthma is that I sometimes don’t know what’s causing breathing symptoms.

Shortness of breath is a symptom of POTS and diabetic autonomic neuropathy specifically, and “prolonged breath-holding” is a symptom of familial dysautonomia (x).

Shortness of breath is also one of the fight-or-flight responses. Again, if you experience shortness of breath due to dysautonomia, your brain might associate that with a situation that triggers your fight-or-flight response, which can trigger anxiety issues.

Personally, if I’m experiencing shortness of breath and a tight feeling in my chest, and there’s something that I know has triggered anxiety in the past, I focus on how I deal with my anxiety symptoms. I hope that that will help my body and brain deal with potential dysautonomia symptoms triggered by anxiety.

If there isn’t something that might have triggered my anxiety, I generally make sure that I’m all on top of my POTS symptoms and treatment. And if it’s still persisting, I take my albuterol inhaler for my asthma.

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Anxiety due to medical condition – This is a whole anxiety disorder and the name is anxiety disorder due to another medical condition. It’s basically anxiety symptoms (as listed above) that are brought on by having another medical condition and are related to that condition (x). You can have this form of anxiety with any medical condition, which therefore includes dysautonomia.

Additionally, this form of anxiety includes anxiety related to some circumstances specific to medical conditions. People with anxiety due to medical conditions “expect disaster to occur and have increasing concern about health, money, family problems, or work” (x). For example, if you have dysautonomia, then you might be anxious about experiencing symptoms in public.

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Symptoms of an anxiety attack – So, first things first, there is a difference between anxiety attacks and panic attacks. WebMD says, “Panic attacks are intense periods of fear or feelings of doom developing over a very short time frame — up to 10 minutes” (x). Symptoms of panic attacks include: sweating, overwhelming feelings of fear, shortness of breath, chest pain, nausea, dizziness, fear of dying, numbness, and so much more (x).

However, not all panic attacks are caused by a panic disorder (x). Some conditions that can trigger them are heart attacks, PTSD, hyperthyroidism, and many more (x).

Anxiety attacks are connected or triggered to a specific event, while panic attacks can happen without a trigger (x).

Anxiety attacks are less severe than panic attacks, gradually develop rather than develop quickly, and include physical symptoms like “a racing heart or ‘knot in the stomach'” (x).

Panic attacks’ physical symptoms can make the person with them genuinely think they’re going to die, while anxiety attacks’ physical symptoms aren’t severe enough for the person to think that (x).

Additionally, anxiety and stress “cause our bodies to release a chemical in the blood stream called norepinephrine,” which people with POTS seem to be especially susceptible to (x).

Finally, as I’ve covered a lot in this post, the symptoms of dysautonomia and anxiety can be very similar.

Because they’re so similar, it can be confusing as to which condition is causing which symptom. And one can cause increased symptoms of the other!

So, assuming you’re dealing with both, let’s talk about how to deal with dysautonomia and anxiety.

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How Do We Deal with Dysautonomia and Anxiety?

Go to therapy – If you can afford it, see a therapist. If you are in college, your student health services might provide counseling. You should definitely try therapy if you’re going through a rough patch health-wise or you feel like you’re starting to struggle with everything.

Basically, therapy is great. I went back to therapy when Trump won because my generalized anxiety disorder flared up due to his, like, whole deal. It has gotten a lot better, but I’m still seeing my therapist to help manage the mental aspect of all of my physical health issues. He has helped me a lot through the pandemic, during which I’ve been doing phone appointments.

Because I have generalized anxiety disorder and a history of depressive episodes, it’s so important for me to be on top of my mental health. This is why I consider therapy as a part of my anxiety toolkit.

There are different types of therapy, and if you don’t like in-person therapy, or don’t plan on going back to in-person activity for a while, you could try Talkspace. Plans start at $49/week. (not affiliate link nor sponsored)

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Practice self-care – PsychCentral says, “Self-care is any activity that we do deliberately in order to take care of our mental, emotional, and physical health. Although it’s a simple concept in theory, it’s something we very often overlook. Good self-care is key to improved mood and reduced anxiety. It’s also key to a good relationship with oneself and others” (x).

For me, self-care can include meditating, reading, going to bed early, not looking at my phone for an hour or two, and taking my medications on time. Self-care helps me manage my anxiety and other health needs … like dysautonomia.

Self-care is not going to look exactly the same for every person. For example, if your body is unable to process lettuce for whatever reason, eating a salad is not going to be self-care. Similarly, while drinking 8 glasses a water a day is great for most people, it’s nowhere near enough for me because I have POTS.

If you’re interested in learning more about self-care and practicing it as a chronic illness patient, check out this post all about self-care and chronic illness.

Make sure that your dysautonomia is treated – This sounds simple, but it isn’t always easy. It will depend on what kind of dysautonomia you have, and also what other condition(s) you have. But if you are treating your dysautonomia, and it’s working, then it might lessen anxiety caused by dysautonomia flaring.

Medical News Today says: “Treatment aims to reduce symptoms enough that the individual can start a program to physically condition and strengthen their body. This can help them balance the effects of the autonomic nervous system when it is not working as it should” (x).

If you’ve followed me for a while, then you’ll know that at one point I tried a POTS exercise protocol to retrain my ANS. The pandemic broke out before I could really figure out if it works for me, but I kept a journal of my experience, then you should check out my POTS exercise protocol diary entries. I might try it again, but I’m not positive right now.

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Check out anxiety treatment – Similarly, if you’re treating your anxiety, you might be able to help some of your dysautonomia symptoms, or at least reducing the frequency that your anxiety trigger dysautonomia symptoms. I do a lot of things to manage my anxiety, and some might work for you while others might not.

There are a lot of non-medication tools for anxiety, but if you need medication, that’s okay! Anxiety disorders are mental illnesses, and sometimes you need medications for illnesses. You don’t need to take medication, but if you do, it’s not a negative statement about you and who you are.

You are not weak for needing or wanting anxiety medication. Please don’t let anyone, including your own brain, tell you otherwise.

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And if you want to start small, or if you’re waiting for your appointment, try CBD. It doesn’t help everyone, but it’s something you can do while waiting for pharmaceutical treatment. CBD Gummies from Calm by Wellness are the perfect treat to provide you with relief from pain or anxiety

Like this post? Share it! Then check out:

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