Postural Orthostatic Tachycardia Syndrome, or POTS, is a condition that affects the autonomic nervous system, which controls the 'automatic' functions of the body such as heart rate, blood pressure, digestion, and body temperature. When you have POTS, standing up can cause an abnormal increase in heart rate, alongside a variety of other symptoms.
Understanding POTS and its connection to mental health is crucial for both patients and their loved ones. This understanding can enhance patient care, foster supportive relationships, and guide effective strategies for managing symptoms.
POTS is characterized by a sustained heart rate increase of more than 30 beats per minute upon standing, without a drop in blood pressure. Symptoms can include fatigue, 'brain fog' or concentration difficulties, gastrointestinal dysfunction, and orthostatic intolerance symptoms like dizziness, lightheadedness, palpitations, reduced exercise tolerance, and chest pain.
In POTS, pro-inflammatory cytokines (proteins that can influence the behavior of cells) trigger increased sympathetic activity, which can cause chronic immune activation. Interestingly, POTS is often linked with autoimmune disorders, where the body's immune system mistakenly attacks its own cells.
POTS and Mental Health: The Connection
One subtype of POTS, known as 'hyperadrenergic,' is associated with elevated levels of catecholamines. Catecholamines are chemicals produced by your adrenal glands that act as neurotransmitters, or chemical messengers. They include adrenaline (also known as epinephrine), noradrenaline (norepinephrine), and dopamine, and play a crucial role in your body's response to stress.
In the hyperadrenergic subtype of POTS, there is an excess of these catecholamines, particularly norepinephrine. This can cause symptoms such as palpitations, lightheadedness, dizziness, shortness of breath, and sometimes nausea, diarrhea, headache, and fainting. It can also lead to chronic fatigue, confusion, and anxiety.