Thursday, February 4, 2010

Dysautonomia: A Clarification

One of several versions of the painting "...Image via Wikipedia

I really don't want you to get the wrong idea about dysautonomia, so today I need to take a step back and clarify a key point.

I realize as I have been talking about the symptoms of dysautonomia that it might sound an awful lot like a description of anxiety or panic attacks. Dysautonomia is not a mental health disorder, it is a neurological disorder. I can say from experience that the symptoms are similar to a panic attack, but in dysautonomia the feelings of anxiety and panic come AFTER the physical symptoms of rapid heart rate, dizziness, feeling faint and others occur. In an anxiety or panic disorder, anxious thoughts and feelings precede the onset of physical symptoms.

Something that the medical and psychiatric communities should discuss more is how mental health disorders are diagnosed. I know from my clinical social worker training that a person can only be diagnosed with a mental disorder AFTER all physical causes for the symptoms they are experiencing have been ruled out. There are many physical conditions that cause psychological symptoms, including many endocrine and hormonal disorders, neurological conditions and autoimmune disorders. I personally think it is irresponsible for any health or mental health provider to diagnose a mental health disorder without having their patient complete a thorough medical work-up FIRST to rule out health problems.

O.K., I'll get off my soapbox now...

I guess another way to look at it is from a mind/body perspective. In dysautonomia, the body malfunctions and behaves like it is responding to seeing a tiger that is ready to pounce, leaving the sufferer wondering if they are having a heart or panic attack. With anxiety and panic disorders, the mind imagines a tiger (boss, bill collector, spouse, child) ready to pounce and these thoughts trigger a stress response from the body.

According to my cardiologist, who began her medical career as a psychiatrist, the symptoms of dysautonomia cause a person to feeling anxious. Feeling anxious does not cause dysautonomia. No, you need something that damages the nervous system to accomplish that, which will be the subject of tomorrow post.

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Michelle Roger said...

The confusion between psychiatric and neurological are constant when it comes to dysautonomia. Prior to becoming ill I worked as a clinical neuropsychologist and was used to diagnosing and managing psych vs organic (not that they are always separate) so when the first doc told me I was depressed I was less than pleased. Luckily it made me angry enough that I found a great cardio and proper diagnosis. I wrote on a similar theme on my blog if you're interested.



Anonymous said...

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