Link between FND and POTS
Lately almost all of the patients who are coming to me and eventually get diagnosed with FND (based on inclusion criteria) either have a pre-existing diagnosis of POTS, or are being worked up for POTS.
I was wondering if: 1. others are seeing this link in their clinics and 2. what do we think the underlying mechanism is here?
My theories are:
both diseases have a psychosomatic basis. however, this doesn't seem to be widely accepted with POTS. in any case, patients with POTS may be hyper-aware of bodily sensations which may manifest as FND symptoms?
POTS symptoms are triggering FND symptoms/episodes due to the distress they cause. this actually seems possible - many of my patients are reporting the cardiac sx prior to FND episodes.
FND symptoms are triggering POTS-like symptoms of dysautonomia.
I would love for this to be a productive discussion that would help me in understanding and explaining this link to patients moving forward. I know working with psychosomatic disease can be frustrating (trust me...I KNOW.) But the purpose of this thread is not to be complaining or invalidating patients with psychosomatic symptoms, so please keep it respectful!