Dysautonomia

Dysautonomia is a disorder of the autonomic nervous system – the part of the nervous system that is responsible for control of the bodily functions not consciously directed, such as breathing, heart rate and blood pressure control. It results in an imbalance of the sympathetic nervous system (our “fight or flight” responses) and the parasympathetic nervous system (our “rest and digest” responses). Dysfunction of the autonomic nervous system causes many different symptoms in people and may be called different names depending on those symptoms: orthostatic intolerance, POTS, neuro-cardiogenic syncope or dysautonomia. 

Dysautonomia, also called autonomic dysfunction, is a general term used to describe various diseases or failures of the autonomic nervous system. The autonomic nervous system is in charge of many involuntary functions such as perspiration, digestion, heart rate, sexual arousal, blood pressure, body temperature, salivation, and more. Dysautonomia is a full-body disease that affects everyone differently.

Autonomic dysfunction develops when the nerves of the ANS are damaged. This condition is called autonomic neuropathy or dysautonomia. Autonomic dysfunction can range from mild to life-threatening. It can affect part of the ANS or the entire ANS. Sometimes the conditions that cause problems are temporary and reversible. Others are chronic, or long term, and may continue to worsen over time.

Autonomic dysfunction can affect a small part of the ANS or the entire ANS. Some symptoms that may indicate the presence of an autonomic nerve disorder include:

-dizziness and fainting upon standing up, or orthostatic hypotension

-an inability to alter heart rate with exercise, or exercise intolerance

-sweating abnormalities, which could alternate between sweating too much and not sweating enough

-digestive difficulties, such as a loss of appetite, bloating, diarrhea, constipation, or difficulty swallowing

-urinary problems, such as difficulty starting urination, incontinence, and incomplete emptying of the bladder

-sexual problems in men, such as difficulty with ejaculation or maintaining an erection

-sexual problems in women, such as vaginal dryness or difficulty having an orgasm

-vision problems, such as blurry vision or an inability of the pupils to react to light quickly

You can experience any or all of these symptoms depending on the cause, and the effects may be mild to severe. Symptoms such as tremor and muscle weakness may occur due to certain types of autonomic dysfunction.

Orthostatic intolerance is a condition whereby your body is affected by changes in position. An upright position triggers symptoms of dizziness, lightheadedness, nausea, sweating, and fainting. Lying down improves the symptoms. Often this is related to an improper regulation of the ANS.

Orthostatic hypotension is a type of orthostatic intolerance. Orthostatic hypotension occurs when your blood pressure drops significantly as you stand up. This can cause lightheadedness, fainting, and heart palpitations. Injury to nerves from conditions like diabetes and Parkinson’s disease can cause episodes of orthostatic hypotension due to autonomic dysfunction.

Autonomic dysfunction can vary in symptoms and severity, and they often stem from different underlying causes. Certain types of autonomic dysfunction can be very sudden and severe, yet also reversible.

Different types of autonomic dysfunction include:

Postural orthostatic tachycardia syndrome (POTS) POTS affects anywhere from 1 to 3 million people in the United States. Nearly five times as many women have this condition compared to men. It can affect children, teenagers and adults. It can be also associated with other clinical conditions such as Ehlers-Danlos syndrome, an inherited condition of abnormal connective tissue.

POTS symptoms can range from mild to severe. Up to one out of four people with POTS have significant limitations in activity and are unable to work due to their condition.

Neurocardiogenic syncope (NCS) NCS is also known as vasovagal syncope. It’s a common cause of syncope, or fainting. The fainting is a result of a sudden slowing of blood flow to the brain and can be triggered by dehydration, sitting or standing for a long time, warm surroundings and stressful emotions. Individuals often have nausea, sweating, excessive tiredness, and ill feelings before and after an episode.

Multiple system atrophy (MSA) MSA is a fatal form of autonomic dysfunction. Early on, it has symptoms similar to Parkinson’s disease. But people with this condition usually have a life expectancy of only about 5 to 10 years from their diagnosis. It’s a rare disorder that usually occurs in adults over the age of 40. The cause of MSA is unknown, and no cure or treatment slows the disease.

Hereditary sensory and autonomic neuropathies (HSAN)

HSAN is a group of related genetic disorders that cause widespread nerve dysfunction in children and adults. The condition can cause an inability to feel pain, temperature changes, and touch. It can also affect a wide variety of body functions. The disorder is classified into four different groups depending on age, inherited patterns, and symptoms.

Holmes-Adie syndrome (HAS) HAS mostly affects the nerves controlling the muscles of the eye, causing vision problems. One pupil will likely be larger than the other, and it will constrict slowly in bright light. Often it involves both eyes. Deep tendon reflexes, like those in the Achilles tendon, may also be absent.

HAS may occur due to a viral infection that causes inflammation and damages neurons. The loss of deep tendon reflexes is permanent, but HAN isn’t considered life-threatening. Eye drops and glasses can help correct vision difficulties.

Autonomic neuropathy refers to damage to nerves from certain medications, injury, or disease. Some diseases causing this neuropathy include:

-uncontrolled high blood pressure

-long-term heavy drinking

-diabetes

-autoimmune disorders

-Parkinson’s disease can cause orthostatic hypotension and other symptoms of ANS damage. 

Your doctor will treat autonomic dysfunction by addressing the symptoms. If an underlying disease is causing the problem, it’s important to get it under control as soon as possible.

Often, orthostatic hypotension can be helped by lifestyle changes and prescription medication. The symptoms of orthostatic hypotension may respond to:

-elevating the head of your bed

-drinking enough fluids

-adding salt to your diet

-wearing compression stockings to prevent blood pooling in your legs

-changing positions slowly

-taking medications like midodrine

Nerve damage is difficult to cure. Physical therapy, walking aids, feeding tubes, and other methods may be necessary to help treat more severe nerve involvement.

Damage to the nerves of the ANS is often irreversible. Talk to your doctor if you have any symptoms of autonomic dysfunction. Early diagnosis and treatment of the underlying condition can help slow the progression of the disease and lessen symptoms. This can improve your quality of life regardless of the severity of the condition.

The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible.

Dysautonomic disorders are the not the subject of a specific disability listing, but your symptoms may be similar to one one of the listings. Listings that may be applicable are the cardiovascular, neurological, or digestive system listings. Work with your doctor to figure out whether your condition will meet a listing, and which conditions to list as primary on your application or at your hearing.

If you need help applying for Social Security Disability or SSI, please contact me at joshben99@gmail.com. I have over 20 years experience with Social Security Disability cases.