@cgnet
How tall are you?

My teen son (15) has all of the symptoms you mention. He has ADHD, takes methylphenidate for it, has a bicuspid aortic valve birth defect found by an echocardiogram (have you had one done by a cardiologist?), and high anxiety. Anxiety and depression plus OCD runs in both sides of the family. My son is over 6’ tall and slim (about 158 pounds). He is also still growing.

When my son gets up fast, his heart pounds and he gets lightheaded/dizzy. It seems like POTS but he also has Raynaud's which is a blood vessel valve spasming. He did have Covid 2 times but did not get the mRNA injection due to his heart defect. Covid/mRNA spine protein can damage endothelial cells lining blood vessels and may have something to do with your symptoms as well as my son’s.

Like you, my son gets anxiety just thinking about his heart, feeling it beat hard/palpitate, his veins in his arms fill up and drain visibly with raising/lowering arms (gravity). He gets very nervous/anxious when he goes to the doctors and hears his own heartbeat on the monitor. He also gets nervous when he gets his blood pressure taken.

Due to my son’s age, I haven’t put him on antidepressants/SSRIs due to risk of suicidal thoughts. He most likely will need to consider them in the future as both his father and I need to take them. Which medications have you tried? It can take a while to find one that works for you with minimal side effects and sometimes it takes a combination of medications to work (I am taking Zoloft/sertraline and Wellbutrin/bupropion currently and it took over 1.5 years to find this combination that works for me now).

I have a psychologist working with my son on breathing/thinking techniques that help him calm down when he is at school and starts to panic/have high anxiety due to his heartbeat.

My son takes magnesium at night to calm him down and uses melatonin to help him sleep when needed.

He plays video games and watches videos on his phone a lot which may add to his anxiety and have talked with him about reducing screen time (his cardiologist also recommended this). He doesn’t drink caffeine at all so that is not an issue.

Have you had full bloodwork to see if you have any deficiencies or toxicities? How is your thyroid and iron levels? How are your liver/kidney function?

My son’s cardiologist told my son to make sure he has salt in his diet and to drink a good amount of water to make sure his blood volume stays up. I also learned that he needs electrolytes in his water so his body retains the fluids (has sodium, potassium and magnesium in the LMNT electrolytes he takes). I also understand you should have about 50% of your weight in ounces of water per day. For example, if you are about 140 pounds, you should strive to have at least 70 ounces of water per day.

My son uses white noise/hepa filter/fan at night to help him sleep and his room is really dark.

I can tell you that since he started drinking water with electrolytes, gets up more slowly and gets mental health therapy, his anxiety/OCD/panic has reduced significantly. He needs to work on getting more exercise and getting outdoors in the fresh air and sunshine more often as I know this will also help him manage anxiety and sleep more deeply.