There's a difference between managing your symptoms and actually fixing the problem.
Most POTS and dysautonomia patients are stuck in management mode — tracking heart rate, adjusting salt, timing compression garments, pacing activities. These things help day-to-day. But they don't address the question: Why is the system broken in the first place?
Building Capacity on Dysfunction
Here's the trap: You can get better at tolerating your dysfunction without actually fixing it.
“If you are building more capacity on dysfunction, you're basically getting better at your dysfunction... You're still kind of doing it the same way... But you're still having a vulnerability to it... because that baseline level is a function of the underlying comorbidity or the underlying dysfunction or problem.”
Think of it like driving a car with a misaligned wheel. You can get really good at compensating with the steering wheel. You might even forget the alignment is off. But the tire is still wearing unevenly, and eventually the problem catches up.
The Precision Approach
Instead of building general capacity on top of a broken system, target the specific thing that's broken.
“Rather than trying to think about increasing the capacity of like the whole of you, use your energy in a way that precisely is directed toward the part that is the lynch pin, the part that is not working well... unlocks the ability to then go through that door to affect the whole. So by addressing that one component, we oftentimes have the ability to make the whole system run better and then build real capacity.”
Find the lynchpin. Fix that. The rest often follows. This is a core reason why many dysautonomia treatments fail — they target symptoms instead of the mechanism.
Don't Steal the Compensation
One important nuance: Sometimes your body's compensations are there for a reason. You don't want to remove a compensation before you've fixed the underlying problem.
“Maybe that adjustment is there because it needs to be there and we don't want to steal their compensation. We want to be able to fix the problem so they don't have to compensate anymore.”
A stiff neck might be your body's way of stabilizing a vestibular problem. Loosening the neck without addressing the vestibular issue could make things worse. The goal is to fix why the body is compensating — so the compensation is no longer needed.
Recovery Isn't Just "Less Symptoms"
Real recovery means your system can handle normal life without burning excessive resources.
One patient went from being unable to complete a short exercise class to:
“She decided that she was going to do a whole workout class at the end of the day and felt wonderful, didn't have to rest for hours afterwards and was able to wash her hair, which she was super excited about.”
That's not symptom management. That's a system that works again. Understanding how to reverse post-exertional malaise is part of this picture.
What Your Brain Is Solving For
The key question isn't "how do I manage this symptom?" It's "what is my brain responding to?"
“Rather than focus on how do I solve for that symptom, focus instead on what is my brain responding to that's causing it to have that compensation. And then how do I start to think about solving that. But until we start to get to what is my brain solving for, you're really guessing at that point.”
Post-exertional malaise isn't just "I overdid it." It's telling you the recovery system doesn't have integrity.
“In the post-exertional malaise component you're saying I don't have a system that recovers. I can't adequately recover from very simple things. Recovery is not just like gravity flowing downhill. It is its own process. It's part of how the brain works.”
Recovery is an active brain process. When that process is impaired, you can't just push through. This is why understanding how the brain controls the autonomic system is essential.
Bodies Heal
The good news: When you find and address the mechanism, bodies tend to do the rest.
“Bodies heal. They heal themselves, right? That's where the process happens. We're just trying to create an environment where they do.”
The goal isn't to become a lifelong patient managing a chronic condition. It's to recalibrate the system so you can get on with your life.
Key Takeaways
- Managing symptoms does not equal fixing the problem — You can get better at tolerating dysfunction without resolving it
- Target the lynchpin — Precisely address the one component that unlocks the whole system
- Don't remove compensations prematurely — Fix why the body is compensating first
- Post-exertional malaise means a recovery system that lacks integrity — Not just "overdoing it"
- Bodies heal when given the right environment
Tired of Managing Instead of Recovering?
If you've been managing symptoms but not getting better, a free consultation call can help identify the lynchpin that's keeping your system stuck.
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