Postural Orthostatic Tachycardia Syndrome (POTS) is a disorder of the autonomic nervous system, which is responsible for regulating involuntary bodily functions such as heart rate, blood pressure, breathing, and digestion. The main characteristic of the syndrome is an abnormal and extreme increase in heart rate (tachycardia) when moving from a lying or sitting position to standing, without a sharp drop in blood pressure.
In a typical state, when moving to a standing position, the nervous system automatically constricts blood vessels in the lower body to prevent blood from pooling in the legs due to gravity, thereby ensuring adequate blood supply to the brain. In people with POTS, this regulatory mechanism does not function properly. Blood accumulates in the lower body, and the body compensates by secreting large amounts of adrenaline and sharply increasing the heart rate in a desperate attempt to pump blood back to the head.
This leads to a variety of debilitating daily symptoms, including: dizziness, rapid heart rate and palpitations, fainting or pre-fainting sensations, extreme chronic fatigue, brain fog (difficulty with concentration and memory), as well as headaches, tremors, and nausea.
Modern research shows a direct link, high prevalence, and significant medical comorbidities between POTS and Autism / ASD, as well as EDS (Ehlers-Danlos Syndrome). The combination of weak connective tissues (in EDS) that prevent blood vessels from constricting effectively, along with an innate difference in the autonomic nervous system (dysautonomia) in autistic people, creates fertile ground for the development of the syndrome.
For the autistic person, coping with POTS has a direct impact on mental well-being: extreme physical fluctuations and dizziness completely disrupt Interoception, create bodily sensations similar to anxiety attacks, rapidly deplete daily energy resources (Spoon Theory), and are a quick trigger for Sensory Overload, Meltdown, and Autistic Burnout. Treatment and support for POTS often include increasing fluid and salt intake (to increase blood volume), using compression stockings, adapted physical activity while lying or sitting, and providing an enabling environment that reduces prolonged standing.