How POTS, MCAS, and Chronic Illness Impact Mental Health
If you live with POTS (Postural Orthostatic Tachycardia Syndrome), MCAS (Mast Cell Activation Syndrome), Ehlers-Danlos Syndrome, autoimmune conditions, or other chronic illnesses, you may have been told that your anxiety is “just stress” or that your depression is “separate” from your physical symptoms. But the truth is far more complex—and far more compassionate.
Your nervous system, immune system, and emotional world are deeply interconnected. When your body is chronically dysregulated, your mental health will be too. Understanding this connection can be life-changing—and therapy can be a powerful part of healing.
Why Chronic Illness Often Leads to Anxiety and Depression
Many people with POTS and MCAS experience symptoms like:
Racing heart
Dizziness or fainting
Brain fog
Shortness of breath
GI distress
Histamine reactions
Fatigue and pain
These symptoms closely resemble panic attacks. Over time, your nervous system learns to stay in survival mode. This isn’t psychological weakness—it’s neurobiology.
When your body keeps sending danger signals, your brain adapts by becoming hypervigilant. You may start to feel:
Constant anxiety or impending doom
Fear of leaving home
Health anxiety
Social withdrawal
Depression and grief
Trauma responses
Many clients with chronic illness develop medical trauma from being dismissed, misdiagnosed, or not believed. Over time, this creates deep emotional wounds that live inside the nervous system.
The Nervous System–Immune System Loop
In conditions like POTS and MCAS, the body is already dysregulated. Therapy helps by addressing the feedback loop between:
Stress
Trauma
Autonomic nervous system
Immune activation
Emotional processing
When trauma, grief, or long-term stress is stored in the body, it can worsen inflammation, histamine release, and autonomic instability. This means mental health symptoms are not separate from physical illness—they are part of the same system.
Why Traditional Talk Therapy Often Isn’t Enough
Many people with chronic illness try therapy and feel frustrated when it doesn’t help. That’s because cognitive or talk-based therapy alone cannot calm a dysregulated nervous system.
What helps is trauma-informed, body-based therapy that works directly with the brain and nervous system.
How Trauma-Informed Therapy Helps People With POTS & MCAS
The most effective approaches are those that work bottom-up, not just top-down.
EMDR (Eye Movement Desensitization & Reprocessing)
EMDR helps process:
Medical trauma
Fear of symptoms
Past hospitalizations
Loss of identity and safety
It allows the brain to re-file traumatic experiences so your nervous system no longer reacts as if danger is still happening.
Internal Family Systems (IFS)
IFS helps you work with:
The part of you that is terrified of symptoms
The part that pushes yourself too hard
The part that feels hopeless or ashamed
This creates internal safety, which reduces stress on the body.
Nervous System Regulation & Somatic Therapy
Learning to regulate your body helps:
Reduce panic
Improve sleep
Lower symptom flare frequency
Increase resilience
When your nervous system feels safer, your body follows.
Chronic Illness Is a Loss — And Loss Requires Grief Work
Many people don’t realize they are grieving:
Their old body
Their independence
Their future
Their career
Their relationships
Unprocessed grief turns into depression, anger, or shutdown. Therapy creates space to mourn, adapt, and rebuild a meaningful life—even with illness.
You Are Not Broken — Your Body Is Trying to Protect You
Your anxiety is not a character flaw. Your depression is not laziness. Your nervous system is responding to real physical stress.
When therapy is done in a trauma-informed way, it helps your body learn:
“I am safer now.”
And when the body feels safer, symptoms often soften.
How I Help Clients With Chronic Illness
In my practice, I specialize in helping people who are high-functioning on the outside but struggling deeply on the inside—especially those living with medical complexity, trauma, and nervous system dysregulation.
I integrate:
EMDR
Attachment-based therapy
Internal Family Systems (IFS)
Nervous system regulation
Trauma-informed care
to help clients feel safer in their bodies and more grounded in their lives.
You Don’t Have to Do This Alone
If you live with POTS, MCAS, autoimmune illness, or chronic symptoms—and feel anxious, hopeless, or emotionally exhausted—you deserve support that understands the full picture.
Healing is not about “thinking positive.” It’s about helping your nervous system learn that it’s no longer in danger.
And that kind of healing is possible.