what is dysautonomia, pots and pswt?

May 29

If you've recently been diagnosed with POTS or Dysautonomia or suspect you may be experiencing symptoms, you may be feeling overwhelmed, confused, or unsure where to begin.

Many people spend months or even years searching for answers before receiving a diagnosis. Understanding what POTS and Dysautonomia are can be an important first step in making sense of your symptoms and finding strategies that help.

What Is the Autonomic Nervous System?

The autonomic nervous system (ANS) is responsible for controlling many of the body's automatic functions that occur without us consciously thinking about them. Think of anything that your body is meant to be doing automatically.

These include:

  • Heart rate

  • Blood pressure

  • Breathing

  • Digestion

  • Temperature regulation

  • Sweating

  • Blood flow

  • Bladder function

  • Blood glucose levels

  • Sleep / Wake Cycles

For most people, these processes happen seamlessly in the background. When the autonomic nervous system is not functioning as expected, a person may experience a wide range of symptoms affecting multiple body systems.

What Is Dysautonomia?

Dysautonomia is an umbrella term used to describe conditions that affect the autonomic nervous system. Think of Dysfunction (Dys) of the Autonomic Nervous System (autonomia) = Dysautonomia.

Dysautonomia refers to a group of disorders where the body's automatic functions become disrupted and are now dysregulated.

Symptoms can vary significantly between individuals but may include:

  • Dizziness

  • Lightheadedness

  • Fainting / Presyncope

  • Fatigue

  • Brain fog

  • Heart palpitations

  • Nausea

  • Exercise intolerance

  • Temperature regulation difficulties

  • Digestive symptoms

  • Insomnia / Disrupted Sleep

Because the autonomic nervous system influences so many areas of the body, symptoms can often seem unrelated or difficult to explain.

What Is POTS?

POTS stands for Postural Orthostatic Tachycardia Syndrome.

It is one of the most common forms of Dysautonomia.

POTS is characterised by an excessive increase in heart rate when moving from lying down to standing upright.

To meet the diagnostic critera for POTS, you must have >30bpm increase upon standing (adults) and >40bpm increase upon standing (adolescence).

Importantly, POTS is far more than simply "getting dizzy when standing." Many individuals experience symptoms that impact work, study, exercise, relationships, and daily activities.

What is Postural Symptoms Without Tachycardia (PSWT)?

Many people have heard of POTS (Postural Orthostatic Tachycardia Syndrome), but fewer people are aware of a condition known as PSWT, or Postural Symptoms Without Tachycardia.

PSWT describes individuals who experience symptoms similar to POTS when upright, such as dizziness, light-headedness, fatigue, brain fog, palpitations, nausea, and exercise intolerance, but do not meet the heart rate criteria required for a POTS diagnosis.

For many people, the impact on daily life can be just as significant. Standing for prolonged periods, exercise, heat, illness, and busy environments may all trigger symptoms, making work, study, social activities, and everyday tasks more challenging.

In this article, we'll explore what PSWT is, how it differs from POTS, common symptoms, possible causes, and strategies that may help improve quality of life and day-to-day function.

If you've ever been told "it's not POTS because your heart rate doesn't increase enough" but still experience significant symptoms when upright, this article is for you.

Why Do Symptoms Vary So Much?

One of the most confusing aspects of POTS and Dysautonomia is that symptoms can look very different from person to person. Some individuals primarily experience fatigue and brain fog. Others may struggle with dizziness, gastrointestinal symptoms, temperature regulation issues, or exercise intolerance.

Factors that may influence symptoms include:

  • Hydration status

  • Blood volume

  • Stress levels

  • Sleep quality

  • Illness and infections

  • Hormonal changes

  • Physical activity levels

  • Co-existing conditions

This is one reason why management often requires an individualised approach.

Is There a Cure?

At present, there is no single cure for POTS.

However, many people find that symptoms can improve with a combination of:

  • Education

  • Hydration strategies

  • Electrolyte support

  • Compression garments

  • Exercise and rehabilitation

  • Pacing and energy management

  • Medical management

  • Lifestyle modifications

The goal is often to better understand your body and develop strategies that support your individual needs.

This article is intended for educational purposes only and should not replace personalised medical advice. If you have concerns about your health, please seek advice from an appropriately qualified healthcare professional.