dysautonomia: autopilot on the fritz
Welcome back to another deep dive on the Waning Crescent blog! If you read my last post about the vagus nerve, you might remember me teasing this topic. Today we're exploring dysautonomia—what happens when the autonomic nervous system, the autopilot that's meant to keep things running smoothly in the background, starts glitching.
If you've ever stood up and felt like you might pass out, noticed your heart racing for no apparent reason, struggled with temperature regulation that makes you feel like you're personally experiencing all four seasons in one day, or felt exhausted in a way that sleep just doesn't fix—you might be dealing with dysautonomia. And if you're someone living with conditions like hypermobile Ehlers-Danlos Syndrome (hEDS) or autoimmune disorders, this is especially for you.
Let's get nerdy about what's happening, why it matters, and how working with your body (yes, including bodywork and breathwork) can help you find more stability.
What IS Dysautonomia?
Dysautonomia is an umbrella term for conditions where the autonomic nervous system (ANS) doesn't function properly. The ANS is the control center that manages all the things you don't consciously think about: heart rate, blood pressure, digestion, temperature regulation, breathing patterns, and more.
When this system is working well, it's like having the world's best personal assistant—constantly making micro-adjustments to keep you stable as you move through your day. Blood pressure drops when you stand? No problem, it compensates. Need to digest that meal? On it. Temperature fluctuating? Already adjusting.
But with dysautonomia, that assistant is... let's say, having a really rough day. Or year. The communication between your brain and body gets scrambled, and suddenly your body is overreacting, underreacting, or just plain confused about what's needed.
The result? A constellation of symptoms that can feel maddeningly inconsistent and are often dismissed because they don't show up on standard tests. We're talking:
Dizziness and lightheadedness, especially upon standing (orthostatic intolerance)
Heart rate abnormalities—racing, pounding, or irregular heartbeats
Blood pressure fluctuations
Temperature dysregulation and sweating abnormalities
Digestive issues—nausea, bloating, constipation, IBS-like symptoms
Brain fog and difficulty concentrating
Chronic fatigue that rest doesn't resolve
Exercise intolerance
Shortness of breath
Sleep disturbances
Sound familiar? For many people, these symptoms have been there for years, often written off as anxiety, stress, or "just in your head." Spoiler alert: it's not in your head. It's in your autonomic nervous system.
The Chronic Stress Connection: When Your Body Can't Find the Off Switch
Here's where things might start feeling a little too close for comfort: dysautonomia and chronic stress have a complex, bidirectional relationship—each one feeding into the other in a loop that can be hard to break.
Remember from our vagus nerve post how Polyvagal Theory describes three states: ventral vagal (safe and social), sympathetic (mobilized for action), and dorsal vagal (shutdown)? When your autonomic nervous system is dysregulated, you can get stuck toggling between sympathetic overdrive and dorsal vagal collapse—with that sweet spot of ventral vagal regulation feeling increasingly hard to access.
Your nervous system is constantly scanning for threats, and when the communication systems are faulty, your body might perceive danger even when you're objectively safe. You're sitting on the couch, but your heart is racing like you're being chased. You're trying to sleep, but your body won't shift into parasympathetic mode. You stand up to grab coffee, and your blood pressure does something weird, triggering a cascade of stress signals.
This chronic activation of stress responses doesn't just feel awful—it has real physiological consequences:
Inflammation runs wild: Chronic sympathetic activation suppresses the vagus nerve's anti-inflammatory pathway.
Pain perception amplifies: When your nervous system is stuck in threat mode, your pain threshold drops. The same stimuli that wouldn't normally register as painful suddenly hurt.
Recovery becomes impossible: Healing happens in parasympathetic mode—rest and digest. But if your system can't reliably shift into that state, your body never gets the chance to repair, restore, and recover.
The stress loop perpetuates itself: Dysautonomia creates stress symptoms, those symptoms create more stress (both physical and psychological), and that stress further dysregulates the autonomic nervous system. Round and round we go.
hEDS and Autonomic Dysfunction
If you're living with hypermobile Ehlers-Danlos Syndrome or autoimmune conditions, you're statistically much more likely to experience dysautonomia. Let's talk about why. Hypermobile EDS is a connective tissue disorder affecting collagen production and structure. Collagen isn't just in your joints—it's everywhere, including the walls of your blood vessels. When your blood vessels are extra stretchy, they don't maintain proper tension, making it harder for your body to regulate blood pressure and blood flow.
When you stand up, gravity pulls blood down into your legs. Normally, your blood vessels would constrict to push blood back up to your brain and heart. But with hEDS, those vessels might be too lax to respond appropriately. The result? Blood pools in your legs, your brain doesn't get enough oxygen, and you feel dizzy, lightheaded, or experience tachycardia (rapid heart rate) as your body tries to compensate.
Studies show that up to 80% of people with hEDS also have some form of dysautonomia, most commonly Postural Orthostatic Tachycardia Syndrome (POTS). The overlap is so significant that many specialists now consider autonomic screening essential for anyone with hypermobility.
Beyond blood vessels, hypermobility affects proprioception—your body's sense of where it is in space. When your joints are unstable and your body can't trust its position sense, your nervous system stays on high alert. You're constantly micromanaging stability, which keeps you in sympathetic activation. It's exhausting, and it perpetuates the dysautonomia cycle.
Chronic Pain: The Dysautonomia Amplifier
Chronic pain and dysautonomia are deeply intertwined, each making the other worse in ways that can feel impossible to untangle. When your autonomic nervous system is dysregulated, your pain processing changes. The nervous system becomes hypersensitive, a phenomenon called central sensitization. Your nervous system starts treating even normal sensations as painful—a light touch might feel like burning, muscle tension that used to be manageable becomes excruciating, etc.
This isn't "just pain." This is your nervous system stuck in a threat state, interpreting everything through a lens of danger. And when you're in pain, your nervous system responds with—you guessed it—more sympathetic activation. More stress hormones, more muscle tension, more inflammation, less sleep, more pain. The loop tightens.
For people with hEDS, chronic pain often stems from joint instability, frequent subluxations, and the muscular compensation patterns your body develops trying to stabilize loose joints. Your muscles are working overtime, and that constant tension feeds back into nervous system dysregulation.
For those with autoimmune conditions, pain might come from inflammation in joints, tissues, or organs—pain that waxes and wanes unpredictably, which itself is a stressor for the nervous system.
The beautiful and frustrating truth is this: you can't address chronic pain without addressing nervous system regulation, and you can't regulate the nervous system while ignoring chronic pain. They must be approached together.
Coming Home to Your Body: Regulation Through Somatics
So what do we do with all this information? How do we work with a system that feels broken? The answer lies in understanding that your nervous system isn't actually broken—it's actually incredibly clever, adapted to protect you, and now it needs help finding its way back to balance. This is where somatic practices—working through the body—become essential.
Remember Peter Levine's work on trauma and the body's innate capacity to discharge stress? The same principles apply here. Your body holds the wisdom to regulate itself; it just needs the right conditions and support to access that capacity.
This is where bodywork becomes not just relaxing, but therapeutic in the truest sense.
The Case for Bodywork in Dysautonomia
Skilled, trauma-informed bodywork creates a unique opportunity for nervous system regulation. Here's why:
Safe touch sends powerful signals: When you receive caring, attuned touch in a safe environment, your nervous system receives direct input that you're not in danger. This isn't intellectual—it's visceral. Touch activates mechanoreceptors in your skin and deeper tissues that communicate directly with your brain, triggering parasympathetic responses.
Proprioceptive input grounds you: For people with hEDS or chronic pain, proprioception (knowing where your body is in space) is often impaired. Gentle, intentional touch and movement helps your brain create a clearer map of your body, which reduces the "where am I?" stress that keeps your nervous system on edge.
Fascial release reduces threat signals: Chronic pain creates areas of tissue restriction and tension. When these tissues are gently released, the constant stream of "something's wrong here" signals to your brain decreases. Less threat input means your nervous system can start to downregulate.
Co-regulation is medicine: Your nervous system doesn't regulate in isolation—it regulates in relationship. When you're working with a practitioner whose own nervous system is calm and present, your system picks up on those cues. This is co-regulation in action, and it's one of the most powerful tools we have.
The treatment table is a laboratory: Bodywork sessions become a safe place to practice being in your body, noticing sensations without immediately reacting, and building capacity to tolerate relaxation (which, paradoxically, can feel threatening if you've been in survival mode for years).
The goal isn't to "fix" you or make everything perfect. It's to create moments—even brief ones—where your system can experience safety, where ventral vagal engagement is possible, where your body remembers how to rest.
Breathwork: Your Portable Vagus Nerve Stimulator
If bodywork is the professional-grade nervous system support, breathwork is your portable, always-accessible tool for regulation. And for people with dysautonomia, it's especially powerful because breath is one of the few autonomic functions you can consciously control.
When you breathe slowly and deeply, especially with a longer exhale, you're directly stimulating your vagus nerve. That exhale activates the parasympathetic nervous system, telling your body it's safe to rest. You're literally applying the vagal brake.
For people with POTS or orthostatic intolerance, controlled breathing before standing can help prepare your cardiovascular system for the position change. For those dealing with panic or anxiety (common when your heart randomly starts racing), breath work gives you a tangible way to intervene.
Diaphragmatic breathing engages the vagus nerve mechanically—your diaphragm literally massages your heart and stimulates vagal fibers. This isn't woo-woo; this is anatomy.
Box breathing (4 counts in, 4 hold, 4 out, 4 hold) can help when you're feeling sympathetically activated and need to create rhythm and regulation.
Coherent breathing (breathing at about 5-6 breaths per minute) has been shown to optimize heart rate variability, which is a key marker of vagal tone and autonomic balance.
The beauty of breathwork is that you can do it anywhere—standing in line, sitting at your desk, lying in bed when sleep won't come, or right before a potentially triggering situation. It's free, it's always with you, and it works.
Building Your Regulation Toolkit
Living with dysautonomia isn't about finding a magic cure (though I wish it were that simple). It's about collecting tools, practices, and supports that help your nervous system find more moments of regulation, more access to that ventral vagal state where healing happens.
Your toolkit might include:
Regular bodywork sessions with a practitioner who understands nervous system regulation. I STRONGLY recommend Craniosacral therapy for my hEDS/dysautonomia/chronic pain clientele.
Daily breathwork practice, even just 5 minutes
Gentle movement that doesn't trigger post-exertional malaise (walking, swimming, restorative yoga)
Compression garments to support blood flow (especially for POTS)
Adequate hydration and electrolytes (seriously, this matters)
Consistent sleep and wake times to support circadian rhythm
Cold exposure (that vagus nerve loves it)
Community and co-regulation with safe people
Medical support from practitioners who understand dysautonomia (cardiologists, neurologists, physical therapists, massage therapists :D)
The most important thing? Be patient with yourself. Your nervous system didn't become dysregulated overnight, and it won't regulate overnight either. You're retraining patterns that have been running for months or years, and that takes time, consistency, and compassion.
Takeaway:
Understanding dysautonomia isn't just about naming what's happening in your body—it's about reclaiming agency in your own healing. When you understand that your symptoms aren't random, aren't "in your head," and aren't your fault, you can stop fighting against your body and start working with it.
Your autonomic nervous system is doing its best with the information and resources it has. When it's stuck in sympathetic overdrive or dorsal collapse, it's trying to protect you. The question becomes: how do we send it different information? How do we help it learn that it's safe to rest, safe to heal, safe to be present?
For those of us working with bodies—our own or others'—this is the work. We're not just addressing pain or tension or fatigue in isolation. We're supporting nervous systems in finding their way back to balance, creating conditions where the body remembers how to regulate itself.
Your body isn't broken. It's adapted, it's tired, and it needs support. And that support is possible.
✨ Stay well, stay curious, and stay connected. ✨