Everyone says your 20s are supposed to be the best years of your life. Spoiler alert: mine have been… not that. Unless “best” includes collecting medical diagnoses like they’re loyalty card stamps. Here is to hoping my 90s will be a lot calmer!

It’s 2023, and I’m a recent graduate from Salford University - First Class Law Degree; the world is my oyster. Excited yet somewhat overwhelmed by being thrust into the world of being a “real adult,” I decided it was best to take a gap year and consider all my options. Sadly, my options turned out to be very limited, as here I am three years later living with POTS, CFS, and Long COVID. Not exactly what I’d planned, but definitely a journey.

Raising Awareness

Recently, POTS (as I spoke about in a previous blog post, click here to read) has gained a bit more attention in the media and wider public as Cat Smith MP for Lancaster and Wyre secured a debate in the House of Commons surrounding the condition. It was a huge step forward in raising awareness for the condition, putting it on people’s radars so that they can provide help and support to those who have the condition. Click here to read a bit more about that.

There is still so much unknown about the condition that affects around one in 500 across the UK; however, research suggests there are a few overlaps between POTS and two other increasingly diagnosed conditions - Long COVID, and myalgic encephalomyelitis, or as it’s more commonly known to people, chronic fatigue syndrome (CFS).

27% of individuals who have been diagnosed with CFS and 12% of individuals diagnosed with Long COVID have also been diagnosed with POTS (statistics found here. I am one of those lucky individuals diagnosed with all three.

When Things Went South

My latest downhill turn began in June 2025, when I caught what seemed like a harmless bug from my niece – my best friend in the entire world. She’s one, so she can do no wrong… even if she is a tiny little germ factory. I expected a rough 48 hours, not the start of months-long exhaustion.

After recovering from the stomach bug, I suddenly felt worse—tired, dizzy—barely able to stand. I was sleeping constantly yet still exhausted, so I went to the doctor. Bloods came back normal, and I thought, “Okay, it’ll pass.” It didn’t. It got worse.

Eventually, I ended up back with my cardiologist, who then referred me to a neurologist. Cue a round of tests which included but were not limited to:

• Walking in a straight line
• Walking in a straight line heel to toe
• Looking at his finger with my eyes
• Touching his finger and then my nose several times whilst he tried to catch me off guard
• Tapping the funny spot in my knee to make it go ping!

The verdict? Long COVID and CFS. Which, apparently, decided to move in alongside POTS and redecorate my entire nervous system.

What is CFS?

Chronic Fatigue Syndrome, or CFS, is a chronic neurological condition that affects almost every aspect of the body, from the nervous system to the immune system, muscular, skeletal, and many more. Way back when, before it earned the title it has now, it was known as ‘Post-Viral Fatigue’, and as explained by neurologists, had something to do with farmers being ill… although I’m not sure of its relevance, so I’ll stick to what I do know!

The cause of CFS is rarely pinpointed; however, it is said that people develop it after a period of one of the following:

• infection,
• trauma,
• surgery; or
• a stressful major life event, such as a loss.

What is the Treatment?

Sadly there isn’t one!

The “treatment” for Myalgic Encephalomyelitis, which is its fancy (very pompous) medical name, is symptom management and understanding the condition to allow for a more tailored approach to symptom management as opposed to treatment.

Despite this, however, interesting revelations that have been… revealed. In individuals with CFS, everyone’s favourite powerhouse of the cell, the mitochondria, is somewhat dysfunctional in patients with CFS.

Here is a link to the study if you want to read it - https://pmc.ncbi.nlm.nih.gov/articles/PMC2680051/ - but I’m going to do my best to try to summarise it here.

Basically, what this research paper states is that for those who have CFS, the powerhouse of the cell mitochondria does not correctly regulate the energy levels in the cell, leading to the symptoms found in those patients with CFS; fatigue, dizziness, nausea, weakness, etc.

The Science!

This energy is called adenosine triphosphate (ATP), which is produced by the mitochondria and is the basis of all energy in the body. This energy is produced by recycling another factor in this equation, adenosine diphosphate (ADP), to help create that energy ATP more reliably. It is this process in those with CFS which is said to be dysfunctional, with some patients having healthy levels of both types of energy and others not.

These types of dysfunction on a cellular level are hypothesised to take place across all levels of the body in those with CFS, from immune cells and thyroid cells - hence a poor immune system in patients with CFS - to muscular-skeletal cells, and all the other cells involved in the functioning of the human body, which ultimately contributes to a more widespread ‘orthostatic intolerance’ (an intolerance to being in any position other than lying down) which is also found in CFS patients.

The Practicalities

Taking this into account, let’s look at the practicalities. In my body, for example, my mitochondria might make too little energy, leading to fatigue, or it might make too much and not know what to do with it, which then causes my body to fatigue and cause a whole other range of other symptoms one with the condition may feel.

In simpler terms, the powerhouse glitches and is unable to regulate its energy output.

It is because of this failure of a fundamental system in the body that no amount of rest will “fix” the fatigue. If you charge a phone when the actual battery itself is broken, will it charge?

Day-to-Day Life

So other than seemingly complaining about my ailments 24/7, how does my life look at 24 with three chronic illnesses? Well, in all honesty, it is really difficult and isolating.

Most days, the simplest of tasks cause me extreme fatigue. Washing, cooking, getting dressed are all things that have to be carefully planned and paced so I don’t overdo it. If I do, I pay for it for the next few days or weeks in what we call a CFS “crash”. Oh, and don’t get me started on how I manage and tell the difference between a POTS crash and a CFS crash; the two conditions are like peas in a pod at this point - it’s all hands on deck throwing everything at it until something sticks and grants me some relief!

And a bad day? Well, quite simply, I cannot get out of bed. Talking is exhausting, eating is exhausting; I cannot think straight or do anything other than sleep, and as we established earlier, even this doesn’t grant me any relief. On days like this, looking after my mental health is so important.

Having these illnesses and the way they have affected my life has been one of the most difficult things myself and my family have ever had to deal with.

The Real Takeaway

The hardest part of being chronically ill isn’t the dizziness, the constant fatigue, or nausea — it’s feeling invisible; being isolated from your peers because no one can relate to what’s going on inside your body or how you feel, or because you look “too well” to be chronically ill. That’s why awareness matters so much. Posts like this help me process what’s happening, but they also hopefully help others recognise these conditions for what they are.

I’m trying to accept who I am now, conditions and all. It’s not easy, but I’m so lucky to have a great support network between my family, amazing partner, and therapist, that I’m sure I will get there one day. And if sharing this helps one more person feel seen or supported — that’s a win.

Plus, I am pretty sure my therapist would say this counts as “healthy self-expression,” so two wins, actually.

If you want to learn more about things you can do to help those who are chronically ill, check out this link to a post all about it!