TL;DR: POTS (postural orthostatic tachycardia syndrome) is a condition where your heart rate jumps abnormally high when you stand up, because your body struggles to regulate blood flow against gravity. The main symptoms are dizziness or lightheadedness on standing, a racing or pounding heart, fainting or near-fainting, crushing fatigue, brain fog, shakiness, and trouble tolerating heat. It is a real, physical condition of the autonomic nervous system, and it can be genuinely disabling even though people often look fine.
POTS is one of those conditions that sounds almost unbelievable until you live with it, which is why so many people in the community say things like "why does this illness sound so fake?" It is not fake. Here is an honest picture of what POTS actually feels like, checked against Dysautonomia International, the NHS, Johns Hopkins and the Cleveland Clinic.
The core problem: standing up
The defining feature of POTS is what happens when you stand. In most people, the body automatically adjusts blood flow so your brain keeps getting enough. In POTS, that automatic system misfires, blood pools in the lower body, and the heart races to compensate, often by 30 beats per minute or more (40 in teens). That is why standing, showering, or even just being upright can feel like a workout.
Common symptoms
POTS affects far more than heart rate. Commonly reported symptoms include:
- Dizziness or lightheadedness, especially on standing
- A racing, pounding or fluttering heart (palpitations)
- Fainting or near-fainting (pre-syncope)
- Deep, persistent fatigue
- Brain fog and trouble concentrating
- Shakiness, sweating, or feeling cold and clammy
- Heat intolerance, with symptoms worse in summer or hot showers
- Nausea and digestive problems
- Headaches
- "Coat-hanger" pain across the neck and shoulders
Symptoms can change hour to hour and are often worse in the morning, after eating, in heat, or when unwell.
Why it is so exhausting
When your body has to work overtime just to keep you upright, everyday tasks cost far more energy than they should. That is why fatigue is one of the most disabling parts of POTS, and why pacing becomes essential. Many people describe feeling wiped out by things others do without thinking.
Who gets POTS?
It most often affects women and people assigned female at birth, frequently young, and it commonly begins after a viral illness, surgery, pregnancy, or a period of rapid growth. It also overlaps with conditions like ME/CFS and hypermobility. None of this means you caused it.
It is invisible, and that is hard
Because you can look completely well while your heart is racing and the room is spinning, POTS is often doubted, even by medical staff. The internal experience and the outward appearance do not match, which is exhausting in its own right. Your symptoms are real even when no one can see them.
On the hard days, comfort and rest help. Cooling, compression, a little extra support like an ankle support brace when you are upright a lot, and a soft place to recover are what many people reach for, and our POTS comfort collection is built around exactly that. Comfort, never a cure.
Frequently asked questions
What are the main symptoms of POTS?
Dizziness or lightheadedness on standing, a racing heart, fainting or near-fainting, fatigue, brain fog, shakiness and heat intolerance, often changing through the day.
What does POTS feel like?
Many describe feeling like standing up is exhausting or makes the room spin, with a pounding heart, weakness and fog, as if the body is working far too hard just to stay upright.
Is POTS a serious condition?
It is a real autonomic nervous system disorder that can be genuinely disabling, affecting daily life, work and independence, even though it is not usually life-threatening.
What triggers POTS symptoms?
Standing, heat, hot showers, eating large meals, dehydration, illness and mornings commonly make symptoms worse.
Who gets POTS?
It most often affects young women, frequently starting after a viral illness, surgery, pregnancy or rapid growth, and overlaps with conditions like ME/CFS and hypermobility.
This article is general information, not medical advice, and is not intended to diagnose, treat, cure, or prevent any condition. Only a qualified clinician can diagnose POTS. Sources: Dysautonomia International, NHS, Johns Hopkins Medicine, Cleveland Clinic.
Written by the Soft Days team, a small brand built by a family that lives with chronic illness. Last updated June 2026.