{"id":2318,"date":"2026-08-25T21:58:24","date_gmt":"2026-08-25T19:58:24","guid":{"rendered":"https:\/\/equilibriumpsychotherapy.net\/?p=2318"},"modified":"2026-11-02T15:01:17","modified_gmt":"2026-11-02T14:01:17","slug":"hypermobility-and-the-nervous-system","status":"publish","type":"post","link":"https:\/\/equilibriumpsychotherapy.net\/hr\/hypermobility-and-the-nervous-system\/","title":{"rendered":"Hypermobility and the Nervous System"},"content":{"rendered":"\n<style>\n\/* The accent is a light-background device. 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brackets, italic and muted ---- *\/\n.eqp .ra-aside{font-style:italic;color:#6b6259}\n\n\/* ---- fun fact ---- *\/\n.ra-ff{display:grid;grid-template-columns:auto minmax(0,1fr);gap:4px 16px;align-items:start;background:#fff;border:1.5px dashed #ecd2ae;\n  border-radius:18px;padding:20px 24px}\n.ra-ff .mk{grid-row:1\/3;width:40px;height:40px;border-radius:50%;background:#fcf2e6;color:#95560b;display:flex;align-items:center;justify-content:center}\n.ra-ff .mk svg{width:22px;height:22px}\n.ra-ff .k{font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#95560b;margin:2px 0 4px}\n.ra-ff .t{font-size:clamp(14px,calc(10.2px + .62vw),18px);line-height:1.6;color:#2a2622;margin:0}\n@media(max-width:560px){.ra-ff{grid-template-columns:minmax(0,1fr);padding:18px}.ra-ff .mk{grid-row:auto;width:34px;height:34px}}\n\n\/* ---- the questions (part five): one card each, a berry question mark, the\n   answer on warm paper under a rule ---- 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.25s ease}\n.ra-faq .qb i{position:absolute;left:0;right:0;top:3px;text-align:center;font-style:normal;font-family:\"Playfair Display\",Georgia,serif;\n  font-size:23px;font-weight:800;line-height:1.3;color:#95560b;transform:rotate(-9deg)}\n.ra-faq .qb .x{display:none;color:#1d5f66;transform:rotate(6deg)}\n.ra-faq details[open] .qb path{fill:#e9f3f3;stroke:#bcd7d8}\n.ra-faq details[open] .qb .q{display:none}\n.ra-faq details[open] .qb .x{display:block}\n.ra-faq summary:hover .qb{animation:raWig .55s ease}\n@keyframes raWig{0%,100%{transform:rotate(0)}30%{transform:rotate(-9deg)}65%{transform:rotate(6deg)}}\n@media(prefers-reduced-motion:reduce){.ra-faq summary:hover .qb{animation:none}}\n.ra-faq summary .pl{width:30px;height:30px;border-radius:50%;border:1.5px solid #bcd7d8;color:#1d5f66;display:flex;align-items:center;justify-content:center;transition:transform .2s ease,background .2s ease}\n.ra-faq summary .pl svg{width:12px;height:12px}\n.ra-faq details[open] summary .pl{transform:rotate(45deg);background:#e9f3f3}\n.ra-faq .an{background:#faf8f3;border-top:1.5px solid #e8e1d5;padding:18px 24px 20px 74px}\n.ra-faq .an p{font-size:18.5px;line-height:1.66;color:#2a2622;margin:0 0 12px}\n.ra-faq .an p:last-child{margin-bottom:0}\n@media(max-width:560px){.ra-faq summary{gap:12px;padding:16px}.ra-faq .qb{width:38px;height:35px}.ra-faq .qb i{font-size:19px;top:2px}.ra-faq .an{padding:16px}.ra-faq .an p{font-size:17.5px}}\n.ra-faq .all{display:flex;justify-content:flex-end;margin:0 0 2px}\n.ra-faq .all button{font:600 14.5px\/1.2 \"Work Sans\",sans-serif;border:0;background:none;color:#1d5f66;cursor:pointer;text-decoration:underline;text-underline-offset:3px;padding:6px 4px}\n\n\/* ---- when to talk to a doctor: tiles, one small icon each ---- *\/\n.ra-dr{background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:22px;padding:26px 28px;margin:4px 0 32px}\n.ra-dr .k{font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66;margin:0 0 16px}\n.ra-dr ul{list-style:none;margin:0;padding:0;display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:10px}\n@media(max-width:640px){.ra-dr ul{grid-template-columns:minmax(0,1fr)}.ra-dr{padding:20px 16px}}\n.ra-dr li{display:grid;grid-template-columns:auto minmax(0,1fr);gap:12px;align-items:center;background:#fff;border:1.5px solid #e8e1d5;border-radius:14px;\n  padding:14px 16px;margin:0;font-size:17px;line-height:1.45;color:#2a2622}\n.ra-dr li .i{width:36px;height:36px;border-radius:10px;background:#e9f3f3;color:#1d5f66;display:flex;align-items:center;justify-content:center}\n.ra-dr li .i svg{width:20px;height:20px}\n\n\n\/* ---- Hypermobility and the Nervous System: this post's own sheet ----\n   Palette: the post's own teal family carries headings, labels, part numerals,\n   figure titles and every figure state; a vivid amber, taken from the amber\n   the live post already used for its caveat labels, carries bold, italics and\n   links. Grounds stay warm neutral. No red, no green: nothing in a figure is\n   coded as good or bad by hue.\n\n   Redrawn in the sweep of 24 Sep 2026. One vocabulary for every figure:\n     structure hairlines 1.5px  #e8e1d5 (warm) or #d9e7e6 (cool)\n     drawn marks         1.75px icons, 2.4px pictograms, currentColor\n     data strokes        3.5px  #1d5f66\n     states              #1d5f66 fill, #e9f3f3 tint, #bcd7d8 light line\n   Icon badges are 44px circles, tinted #e9f3f3, icon in #1d5f66. *\/\n\n\/* the part numeral takes the cool hue, as in the house distribution *\/\n.ov-part .no{color:#e9f3f3;-webkit-text-stroke:1.5px #1d5f66}\n.ov-part h2{color:#00373e}\n\n\/* Gutenberg padding is inline at one value, so on a phone the panels left 159px of measure *\/\n@media(max-width:620px){.eqp .wp-block-group.has-background{padding:26px 22px!important}}\n@media(max-width:420px){.eqp .wp-block-group.has-background{padding:22px 18px!important}}\n\/* the subtitle under the title: a small tracked label, not a second headline *\/\n.eqp .eq-subtitle{text-transform:uppercase}\n\n\/* ---- citation markers and the numbered reference list (sweep, 24 Sep 2026) ---- *\/\n.eqp sup.eq-cite{font-size:12px;line-height:0;vertical-align:super;position:relative;top:-.05em;font-weight:600;font-style:normal;\n  letter-spacing:.02em;color:#1d5f66;margin-left:1px;white-space:nowrap;font-variant-numeric:lining-nums}\n.eqp sup.eq-cite a{color:#1d5f66!important;text-decoration:none!important;border:0!important;box-shadow:none!important;padding:0 1px}\n.eqp sup.eq-cite a:hover{text-decoration:underline!important;text-underline-offset:2px}\n.eqp sup.eq-cite a:focus-visible{outline:2px solid #1d5f66;outline-offset:1px;border-radius:2px}\n.eqp .eq-ondark sup.eq-cite,.eqp .eq-ondark sup.eq-cite a{color:#bcd7d8!important}\n.eqp .eq-refs li{margin:0 0 8px;padding-left:6px;scroll-margin-top:120px;border-radius:6px;transition:background .3s ease}\n.eqp .eq-refs li::marker{color:#6b6259;font-variant-numeric:tabular-nums}\n.eqp .eq-refs li:target{background:#e9f3f3;box-shadow:0 0 0 5px #e9f3f3}\n.eqp .eq-refs a{word-break:break-word}\n\n\/* ---- the short version: a heading, then one numbered finding per part ----\n   The evidence panel's ground (mist, cool hairline) stays; inside it, a real\n   heading and nine rows, three across on a laptop, two on a tablet, one on\n   a phone. The numeral is the part number, drawn like the part heads, and\n   it links to that part. The lead phrase is the row's one bold. *\/\n.hm-sv .top{display:flex;align-items:flex-end;justify-content:space-between;gap:8px 24px;flex-wrap:wrap;margin:0 0 20px;padding:0 0 18px;border-bottom:1.5px solid #d9e7e6}\n.hm-sv .k{font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66;margin:0 0 8px}\n.hm-sv .h{font-family:\"Work Sans\",sans-serif;font-size:clamp(22px,2.5vw,27px);font-weight:700;line-height:1.2;color:#00373e;margin:0}\n.hm-sv .sub{font-size:14.5px;line-height:1.4;color:#6b6259;margin:0 0 2px}\n.hm-sv .rows{list-style:none;margin:0;padding:0;display:grid;grid-template-columns:repeat(3,minmax(0,1fr));column-gap:34px}\n.hm-sv .rows li{display:grid;grid-template-columns:46px minmax(0,1fr);column-gap:12px;align-items:start;margin:0;padding:18px 0 20px;border-top:1px solid #d9e7e6}\n.hm-sv .rows li:nth-child(-n+3){border-top:0;padding-top:4px}\n.hm-sv a.n{display:block;font-family:\"Playfair Display\",Georgia,serif;font-weight:800;font-size:34px;line-height:1;color:#f1f6f6!important;\n  -webkit-text-stroke:1.3px #1d5f66;text-decoration:none!important;font-variant-numeric:lining-nums tabular-nums;padding-top:1px;transition:color .2s ease}\n.hm-sv a.n:hover{color:#bcd7d8!important}\n.hm-sv a.n:focus-visible{outline:2px solid #1d5f66;outline-offset:3px;border-radius:3px}\n.hm-sv .rows p{margin:0;font-size:16.5px;line-height:1.6;color:#2a2622}\n.hm-sv .rows strong{display:block;color:#95560b;font-weight:700;line-height:1.38;margin:0 0 4px}\n@media(max-width:980px){\n  .hm-sv .rows{grid-template-columns:repeat(2,minmax(0,1fr));column-gap:28px}\n  .hm-sv .rows li:nth-child(-n+3){border-top:1px solid #d9e7e6;padding-top:18px}\n  .hm-sv .rows li:nth-child(-n+2){border-top:0;padding-top:4px}\n}\n@media(max-width:640px){\n  .hm-sv .rows{grid-template-columns:minmax(0,1fr)}\n  .hm-sv .rows li:nth-child(-n+2){border-top:1px solid #d9e7e6;padding-top:16px}\n  .hm-sv .rows li:first-child{border-top:0;padding-top:2px}\n  .hm-sv .rows li{grid-template-columns:38px minmax(0,1fr);column-gap:10px;padding:16px 0 17px}\n  .hm-sv a.n{font-size:29px}\n  .hm-sv .rows p{font-size:16px}\n}\n\n\/* ---- a set is not a list: short unranked items become lowercase chips ---- *\/\n.eqp .hm-chips{list-style:none;margin:0 0 30px;padding:0;display:flex;flex-wrap:wrap;gap:8px}\n.eqp .hm-chips li{margin:0;font:500 16px\/1.3 \"Work Sans\",sans-serif;color:#2a2622;background:#faf8f3;\n  border:1.5px solid #e8e1d5;border-radius:999px;padding:8px 15px}\n.eqp .hm-chips.open li{background:#fff;border-style:dashed;border-color:#bcd7d8;color:#00373e}\n\n\/* ---- the one chain the article proposes and then takes apart ---- *\/\n.eqp .hm-chain{display:flex;flex-wrap:wrap;align-items:center;gap:8px 10px;margin:4px 0 30px;padding:18px 20px;\n  background:#faf8f3;border:1.5px dashed #e8e1d5;border-radius:16px}\n.eqp .hm-chain span{font:600 16.5px\/1.3 \"Work Sans\",sans-serif;color:#00373e;background:#fff;border:1.5px solid #e8e1d5;\n  border-radius:10px;padding:8px 13px}\n.eqp .hm-chain i{font-style:normal;color:#8a8076;font-size:1.125rem}\n\n\/* ---- the what-helps boxes: a sentence-case lead, then the steps ---- *\/\n.eqp .hm-lead{font-family:\"Work Sans\",sans-serif;font-size:17px;font-weight:700;line-height:1.4;color:#6e3f10;margin:0 0 12px}\n\n\/* ---- shared figure marks ---- *\/\n.eqp .ra-fig .ic{display:block;width:24px;height:24px;flex:0 0 auto}\n\n\/* ---- figure 1: three names, on one spectrum ---- *\/\n.hm-sp .st{list-style:none;margin:6px 0 0;padding:0;display:grid;grid-template-columns:repeat(3,minmax(0,1fr));gap:16px;position:relative}\n.hm-sp .st::before{content:\"\";position:absolute;left:16.6%;right:16.6%;top:27px;height:3px;border-radius:3px;background:linear-gradient(90deg,#bcd7d8 0%,#6f9ea2 50%,#1d5f66 100%)}\n.hm-sp .s{margin:0;display:flex;flex-direction:column;align-items:center;position:relative}\n.hm-sp .node{position:relative;z-index:1;flex:0 0 auto;width:56px;height:56px;border-radius:50%;display:flex;align-items:center;justify-content:center;\n  background:#fff;border:2px solid #bcd7d8;color:#1d5f66;box-shadow:0 0 0 6px #fff}\n.hm-sp .node .ic{width:27px;height:27px}\n.hm-sp .s2 .node{background:#e9f3f3;border-color:#6f9ea2}\n.hm-sp .s3 .node{background:#1d5f66;border-color:#1d5f66;color:#fff}\n.hm-sp .card{align-self:stretch;flex:1 1 auto;margin:16px 0 0;border:1.5px solid #e8e1d5;border-radius:16px;padding:18px 18px 20px;background:#fff;position:relative}\n.hm-sp .card::before{content:\"\";position:absolute;left:50%;top:-8px;width:13px;height:13px;margin-left:-7px;background:inherit;border-left:1.5px solid;border-top:1.5px solid;border-color:inherit;transform:rotate(45deg)}\n.hm-sp .s2 .card{background:#f1f6f6;border-color:#d9e7e6}\n.hm-sp .s3 .card{background:#e9f3f3;border-color:#bcd7d8}\n.hm-sp .k{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259;margin:0 0 10px}\n.hm-sp .ab{font:800 30px\/1 \"Playfair Display\",Georgia,serif;color:#1d5f66;margin:0 0 8px}\n.hm-sp .nm{font-size:17px;font-weight:600;line-height:1.3;color:#2a2622;margin:0 0 8px}\n.hm-sp .d{font-size:15px;line-height:1.55;color:#4a433c;margin:0}\n.hm-sp .ends{display:flex;justify-content:space-between;gap:16px;margin:14px 0 0;font-size:12px;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#6b6259}\n.hm-sp .ends span:first-child::before{content:\"\u2190\";display:inline-block;margin-right:8px;color:#6f9ea2}\n.hm-sp .ends span:last-child{text-align:right}\n.hm-sp .ends span:last-child::after{content:\"\u2192\";display:inline-block;margin-left:8px;color:#1d5f66}\n@media(max-width:720px){\n  .hm-sp .st{grid-template-columns:minmax(0,1fr);gap:14px}\n  .hm-sp .st::before{left:26.5px;right:auto;top:28px;bottom:28px;width:3px;height:auto;background:linear-gradient(180deg,#bcd7d8 0%,#6f9ea2 50%,#1d5f66 100%)}\n  .hm-sp .s{flex-direction:row;align-items:flex-start;gap:14px}\n  .hm-sp .card{margin:0}\n  .hm-sp .card::before{left:-8px;top:21px;margin-left:0;transform:rotate(-45deg)}\n  .hm-sp .ends{display:none}\n}\n\n\/* ---- figure 2: the Beighton score ---- *\/\n.eqp .bgt .hint{font-size:15.5px;line-height:1.6;color:#4a433c;margin:0 0 20px}\n.eqp .bgt .mv{list-style:none;margin:0;padding:0}\n.eqp .bgt .mv li{display:flex;gap:12px 18px;align-items:center;flex-wrap:wrap;padding:14px 0;border-top:1px solid #e8e1d5;margin:0}\n.eqp .bgt .mv li:first-child{border-top:0;padding-top:0}\n.eqp .bgt .pic{flex:0 0 auto;width:64px;height:64px;border-radius:14px;background:#f1f6f6;border:1.5px solid #d9e7e6;color:#1d5f66;display:flex;align-items:center;justify-content:center}\n.eqp .bgt .pic svg{width:54px;height:54px;display:block}\n.eqp .bgt .pic .rf{stroke:#9fc2c4;stroke-width:2;stroke-dasharray:3 3.5}\n.eqp .bgt .pic .ar{stroke:#6f9ea2;stroke-width:1.6}\n.eqp .bgt .pic .fl{stroke:#bcd7d8}\n.eqp .bgt .pic .fl{stroke-width:2}\n.eqp .bgt .pic .jt{fill:#fff;stroke:#1d5f66;stroke-width:2.2}\n.eqp .bgt .pic .tp{fill:#6f9ea2;stroke:none}\n.eqp .bgt .pic .hd{fill:#1d5f66;stroke:none}\n.eqp .bgt .mq{font-size:17px;line-height:1.45;color:#2a2622;margin:0;flex:1 1 280px;min-width:0}\n.eqp .bgt .sd{display:flex;gap:9px;flex:0 0 auto;margin-left:auto}\n.eqp .bgt .sd label{position:relative;display:inline-flex;flex:0 0 auto}\n.eqp .bgt .sd label span{display:inline-flex;align-items:center;justify-content:center;width:100%;box-sizing:border-box;min-width:74px;\n  font:600 14.5px\/1.2 \"Work Sans\",sans-serif;color:#6b6259;padding:10px 16px;border:1.5px solid #e8e1d5;border-radius:999px;background:#fff;cursor:pointer;\n  transition:background .14s ease,color .14s ease,border-color .14s ease}\n.eqp .bgt input{position:absolute;opacity:0;width:100%;height:100%;left:0;top:0;margin:0;cursor:pointer;z-index:1}\n.eqp .bgt .sd input:checked + span{background:#1d5f66;border-color:#1d5f66;color:#fff}\n.eqp .bgt input:focus-visible + span{outline:2px solid #1d5f66;outline-offset:3px}\n.eqp .bgt .age{border:0;padding:0;margin:22px 0 0;display:flex;gap:12px 18px;align-items:center;flex-wrap:wrap}\n.eqp .bgt .age legend{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259;padding:0;float:left;width:100%;margin:0 0 9px}\n.eqp .bgt .seg{display:inline-flex;flex-wrap:wrap;gap:4px;padding:4px;background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:999px}\n.eqp .bgt .seg label{position:relative;display:inline-flex}\n.eqp .bgt .seg label span{display:inline-flex;align-items:center;font:600 14.5px\/1.2 \"Work Sans\",sans-serif;color:#6b6259;padding:8px 16px;border-radius:999px;cursor:pointer}\n.eqp .bgt .seg input:checked + 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.tl{display:grid;grid-template-columns:repeat(9,minmax(0,1fr));gap:6px;max-width:360px;margin:7px 0 0;visibility:hidden;height:16px}\n.eqp .bgt .tl.vis{visibility:visible}\n.eqp .bgt .tl span{justify-self:center;font-size:12px;font-weight:700;letter-spacing:.1em;text-transform:uppercase;color:#6f9ea2;white-space:nowrap;line-height:16px}\n.eqp .bgt .rd{font-size:15.5px;line-height:1.6;color:#2a2622;margin:10px 0 0}\n.eqp .bgt .foot{display:flex;gap:10px;flex-wrap:wrap;margin:16px 0 0}\n.eqp .bgt .foot button{font:600 14px\/1.2 \"Work Sans\",sans-serif;cursor:pointer;padding:9px 16px;border-radius:999px;border:1.5px solid #e8e1d5;background:#fff;color:#6b6259}\n.eqp .bgt .foot .pdf{border-color:#1d5f66;color:#1d5f66}\n.eqp .bgt .foot button:hover{border-color:#1d5f66;color:#1d5f66}\n@media(max-width:640px){\n  .eqp .bgt .mv li{align-items:flex-start;flex-wrap:wrap}\n  .eqp .bgt .pic{width:56px;height:56px}\n  .eqp .bgt .pic svg{width:47px;height:47px}\n  .eqp .bgt .mq{flex:1 1 0;min-width:0;align-self:center}\n  .eqp .bgt .sd{width:100%;margin-left:0}\n  .eqp .bgt .sd label{flex:1 1 0;min-width:0}\n  .eqp .bgt .sd label span{min-width:0;min-height:44px}\n  .eqp .bgt .sc b{font-size:46px}\n  .eqp .bgt .dots i{width:20px;height:20px}\n}\n@media print{.eqp .bgt .foot{display:none}}\n.bgt-sheet{display:none}\n@media print{\nhtml.bgt-printing body>*{display:none!important}\nhtml.bgt-printing .bgt-sheet{display:block!important;margin:0;padding:0;color:#17120f;font-family:\"Work Sans\",sans-serif}\n.bgt-sheet h1{font-family:\"Playfair Display\",Georgia,serif;font-size:25px;font-weight:800;margin:0 0 3px}\n.bgt-sheet .dt{font-size:10.5px;letter-spacing:.13em;text-transform:uppercase;color:#6b6259;margin:0 0 22px}\n.bgt-sheet .hd{display:flex;gap:14px;align-items:baseline;margin:0 0 12px}\n.bgt-sheet .big{font-family:\"Playfair Display\",Georgia,serif;font-size:52px;line-height:1;font-weight:700;color:#1d5f66;margin:0}\n.bgt-sheet .of{font-size:11px;letter-spacing:.12em;text-transform:uppercase;font-weight:700;color:#6b6259;margin:0}\n.bgt-sheet .th{font-size:12.5px;color:#6b6259;margin:0 0 12px}\n.bgt-sheet .rd{font-size:13.5px;line-height:1.55;margin:0 0 22px;max-width:74ch}\n.bgt-sheet h2{font-family:\"Work Sans\",sans-serif;font-size:11px;letter-spacing:.14em;text-transform:uppercase;font-weight:700;color:#6b6259;margin:0 0 8px}\n.bgt-sheet ul{margin:0 0 22px;padding:0 0 0 17px;font-size:12.5px;line-height:1.7}\n.bgt-sheet .none{font-size:12px;font-style:italic;color:#6b6259;margin:0 0 22px}\n.bgt-sheet .cv{font-size:11.5px;line-height:1.55;color:#3a3530;border-top:1px solid #c9bfae;padding:13px 0 0;margin:0 0 16px;max-width:80ch}\n.bgt-sheet .cv b{color:#1d5f66;font-weight:700}\n.bgt-sheet .ft{font-size:10px;color:#6b6259;margin:0}\n}\n\n\/* ---- figure 3: which of these do you recognize ---- *\/\n.hm-sm .sys{display:grid;grid-template-columns:repeat(2,minmax(0,1fr));gap:12px}\n.hm-sm .grp{border:1.5px solid #e8e1d5;border-radius:16px;padding:16px 18px 18px;background:#fff;transition:border-color .2s ease,background .2s ease}\n.hm-sm .grp.on{border-color:#bcd7d8;background:#f1f6f6}\n.hm-sm .gh{display:flex;align-items:center;gap:12px;margin:0 0 14px}\n.hm-sm .gi{flex:0 0 auto;width:40px;height:40px;border-radius:50%;background:#e9f3f3;color:#1d5f66;display:flex;align-items:center;justify-content:center;transition:background .2s ease,color .2s ease}\n.hm-sm .gi .ic{width:22px;height:22px}\n.hm-sm .grp.on .gi{background:#1d5f66;color:#fff}\n.hm-sm .gn{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#00373e;margin:0;flex:1 1 auto;min-width:0}\n.hm-sm .gp{font-size:13px;color:#6b6259;margin:0;white-space:nowrap}\n.hm-sm .chips{display:flex;flex-wrap:wrap;gap:8px}\n.hm-sm .chips button{font:500 15px\/1.3 \"Work Sans\",sans-serif;border:1.5px solid #e8e1d5;background:#fff;color:#2a2622;border-radius:999px;\n  padding:8px 14px;cursor:pointer;text-align:left;transition:border-color .18s ease,background .18s ease,color .18s ease}\n.hm-sm .chips button:hover{border-color:#bcd7d8}\n.hm-sm .chips button[aria-pressed=true]{background:#1d5f66;border-color:#1d5f66;color:#fff}\n.hm-sm .out{margin:18px 0 0;padding:18px 20px;border-radius:16px;background:#faf8f3;border:1.5px solid #e8e1d5;display:grid;grid-template-columns:minmax(0,210px) minmax(0,1fr);gap:14px 26px;align-items:start}\n.hm-sm .ml{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259;margin:0 0 9px}\n.hm-sm .seg6{display:grid;grid-template-columns:repeat(6,minmax(0,1fr));gap:5px}\n.hm-sm .seg6 i{display:block;height:12px;border-radius:999px;background:#fff;border:1.5px solid #d9e7e6;transition:background .25s ease,border-color .25s ease}\n.hm-sm .seg6 i.on{background:#1d5f66;border-color:#1d5f66}\n.hm-sm .msg p{margin:0;font-size:16px;line-height:1.6;color:#2a2622}\n.hm-sm .msg b{color:#00373e}\n.hm-sm .where{list-style:none;margin:10px 0 0;padding:0;display:flex;flex-wrap:wrap;gap:8px}\n.hm-sm .where li{margin:0}\n.hm-sm .where a{display:inline-block;font:600 14.5px\/1.3 \"Work Sans\",sans-serif;color:#1d5f66;background:#fff;border:1.5px solid #bcd7d8;border-radius:999px;\n  padding:7px 14px;text-decoration:none}\n.hm-sm .where a:hover{background:#e9f3f3}\n.hm-sm .ft{display:flex;justify-content:space-between;align-items:flex-start;gap:14px;flex-wrap:wrap;margin:14px 0 0}\n.hm-sm .nd{font-size:14.5px;line-height:1.55;color:#4a433c;margin:0;flex:1 1 300px}\n.hm-sm .nd b{color:#2a2622}\n.hm-sm .clr{font:600 14px\/1.2 \"Work Sans\",sans-serif;cursor:pointer;padding:9px 16px;border-radius:999px;border:1.5px solid #e8e1d5;background:#fff;color:#6b6259}\n.hm-sm .clr:hover{border-color:#1d5f66;color:#1d5f66}\n@media(max-width:720px){.hm-sm .sys{grid-template-columns:minmax(0,1fr)}.hm-sm .out{grid-template-columns:minmax(0,1fr)}}\n\n\/* ---- figure 4: standing up ---- *\/\n.hm-st .ctl{margin:0 0 18px}\n.hm-st .lay{display:grid;grid-template-columns:minmax(0,1.25fr) minmax(0,1fr);gap:30px;align-items:start}\n.hm-st .plot{position:relative;padding:30px 0 0}\n.hm-st .yl{position:absolute;left:0;top:0;margin:0;display:flex;align-items:center;gap:7px;font-size:12px;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#6b6259}\n.hm-st .yl .ic{width:18px;height:18px;color:#1d5f66}\n.hm-st .cv{position:relative;height:200px}\n.hm-st .cv svg{display:block;width:100%;height:100%;overflow:visible}\n.hm-st .cv path{vector-effect:non-scaling-stroke;transition:stroke .3s ease,stroke-width .3s ease,opacity .3s ease,fill-opacity .3s ease}\n.hm-st .cv .bd{fill:none;stroke:#e8e1d5;stroke-width:1.5}\n.hm-st .cv .gl{fill:none;stroke:#f0ebe2;stroke-width:1.5;stroke-dasharray:2 6}\n.hm-st .cv .mk{fill:none;stroke:#c9bfae;stroke-width:1.5;stroke-dasharray:4 5}\n.hm-st .cv .au,.hm-st .cv .ap{fill:#e9f3f3;fill-opacity:0;stroke:none}\n.hm-st[data-s=u] .cv .au,.hm-st[data-s=p] .cv .ap{fill-opacity:.85}\n.hm-st .cv .pu,.hm-st .cv .pp{fill:none;stroke:#cfc7ba;stroke-width:2;stroke-dasharray:6 6;opacity:.9}\n.hm-st[data-s=u] .cv .pu,.hm-st[data-s=p] .cv .pp{stroke:#1d5f66;stroke-width:3.5;stroke-dasharray:none;opacity:1}\n.hm-st .tg{position:absolute;right:0;margin:0;font-size:13px;font-weight:600;padding:3px 10px;border-radius:999px;background:#fff;border:1.5px solid #e8e1d5;color:#6b6259;\n  transition:color .3s ease,border-color .3s ease,background .3s ease}\n.hm-st .tg.u{top:calc(200px * .659 - 34px)}\n.hm-st .tg.p{top:calc(200px * .273 - 34px)}\n.hm-st[data-s=u] .tg.u,.hm-st[data-s=p] .tg.p{color:#fff;border-color:#1d5f66;background:#1d5f66}\n.hm-st .xl{position:relative;height:44px;margin:8px 0 0}\n.hm-st .xl p{position:absolute;top:0;margin:0;display:flex;align-items:center;gap:5px;font-size:12.5px;color:#6b6259;white-space:nowrap}\n.hm-st .xl .ic{width:20px;height:20px;color:#1d5f66}\n.hm-st .xl .a{left:0}\n.hm-st .xl .b{left:30%;transform:translateX(-12px);font-weight:600;color:#2a2622}\n.hm-st .xl .c{right:0}\n.hm-st .steps{list-style:none;margin:0;padding:0;display:grid;gap:10px}\n.hm-st .steps li{display:grid;grid-template-columns:40px minmax(0,1fr);gap:12px;align-items:center;margin:0;font-size:16px;line-height:1.5;color:#2a2622}\n.hm-st .si{width:40px;height:40px;border-radius:50%;background:#e9f3f3;color:#1d5f66;display:flex;align-items:center;justify-content:center}\n.hm-st .si .ic{width:22px;height:22px}\n.hm-st .steps li.last{padding:12px 14px 12px 12px;border-radius:16px;background:#f1f6f6;border:1.5px solid #d9e7e6;transition:background .3s ease,border-color .3s ease}\n.hm-st .steps li.last .si{background:#fff}\n.hm-st[data-s=p] .steps li.last{background:#e9f3f3;border-color:#1d5f66}\n.hm-st[data-s=p] .steps li.last .si{background:#1d5f66;color:#fff}\n.hm-st .steps b{color:#00373e}\n@media(max-width:760px){\n  .hm-st .lay{grid-template-columns:minmax(0,1fr);gap:16px}\n  .hm-st .cv{height:170px}\n  .hm-st .tg.u{top:calc(170px * .659 - 34px)}\n  .hm-st .tg.p{top:calc(170px * .273 - 34px)}\n}\n@media(max-width:420px){.hm-st .xl .c{display:none}}\n\n\/* ---- figure 5: the overlap, two spans on one scale ---- *\/\n.hm-rg .plot{position:relative;padding:4px 0 0}\n.hm-rg .grid{position:absolute;left:0;right:0;top:0;bottom:24px;pointer-events:none}\n.hm-rg .grid i{position:absolute;top:0;bottom:0;width:0;border-left:1.5px dashed #ece6dc}\n.hm-rg .rw{position:relative;margin:0 0 30px}\n.hm-rg .rw + .rw{margin-top:8px}\n@media(max-width:560px){.hm-rg .rw{margin-bottom:34px}.hm-rg .rw + .rw{margin-top:14px}.hm-rg .bl{font-size:15px}}\n.hm-rg .bl{position:relative;display:inline-block;font-size:15.5px;font-weight:600;color:#2a2622;margin:0 0 12px;background:#fff;padding-right:10px}\n.hm-rg .tr{position:relative;height:18px}\n.hm-rg .tr::before{content:\"\";position:absolute;left:0;right:0;top:8px;height:2px;background:#e8e1d5;border-radius:2px}\n.hm-rg .rb{position:absolute;top:6px;height:6px;border-radius:6px;background:#1d5f66}\n.hm-rg .e{position:absolute;top:0;width:18px;height:18px;margin-left:-9px;border-radius:50%;background:#fff;border:3.5px solid #1d5f66;box-sizing:border-box}\n.hm-rg .v{position:absolute;top:24px;transform:translateX(-50%);font-size:14px;font-weight:700;color:#00373e;white-space:nowrap;font-variant-numeric:tabular-nums}\n.hm-rg .ax{position:relative;height:24px;border-top:1.5px solid #e8e1d5;margin:4px 0 0}\n.hm-rg .ax span{position:absolute;top:6px;transform:translateX(-50%);font-size:12px;color:#6b6259}\n.hm-rg .ax span:first-child{transform:none}\n.hm-rg .ax span:last-child{transform:translateX(-100%)}\n.hm-rg .key{display:flex;flex-wrap:wrap;align-items:center;gap:6px 8px;margin:14px 0 0;font-size:13px;color:#6b6259}\n.hm-rg .key span{display:inline-block;flex:0 0 auto}\n.hm-rg .key .k1{width:13px;height:13px;border-radius:50%;border:3px solid #1d5f66;box-sizing:border-box;background:#fff;margin-left:8px}\n.hm-rg .key .k1:first-child{margin-left:0}\n.hm-rg .key .k2{width:26px;height:6px;border-radius:6px;background:#1d5f66;margin-left:8px}\n\n\/* ---- figure 6: the loop, drawn as a loop ---- *\/\n.hm-lp .lay{display:grid;grid-template-columns:minmax(0,1fr) minmax(0,1fr);gap:30px;align-items:center}\n.hm-lp .ringbox{position:relative;width:100%;max-width:440px;aspect-ratio:1\/1;margin:0 auto}\n.hm-lp .rg{position:absolute;inset:7%;width:86%;height:86%;overflow:visible}\n.hm-lp .rg .trk{fill:#f1f6f6;stroke:#d9e7e6;stroke-width:1.5;vector-effect:non-scaling-stroke}\n.hm-lp .rg .arc{fill:none;stroke:#8fb6b9;stroke-width:2.5;stroke-linecap:round;vector-effect:non-scaling-stroke;transition:stroke .25s ease}\n.hm-lp .rg .arc.on{stroke:#1d5f66;stroke-width:3.5}\n.hm-lp .nodes{list-style:none;margin:0;padding:0;position:absolute;inset:7%}\n.hm-lp .nodes li{position:absolute;transform:translate(-50%,-50%);margin:0;width:max-content;max-width:31%;display:flex;align-items:center;gap:7px;\n  font:600 14px\/1.25 \"Work Sans\",sans-serif;color:#2a2622;background:#fff;border:1.5px solid #bcd7d8;border-radius:999px;padding:6px 12px 6px 6px;\n  box-shadow:0 2px 0 rgba(0,55,62,.05);transition:background .25s ease,border-color .25s ease,color .25s ease}\n.hm-lp .nodes li b{flex:0 0 auto;width:24px;height:24px;border-radius:50%;background:#e9f3f3;color:#00373e;font:700 12.5px\/24px \"Work Sans\",sans-serif;text-align:center}\n.hm-lp .nodes li.on{background:#1d5f66;border-color:#1d5f66;color:#fff}\n.hm-lp .nodes li.on b{background:#fff;color:#00373e}\n.hm-lp .core{position:absolute;left:50%;top:50%;transform:translate(-50%,-50%);display:flex;flex-direction:column;align-items:center;gap:4px}\n.hm-lp .hb{display:block;width:54px;height:54px;color:#1d5f66;transition:transform .5s cubic-bezier(.2,.7,.2,1)}\n.hm-lp .hb .ic{width:54px;height:54px}\n.hm-lp .hb .ic path{fill:#e9f3f3;stroke-width:1.5}\n.hm-lp .lp{margin:6px 0 0;font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259}\n.hm-lp .ring{list-style:none;margin:0;padding:0;display:grid;gap:6px}\n.hm-lp .ring li{display:grid;grid-template-columns:28px minmax(0,1fr);column-gap:12px;margin:0;padding:9px 12px;border-radius:14px;border:1.5px solid transparent;transition:background .25s ease,border-color .25s ease}\n.hm-lp .ring li.on{background:#f1f6f6;border-color:#d9e7e6}\n.hm-lp .ring .n{width:28px;height:28px;border-radius:50%;background:#e9f3f3;color:#00373e;font:700 13px\/28px \"Work Sans\",sans-serif;text-align:center;margin:0}\n.hm-lp .ring li.on .n{background:#1d5f66;color:#fff}\n.hm-lp .ring .nm{font-size:15.5px;font-weight:600;line-height:1.3;color:#2a2622;margin:3px 0 2px}\n.hm-lp .ring .tx{font-size:14px;line-height:1.5;color:#4a433c;margin:0}\n.hm-lp .mt{margin:16px 0 0}\n.hm-lp .ml{font-size:12px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259;margin:0 0 8px}\n.hm-lp .mtr{height:12px;border-radius:999px;background:#faf8f3;border:1.5px solid #e8e1d5;overflow:hidden}\n.hm-lp .mtr i{display:block;height:100%;width:12%;background:#1d5f66;border-radius:999px;transition:width .5s cubic-bezier(.2,.7,.2,1)}\n.hm-lp .st{margin:14px 0 0;font-size:15.5px;line-height:1.6;color:#2a2622;padding:12px 14px;border-radius:14px;background:#faf8f3;border:1.5px solid #e8e1d5}\n.hm-lp .st b{color:#00373e}\n.hm-lp .ctl{display:flex;flex-wrap:wrap;gap:10px;align-items:center;margin:16px 0 0}\n.hm-lp .ctl button{font:600 14.5px\/1.2 \"Work Sans\",sans-serif;cursor:pointer;padding:10px 18px;border-radius:999px;border:1.5px solid #1d5f66;background:#1d5f66;color:#fff}\n.hm-lp .ctl button.sec{background:#fff;color:#6b6259;border-color:#e8e1d5}\n@media(max-width:900px){.hm-lp .lay{grid-template-columns:minmax(0,1fr);gap:18px}}\n@media(max-width:520px){\n  .hm-lp .nodes li{font-size:12.5px;padding:4px 9px 4px 4px;gap:5px;max-width:34%;white-space:normal}\n  .hm-lp .nodes li b{width:20px;height:20px;line-height:20px;font-size:12px}\n  .hm-lp .hb,.hm-lp .hb .ic{width:40px;height:40px}\n}\n\n\/* ---- figure 7: one symptom at the center, its contributors around it ---- *\/\n.hm-ct .ctl{margin:0 0 10px}\n.hm-ct .map{position:relative;height:430px;margin:0}\n.hm-ct .ln{position:absolute;inset:0;width:100%;height:100%;overflow:visible}\n.hm-ct .ln path{fill:none;stroke:#bcd7d8;stroke-width:2;vector-effect:non-scaling-stroke}\n.hm-ct .core{position:absolute;left:50%;top:50%;transform:translate(-50%,-50%);width:170px;height:170px;border-radius:50%;background:#1d5f66;color:#fff;\n  display:flex;flex-direction:column;align-items:center;justify-content:center;text-align:center;box-shadow:0 0 0 10px #e9f3f3;padding:0 14px}\n.hm-ct .cn{margin:0;font:700 21px\/1.2 \"Work Sans\",sans-serif;color:#fff}\n.hm-ct .cc{margin:6px 0 0;font-size:12px;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#bcd7d8}\n.hm-ct .nodes{list-style:none;margin:0;padding:0}\n.hm-ct .nodes li{position:absolute;transform:translate(0,-50%);margin:0;width:max-content;max-width:26%;\n  font:500 15px\/1.3 \"Work Sans\",sans-serif;color:#00373e;background:#fff;border:1.5px solid #bcd7d8;border-radius:999px;padding:8px 15px;animation:hmct .35s ease both}\n.hm-ct .nodes li.l{transform:translate(-100%,-50%)}\n@keyframes hmct{from{opacity:0}to{opacity:1}}\n.hm-ct .res{margin:14px 0 0;font-size:16px;line-height:1.6;color:#2a2622;padding:14px 16px;border-radius:14px;background:#f1f6f6;border:1.5px solid #d9e7e6}\n.hm-ct .res b{color:#00373e}\n@media(max-width:820px){\n  .hm-ct .map{height:auto;padding:0 0 0 0}\n  .hm-ct .ln{display:none}\n  .hm-ct .core{position:relative;left:auto;top:auto;transform:none;width:auto;height:auto;border-radius:16px;box-shadow:none;padding:14px 18px;flex-direction:row;justify-content:space-between;margin:10px 0 0}\n  .hm-ct .cc{margin:0}\n  .hm-ct .nodes{position:relative;margin:0 0 0 20px;padding:10px 0 0 22px;border-left:2px solid #bcd7d8;display:grid;gap:8px}\n  .hm-ct .nodes li,.hm-ct .nodes li.l{position:relative;left:auto!important;top:auto!important;transform:none;max-width:none;width:auto;justify-self:start}\n  .hm-ct .nodes li::before{content:\"\";position:absolute;left:-24px;top:50%;width:22px;height:2px;background:#bcd7d8}\n}\n\n\/* ---- figure 8: the gut, a hundred dots ---- *\/\n.hm-gut .ctl{margin:0 0 20px}\n.hm-gut .ctl .ra-seg{display:flex;flex-wrap:wrap;gap:8px;padding:0;background:none;border:0;border-radius:0}\n.hm-gut .ctl .ra-seg button{border:1.5px solid #e8e1d5;background:#fff;padding:8px 14px;font-weight:600;color:#4a433c}\n.hm-gut .ctl .ra-seg button:hover{border-color:#bcd7d8;color:#00373e}\n.hm-gut .ctl .ra-seg button[aria-pressed=true]{background:#1d5f66;border-color:#1d5f66;color:#fff}\n.hm-gut .lay{display:grid;grid-template-columns:minmax(0,300px) minmax(0,1fr);gap:22px 34px;align-items:center}\n.hm-gut .dots{display:grid;grid-template-columns:repeat(10,minmax(0,1fr));gap:6px;max-width:300px}\n.hm-gut .dots i{display:block;aspect-ratio:1\/1;border-radius:50%;background:#fff;border:1.5px solid #d9e7e6;transition:background .3s ease,border-color .3s ease}\n.hm-gut .dots i.on{background:#1d5f66;border-color:#1d5f66}\n.hm-gut .v{margin:0 0 6px;display:flex;align-items:baseline;gap:10px}\n.hm-gut .v b{font:800 clamp(52px,7vw,72px)\/1 \"Playfair Display\",Georgia,serif;color:#1d5f66}\n.hm-gut .v span{font-size:13px;font-weight:700;letter-spacing:.14em;text-transform:uppercase;color:#6b6259}\n.hm-gut .t{margin:0;font-size:17px;line-height:1.6;color:#2a2622;max-width:44ch}\n.hm-gut .t b{color:#00373e}\n@media(max-width:640px){.hm-gut .lay{grid-template-columns:minmax(0,1fr)}.hm-gut .dots{max-width:260px}}\n\n\/* ---- figure 9: the whole picture, in three tiers ---- *\/\n.hm-md 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the prose around it *\/\n.eqp .wp-block-group > .eq-kp{margin-left:auto;margin-right:auto}\n\/* the printed Beighton sheet: the theme forces Playfair on every h1 to h6 *\/\n.bgt-sheet h2{font-family:\"Work Sans\",sans-serif!important}\n\n\/* tap targets on the Beighton options, below 900 wide *\/\n@media(max-width:899px){.eqp .bgt .seg label span,.eqp .bgt .sd label span{min-height:44px;box-sizing:border-box}}\n@media(max-width:899px){.eqp .hm-sm button.clr,.eqp .bgt button.clr{min-height:44px!important}}\n\/* the thought-chain figure is hand-lettered *\/\n@font-face{font-family:\"Patrick Hand\";font-style:normal;font-weight:400;font-display:swap;src:url(https:\/\/fonts.gstatic.com\/s\/patrickhand\/v25\/LDI1apSQOAYtSuYWp8ZhfYe8XsLL.woff2) format(\"woff2\")}\n\/* boxed panels: the block padding is one fixed value with no breakpoint *\/\n@media(max-width:560px){.eqp .wp-block-group.has-background{padding:24px 20px!important}}\n\n\/* ---- part head: point 3 of 9 (the Beighton figure) ---- 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It used to ride inside\n     translateX as calc(-50% + var(--sx)), and the variable never took effect:\n     the script set --sx correctly, the sheet shipped correctly, and the\n     computed transform stayed at a flat -50% regardless. Measured on the live\n     page with the compositor running and a control element proving transform\n     itself worked, cards still sat 54 to 61px off the left edge of a 390px\n     screen. margin-left is a layout property, it resolves the variable, and it\n     put every card exactly where the script had calculated. *\/\n  transform:translateX(-50%) translateY(4px);margin-left:var(--sx,0px);\n  opacity:0;visibility:hidden;pointer-events:none;\n  background:#fff;border:1.5px solid var(--eqp-line2);border-radius:12px;\n  box-shadow:0 10px 30px rgba(20,30,40,.14);padding:14px 16px;\n  font-family:\"Work Sans\",sans-serif;font-size:14.5px;line-height:1.55;\n  font-style:normal;font-weight:400;color:var(--eqp-body);text-align:left;\n  transition:opacity .16s ease,transform .16s ease}\n.eqp .gd b{display:block;font-family:\"Work Sans\",sans-serif;font-size:11px;\n  font-weight:700;letter-spacing:.13em;text-transform:uppercase;\n  color:var(--eqp-muted);margin:0 0 6px}\n\/* The pointer, a rotated square sitting half outside the card. It carries the\n   nudge in reverse so it stays under the term when the card has moved. *\/\n.eqp .gd::after{content:\"\";position:absolute;left:calc(50% - 6px - var(--sx,0px));\n  bottom:-7px;width:12px;height:12px;background:#fff;\n  border-right:1.5px solid var(--eqp-line2);border-bottom:1.5px solid var(--eqp-line2);\n  transform:rotate(45deg)}\n.eqp .gl:hover .gd,.eqp .gl:focus .gd,.eqp .gl:focus-within .gd{\n  opacity:1;visibility:visible;pointer-events:auto;\n  transform:translateX(-50%) translateY(0)}\n@media(prefers-reduced-motion:reduce){\n  .eqp .gd{transition:none;transform:translateX(-50%)}\n}\n\/* A popup means nothing on paper, and nothing is lost: every glossed term keeps\n   the author's own sentence around it. *\/\n@media print{.eqp .gd{display:none}.eqp .gl{border-bottom:0}}\n<\/style><style>\n.eqp .gl{color:#95560b}\n.eqp .gl:hover{background:#fcf2e6}\n.eqp .eqb .gl{color:inherit}\n.eqp .gd{border-left:3px solid #b8740f}\n.eqp .gd b{color:#6e3f10;background:#fcf2e6;margin:-14px -16px 12px;padding:10px 16px 9px;border-bottom:1px solid #ecd2ae}\n.eqp .gd::after{border-right-color:#ecd2ae;border-bottom-color:#ecd2ae}\n<\/style><script>\n(function(){\n  \/* The sheet is the first block on the page, so at parse time not one .gl\n     exists yet and binding straight away binds to nothing. It did, silently:\n     the cards still opened, because opening is pure CSS, and only the nudge was\n     missing. Wait for the document instead. *\/\n  function bind(){\n    var gl=document.querySelectorAll('.eqp .gl');\n    if(!gl.length){return;}\n    \/* MEASURE THE TERM, NOT THE CARD. Reading the card's own rect looks like\n       the obvious thing to do and is wrong: the card is mid transition when the\n       pointer arrives, so its rect is wherever the animation has got to, and a\n       nudge computed from it was correct on a first hover and zero on a second.\n       The term does not move and offsetWidth ignores transforms.\n\n       getClientRects()[0] rather than getBoundingClientRect, because a term\n       that wraps across two lines is anchored by CSS to its first line box. *\/\n    function place(el){\n      var card=el.querySelector('.gd');\n      if(!card){return;}\n      var rects=el.getClientRects();\n      var a=rects.length?rects[0]:el.getBoundingClientRect();\n      var mid=a.left+a.width\/2, half=card.offsetWidth\/2, m=14, dx=0;\n      if(mid-half<m){dx=m-(mid-half);}\n      else if(mid+half>window.innerWidth-m){dx=(window.innerWidth-m)-(mid+half);}\n      card.style.setProperty('--sx',dx.toFixed(1)+'px');\n    }\n    for(var 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aria-hidden=\"true\"><i><\/i><\/div><nav id=\"eqp-parts\" aria-hidden=\"true\"><a href=\"#part-1\" data-i=\"1\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">More than flexible<\/span><\/a><a href=\"#part-2\" data-i=\"2\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">How your body keeps track of itself<\/span><\/a><a href=\"#part-3\" data-i=\"3\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Pain that outlasts the injury<\/span><\/a><a href=\"#part-4\" data-i=\"4\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Standing up<\/span><\/a><a href=\"#part-5\" data-i=\"5\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">When your body teaches your brain what to fear<\/span><\/a><a href=\"#part-6\" data-i=\"6\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">The symptoms nobody can see<\/span><\/a><a href=\"#part-7\" data-i=\"7\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Body and mind, without &#8220;it&#8217;s all in your head&#8221;<\/span><\/a><a href=\"#part-8\" data-i=\"8\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Where therapy fits<\/span><\/a><a href=\"#part-9\" data-i=\"9\" tabindex=\"-1\"><span class=\"dot\"><\/span><span class=\"lbl\">Putting it together<\/span><\/a><\/nav><button id=\"eqp-top\" type=\"button\" aria-label=\"Back to the top of the article\"><svg viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M6 10.5V2M2 5.5 6 1.5l4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg>Top<\/button><script>(function(){document.documentElement.setAttribute(\"data-eqp\",\"on\");function init(){var RM=false;if(window.matchMedia){RM=window.matchMedia(\"(prefers-reduced-motion: reduce)\").matches;}var bar=document.querySelector(\"#eqp-rail i\");var 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.st{min-height:5.6em}}\n\/*>*\/<\/style>\n\n\n\n<div class=\"wp-block-group alignfull eqp hmw-post has-global-padding is-layout-constrained wp-container-core-group-is-layout-69fa9525 wp-block-group-is-layout-constrained\" style=\"margin-top:0;margin-bottom:0;padding:0px 22px\">\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<div style=\"color:#6b6259;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:400;margin-top:54px;margin-bottom:0\" class=\"has-link-color wp-elements-1 wp-block-post-date has-text-color has-work-sans-regular-font-family\"><time datetime=\"2026-08-25T21:58:24+02:00\">25 kolovoza, 2026<\/time><\/div>\n\n<div style=\"color:#6b6259;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);font-style:normal;font-weight:700;text-transform:uppercase;margin-top:0;margin-bottom:0\" class=\"taxonomy-category has-link-color wp-elements-2 wp-block-post-terms has-text-color has-work-sans-regular-font-family\"><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/body-and-mind\/\" rel=\"tag\">Body and Mind<\/a><span class=\"wp-block-post-terms__separator\">, <\/span><a href=\"https:\/\/equilibriumpsychotherapy.net\/hr\/category\/deep-dive\/\" rel=\"tag\">Deep Dive<\/a><\/div>\n\n\n<h1 class=\"wp-block-heading has-text-color has-playfair-display-font-family\" id=\"top\" style=\"color:#2a2622;margin-top:24px;margin-bottom:10px;font-size:clamp(26.944px, 1.684rem + ((1vw - 3.2px) * 2.165), 46px);font-style:normal;font-weight:800;line-height:1.12\">Hypermobility and the nervous&nbsp;system<\/h1>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family eq-subtitle wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:20px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.114), 15px);font-weight:600;letter-spacing:.14em;line-height:1.5\">The body, the brain, pain and well-being<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#524a42;margin-top:0;margin-bottom:22px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.55\">What hypermobility is and what it isn&#8217;t, how your body keeps track of where it is, why pain can outlast an injury, why standing up can set your heart racing, how a real symptom can teach your brain to be afraid, the fatigue, fog, headaches and gut trouble nobody can see, why body and mind aren&#8217;t separate, where therapy fits, and how it all fits together<\/p>\n\n\n\n<p class=\"eq-credit\" style=\"--eq-credit-ac:#1d5f66\">Written by <a href=\"\/our-team-ivana\/\" rel=\"author\">Ivana<\/a>, psychologist and psychotherapist<\/p>\n\n\n\n<div style=\"margin-top:0px;margin-bottom:0\"><div class=\"hmw-swbox hmw-keep\" id=\"hmw-swbox\"><div class=\"hmw-metarow\"><p class=\"has-text-color has-work-sans-regular-font-family hmw-metat\" style=\"color:#6b6259;margin-top:0;margin-bottom:0;font-size:15px;line-height:1.5\"><span class=\"hmw-mtw\"><span class=\"hmw-mt-f\"><strong style=\"color:#1d5f66\">39 minute read<\/strong> &nbsp;&middot;&nbsp; 8,772 words<\/span><span class=\"hmw-mt-p\"><strong style=\"color:#1d5f66\">28 minute read<\/strong> &nbsp;&middot;&nbsp; 6,389 words<\/span><\/span><\/p><div class=\"hmw-seg\" id=\"hmw-seg\" role=\"radiogroup\" aria-label=\"Reading version\" aria-describedby=\"hmw-sw-h\"><button type=\"button\" class=\"hmw-segb\" id=\"hmw-seg-full\" role=\"radio\" aria-checked=\"true\" tabindex=\"0\">Detailed<\/button><button type=\"button\" class=\"hmw-segb\" id=\"hmw-seg-plain\" role=\"radio\" aria-checked=\"false\" tabindex=\"-1\">Plain words<\/button><\/div><\/div><p class=\"hmw-hint\" id=\"hmw-sw-h\">Detailed explains the research and the reasons behind each point. 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It never changes the mode. *\/function fromHash(){if(!root.classList.contains(\"hmw-plain\")){return;}var id=window.location.hash;if(2>id.length){return;}try{id=decodeURIComponent(id.slice(1));}catch(e4){id=id.slice(1);}var t=document.getElementById(id);if(!t){return;}if(t.getClientRects().length>0){return;}var n=t;while(n.parentElement){if(n.parentElement===root){break;}n=n.parentElement;}var h2=null;while(n){h2=n.querySelector('h2[id^=\"part-\"]');if(h2){break;}n=n.previousElementSibling;}if(h2){h2.scrollIntoView({block:\"start\",behavior:\"instant\"});}}window.addEventListener(\"hashchange\",fromHash);window.addEventListener(\"load\",fromHash);\/* the floating pill: shown only once the masthead control has scrolled up out of view, and never over the ending (the closing panel and the footer, which are parsed after this script, so they are looked up on first use). The observer says when the control leaves the screen; a passive scroll listener recomputes from the real positions as well, because a jump (a contents link, the End key) can skip an observer entirely. *\/var ends=[null,null],busy=false;function update(){busy=false;var h=window.innerHeight,show=false,hide=false,k,r;if(!ends[0]){ends[0]=document.querySelector(\".hmw-end\");}if(!ends[1]){ends[1]=document.querySelector(\"footer\");}r=seg.getBoundingClientRect();if(0>=r.bottom){show=true;}for(k=0;ends.length>k;k+=1){if(ends[k]){r=ends[k].getBoundingClientRect();if(h-72>r.top){if(r.bottom>0){hide=true;}}}}var sf=document.querySelectorAll(\".hmw-nopill\"),m;for(m=0;sf.length>m;m+=1){r=sf[m].getBoundingClientRect();if(h>r.top){if(r.bottom>0){hide=true;}}}if(show){if(!hide){pill.classList.add(\"hmw-pill-on\");return;}}pill.classList.remove(\"hmw-pill-on\");}function soon(){if(!busy){busy=true;window.requestAnimationFrame(update);}}window.addEventListener(\"scroll\",soon,{passive:true});window.addEventListener(\"resize\",soon);if(window.IntersectionObserver){new IntersectionObserver(soon).observe(seg);}window.addEventListener(\"load\",soon);update();})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family eq-drop wp-block-paragraph\" style=\"color:#35302a;margin-top:46px;margin-bottom:26px;font-size:clamp(14.642px, 0.915rem + ((1vw - 3.2px) * 0.836), 22px);line-height:1.62\">People may have called you flexible your whole life, as if it were a party trick. Perhaps the room tilts for a second when you stand up from the couch, or your heart pounds while you wait in line, or you&#8217;re tired in a way that sleep doesn&#8217;t touch and someone has told you it&#8217;s probably anxiety. If any of that sounds familiar, it makes sense that you&#8217;d want a clearer answer than the ones you&#8217;ve been given.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Hypermobility is often reduced to one simple idea: being unusually flexible. For some people, though, flexibility is only the part other people can see. Joints can feel unstable, pain can hang around, your sense of where your body is can be less precise, standing up can bring dizziness or a racing heart, and fatigue can be hard to explain. Over time, all of that can change how you pay attention to your body and how you respond to it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s where the nervous system comes in. It doesn&#8217;t sit in the background waiting for something to happen. It&#8217;s constantly taking in information from your body, making sense of it, predicting what comes next and adjusting how your body responds. So when your joints, your pain, your sense of position or your heart rate behave differently, your nervous system is part of the picture. <strong class=\"eqb\">That doesn&#8217;t mean your symptoms are psychological, and it doesn&#8217;t mean hypermobility is simply &#8220;nervous-system dysregulation.&#8221;<\/strong> It means body and mind are more connected than either of those shortcuts allows. If you&#8217;d like everything in plainer words, flip the switch above.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-83938ec0 wp-block-group-is-layout-constrained\" style=\"background-color:#f1f6f6;border-color:#d9e7e6;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:40px;margin-bottom:0;padding:34px 38px\">\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><div class=\"hm-sv\"><div class=\"top\"><div><p class=\"k\">The short version<\/p><p class=\"h\">If you read nothing else<\/p><\/div><p class=\"sub\">One line for each of the nine parts<\/p><\/div><ol class=\"rows\"><li><a class=\"n\" href=\"#part-1\" aria-label=\"Go to part one\">01<\/a><p><span class=\"hmw-nrm\"><strong>Being hypermobile isn&#8217;t a diagnosis.<\/strong> What matters is what it means for you, and for some people it comes with pain, unstable joints, fatigue and more.<\/span><span class=\"hmw-pln\"><strong>Being hypermobile isn&#8217;t a diagnosis.<\/strong> What matters is what it means for you. For some people it comes with pain, unstable joints, tiredness and more.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-2\" aria-label=\"Go to part two\">02<\/a><p><span class=\"hmw-nrm\"><strong>Your body may have to work harder to stay steady.<\/strong> Sensing where your joints are and holding them stable can take extra effort, which is one possible reason for tiredness that looks out of proportion to your day.<\/span><span class=\"hmw-pln\"><strong>Your body may have to work harder to stay steady.<\/strong> Feeling where your joints are and holding them steady can take extra effort. That may be one reason you feel more tired than your day seems to explain.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-3\" aria-label=\"Go to part three\">03<\/a><p><span class=\"hmw-nrm\"><strong>Pain your nervous system helps produce is still real pain.<\/strong> Your brain and spinal cord are organs, and pain processing is biology.<\/span><span class=\"hmw-pln\"><strong>Pain is still real pain when your nervous system helps produce it.<\/strong> Your brain and spinal cord are organs, and how pain is handled is biology.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-4\" aria-label=\"Go to part four\">04<\/a><p><span class=\"hmw-nrm\"><strong>A racing heart on standing can be physical.<\/strong> POTS and hypermobility often occur together, and POTS can look like anxiety without being caused by it.<\/span><span class=\"hmw-pln\"><strong>A racing heart when you stand can be physical.<\/strong> POTS, where your heart rate rises too much when you stand, often goes with hypermobility. It can look like anxiety without being caused by it.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-5\" aria-label=\"Go to part five\">05<\/a><p><span class=\"hmw-nrm\"><strong>A real symptom can grow a layer of fear around it.<\/strong> Checking and avoiding can build on top of it, and working on that layer doesn&#8217;t mean the symptom was imaginary.<\/span><span class=\"hmw-pln\"><strong>A real symptom can grow a layer of fear around it.<\/strong> You may start checking your body and avoiding things. Working on that fear doesn&#8217;t mean the symptom was imaginary.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-6\" aria-label=\"Go to part six\">06<\/a><p><span class=\"hmw-nrm\"><strong>The symptoms nobody can see rarely have one neat cause.<\/strong> Fatigue, brain fog, poor sleep, headaches and gut symptoms deserve to be understood as one whole picture.<\/span><span class=\"hmw-pln\"><strong>The symptoms nobody can see rarely have one neat cause.<\/strong> Tiredness, brain fog, poor sleep, headaches and gut trouble are better understood together, as one whole picture.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-7\" aria-label=\"Go to part seven\">07<\/a><p><strong>Body and mind aren&#8217;t separate systems.<\/strong> That never means it&#8217;s all in your head.<\/p><\/li><li><a class=\"n\" href=\"#part-8\" aria-label=\"Go to part eight\">08<\/a><p><span class=\"hmw-nrm\"><strong>Therapy belongs alongside medical care, never instead of it.<\/strong> The research on specific therapies for hypermobility is still limited.<\/span><span class=\"hmw-pln\"><strong>Therapy belongs alongside medical care, never instead of it.<\/strong> There isn&#8217;t much research yet on therapy for hypermobility.<\/span><\/p><\/li><li><a class=\"n\" href=\"#part-9\" aria-label=\"Go to part nine\">09<\/a><p><span class=\"hmw-nrm\"><strong>Your symptoms deserve an individual look.<\/strong> The aim is to understand your nervous system rather than fight it, and to listen to your body without being afraid of it.<\/span><span class=\"hmw-pln\"><strong>Your symptoms deserve a look that fits you.<\/strong> The aim is to understand your nervous system instead of fighting it, and to listen to your body without being afraid of it.<\/span><\/p><\/li><\/ol><\/div><\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-4ccedd2e wp-block-group-is-layout-constrained\" style=\"border-color:#e8e1d5;border-width:1.5px;border-style:solid;border-radius:22px;background-color:#faf8f3;margin-top:56px;margin-bottom:20px;padding:30px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:22px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THIS ARTICLE COVERS &middot; NINE PARTS<\/p>\n\n\n\n<div class=\"wp-block-rank-math-toc-block\">\n<div class=\"eq-toc\"><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 1<\/span><a class=\"ttl\" href=\"#part-1\">More than flexible<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">3 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><span class=\"hmw-p2\">2 min<\/span><\/span><\/summary><ul><li><a href=\"#flexible-is-only-the-part-people-can-see\">Flexible is only the part people can see<\/a><\/li><li><a href=\"#three-names-that-often-get-mixed-up\">Three names that often get mixed up<\/a><\/li><li><a href=\"#the-beighton-score\">The Beighton score<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 2<\/span><a class=\"ttl\" href=\"#part-2\">How your body keeps track of itself<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">4 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><span class=\"hmw-p2\">2 min<\/span><\/span><\/summary><ul><li><a href=\"#your-brain-needs-to-know-where-your-body-is\">Your brain needs to know where your body is<\/a><\/li><li><a href=\"#when-the-signal-is-less-precise\">When the signal is less precise<\/a><\/li><li><a href=\"#staying-steady-can-be-tiring-work\">Staying steady can be tiring work<\/a><\/li><li><a href=\"#its-rarely-only-about-the-joints\">It&#8217;s rarely only about the joints<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 3<\/span><a class=\"ttl\" href=\"#part-3\">Pain that outlasts the injury<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">3 sections<\/span><span class=\"sep\"> &middot; <\/span>2 min<\/span><span class=\"hmw-p2\">2 min<\/span><\/span><\/summary><ul><li><a href=\"#pain-isnt-a-damage-meter\">Pain isn&#8217;t a damage meter<\/a><\/li><li><a href=\"#the-smoke-alarm\">The smoke alarm<\/a><\/li><li><a href=\"#real-pain-even-when-your-nervous-system-is-involved\">Real pain, even when your nervous system is involved<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 4<\/span><a class=\"ttl\" href=\"#part-4\">Standing up<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">5 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"hmw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#the-part-of-your-nervous-system-that-runs-itself\">The part of your nervous system that runs itself<\/a><\/li><li><a href=\"#what-standing-up-asks-of-your-body\">What standing up asks of your body<\/a><\/li><li><a href=\"#pots-and-why-it-can-look-like-panic\">POTS, and why it can look like panic<\/a><\/li><li><a href=\"#how-often-pots-and-hypermobility-go-together\">How often POTS and hypermobility go together<\/a><\/li><li><a href=\"#how-a-racing-heart-turns-into-fear\">How a racing heart turns into fear<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 5<\/span><a class=\"ttl\" href=\"#part-5\">When your body teaches your brain what to fear<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">7 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"hmw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#from-thats-strange-to-maybe-i-shouldnt-go-out\">From &#8220;that&#8217;s strange&#8221; to &#8220;maybe I shouldn&#8217;t go out&#8221;<\/a><\/li><li><a href=\"#the-supermarket-problem\">The supermarket problem<\/a><\/li><li><a href=\"#paying-attention-isnt-the-same-as-imagining-it\">Paying attention isn&#8217;t the same as imagining it<\/a><\/li><li><a href=\"#feeling-the-inside-of-your-body\">Feeling the inside of your body<\/a><\/li><li><a href=\"#why-anxiety-and-hypermobility-show-up-together\">Why anxiety and hypermobility show up together<\/a><\/li><li><a href=\"#when-your-body-stops-being-predictable\">When your body stops being predictable<\/a><\/li><li><a href=\"#having-to-prove-that-something-is-wrong\">Having to prove that something is wrong<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 6<\/span><a class=\"ttl\" href=\"#part-6\">The symptoms nobody can see<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">7 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"hmw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#how-long-term-pain-changes-daily-life\">How long-term pain changes daily life<\/a><\/li><li><a href=\"#the-pain-and-avoidance-cycle\">The pain and avoidance cycle<\/a><\/li><li><a href=\"#the-tiredness-nobody-believes\">The tiredness nobody believes<\/a><\/li><li><a href=\"#sleep-sits-in-the-middle\">Sleep sits in the middle<\/a><\/li><li><a href=\"#brain-fog\">Brain fog<\/a><\/li><li><a href=\"#headaches-and-migraine\">Headaches and migraine<\/a><\/li><li><a href=\"#the-gut\">The gut<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 7<\/span><a class=\"ttl\" href=\"#part-7\">Body and mind, without &#8220;it&#8217;s all in your head&#8221;<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">7 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"hmw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#body-and-mind-arent-separate-systems\">Body and mind aren&#8217;t separate systems<\/a><\/li><li><a href=\"#trauma-and-the-myth-of-a-hypermobile-personality\">Trauma, and the myth of a hypermobile personality<\/a><\/li><li><a href=\"#what-nervous-system-dysregulation-actually-means\">What &#8220;nervous-system dysregulation&#8221; actually means<\/a><\/li><li><a href=\"#the-vagus-nerve-and-what-the-evidence-supports\">The vagus nerve, and what the evidence supports<\/a><\/li><li><a href=\"#you-dont-need-to-calm-your-nervous-system-every-time-you-f\">You don&#8217;t need to calm your nervous system every time you feel something<\/a><\/li><li><a href=\"#same-heartbeat-different-meaning\">Same heartbeat, different meaning<\/a><\/li><li><a href=\"#when-protection-turns-into-restriction\">When protection turns into restriction<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 8<\/span><a class=\"ttl\" href=\"#part-8\">Where therapy fits<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">6 sections<\/span><span class=\"sep\"> &middot; <\/span>4 min<\/span><span class=\"hmw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#what-therapy-can-and-cant-do\">What therapy can and can&#8217;t do<\/a><\/li><li><a href=\"#what-the-research-says-about-therapy\">What the research says about therapy<\/a><\/li><li><a href=\"#fear-of-movement-and-thoughts-that-run-ahead\">Fear of movement, and thoughts that run ahead<\/a><\/li><li><a href=\"#checking-and-avoiding\">Checking and avoiding<\/a><\/li><li><a href=\"#acceptance-isnt-giving-up\">Acceptance isn&#8217;t giving up<\/a><\/li><li><a href=\"#flexibility-on-the-hard-days\">Flexibility on the hard days<\/a><\/li><\/ul><\/details><details><summary><svg class=\"chev\" viewBox=\"0 0 12 12\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 2l4 4-4 4\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/svg><p hidden><\/p><span class=\"num\">PART 9<\/span><a class=\"ttl\" href=\"#part-9\">Putting it together<\/a><span class=\"cnt\"><span class=\"hmw-n2\"><span class=\"sec\">6 sections<\/span><span class=\"sep\"> &middot; <\/span>5 min<\/span><span class=\"hmw-p2\">3 min<\/span><\/span><\/summary><ul><li><a href=\"#one-picture-many-directions\">One picture, many directions<\/a><\/li><li><a href=\"#why-your-symptoms-need-an-individual-look\">Why your symptoms need an individual look<\/a><\/li><li><a href=\"#your-nervous-system-is-not-your-enemy\">Your nervous system is not your enemy<\/a><\/li><li><a href=\"#you-can-believe-your-body-and-still-work-psychologically\">You can believe your body and still work psychologically<\/a><\/li><li><a href=\"#listening-without-being-afraid\">Listening without being afraid<\/a><\/li><li><a href=\"#a-conversation-not-a-battle\">A conversation, not a battle<\/a><\/li><\/ul><\/details><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"53\" cy=\"44\" r=\"8\"\/><circle class=\"nw\" cx=\"53\" cy=\"44\" r=\"4.4\"\/><circle class=\"up\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"up\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"up\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"up\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 1 of 9<\/p><h2 id=\"part-1\">More than flexible<\/h2><p class=\"sb\">What hypermobility is, and what it isn&#8217;t<\/p><\/div><div class=\"no\" aria-hidden=\"true\">01<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Being hypermobile, or &#8220;bendy&#8221;, means some of your joints bend further than most people&#8217;s. <strong class=\"eqb\">For lots of people that&#8217;s all it is, and it never causes them a big problem.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For others it comes with more: pain that keeps coming back, joints that feel unstable, injuries that keep happening, tiredness, a less exact sense of where your body is, dizziness when you stand, or trouble in several other parts of your health. So the most useful question isn&#8217;t only &#8220;are you hypermobile?&#8221; It&#8217;s &#8220;what does it mean for you?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You&#8217;ll see three names online that get used as if they meant the same thing. They don&#8217;t, and the difference changes what, if anything, needs attention. <strong class=\"eqb\">Generalized joint hypermobility<\/strong>, or GJH, means many of your joints bend further than usual. It describes how your joints move, and it isn&#8217;t a diagnosis. <strong class=\"eqb\">Hypermobility spectrum disorder<\/strong>, or HSD, means flexible joints that cause symptoms, when no other specific condition fits. <strong class=\"eqb\">Hypermobile Ehlers-Danlos syndrome<\/strong>, or hEDS, is a specific diagnosis. It&#8217;s one of the Ehlers-Danlos syndromes, or EDS, a group of inherited conditions that affect connective tissue, the tissue that gives your joints, skin and organs their structure.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A clinician diagnoses hEDS by examining you and asking about your history. Unlike the other types of EDS, there&#8217;s currently no established genetic test that confirms it on its own.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Being flexible isn&#8217;t the same as having a disease, and having one of these conditions isn&#8217;t the same as having a &#8220;dysregulated nervous system&#8221;<\/strong>, a phrase part seven looks at.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"flexible-is-only-the-part-people-can-see\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Flexible is only the part people can see<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You might have been the kid who could bend your thumb back to your wrist, or the adult people call &#8220;so flexible.&#8221; Sometimes that&#8217;s all it is. Joint hypermobility simply means a joint can move through a bigger range than is typical. <strong class=\"eqb\">On its own, that isn&#8217;t necessarily a disorder, and plenty of people are naturally hypermobile and never have a significant problem because of it.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-2\" aria-label=\"Reference 2\">2<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">For other people it comes with more: pain that keeps returning, joints that feel unstable, injuries that repeat, fatigue, a less precise sense of where your body is, dizziness when you stand, or other difficulties across several areas of health.<sup class=\"eq-cite\">[<a href=\"#ref-2\" aria-label=\"Reference 2\">2<\/a>]<\/sup> So the most useful question isn&#8217;t only &#8220;are you hypermobile?&#8221; It&#8217;s &#8220;what does that hypermobility mean for you?&#8221;<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"three-names-that-often-get-mixed-up\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Three names that often get mixed up<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Online, you&#8217;ll see a few terms used as if they meant the same thing. They don&#8217;t, and the difference changes what, if anything, needs attention.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Generalized joint hypermobility<\/strong> means many of your joints move further than typical. It&#8217;s a physical finding, not a diagnosis. <strong class=\"eqb\">Hypermobility spectrum disorder<\/strong>, or HSD, means joint hypermobility that causes symptoms but doesn&#8217;t meet the criteria for another specific condition. <strong class=\"eqb\">Hypermobile Ehlers-Danlos syndrome<\/strong>, or hEDS, is a specific diagnosis within the Ehlers-Danlos syndromes, a group of inherited conditions that affect <em class=\"eqi\">connective tissue<\/em>, the tissue that gives your joints, skin and organs their structure.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>,<a href=\"#ref-2\" aria-label=\"Reference 2\">2<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The international classification doctors use today draws this line clearly, keeping hypermobile joints as a physical finding apart from hypermobility-related disorders.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>,<a href=\"#ref-2\" aria-label=\"Reference 2\">2<\/a>]<\/sup> hEDS is still a <em class=\"eqi\">clinical diagnosis<\/em>, which means a clinician makes it by examining you and taking your history. Unlike the other types of EDS, there&#8217;s currently no established genetic test that confirms it on its own.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This matters for everything that follows. <strong class=\"eqb\">Being flexible isn&#8217;t the same thing as having a disease, and having a hypermobility-related condition isn&#8217;t the same thing as having a &#8220;dysregulated nervous system.&#8221;<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-sp\" id=\"hm-sp\"><div class=\"hd\"><p class=\"ti\">Three names<\/p><p class=\"q\"><span class=\"hmw-nrm\">Three different things, often used as if they were one<\/span><span class=\"hmw-pln\">Three different things that often get mixed up<\/span><\/p><\/div><ol class=\"st\"><li class=\"s s1\"><span class=\"node\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M3 17.5h9.5\" stroke-width=\"2.6\"\/><path d=\"M12.5 17.5V5\" stroke-width=\"2.2\"\/><path d=\"M12.5 17.5H21\" stroke-dasharray=\"1.4 2.4\"\/><path d=\"M17.5 17.5a5 5 0 0 0-5-5\"\/><\/svg><\/span><div class=\"card\"><p class=\"k\"><span class=\"hmw-nrm\">A physical finding<\/span><span class=\"hmw-pln\">Something a clinician can see<\/span><\/p><p class=\"ab\">GJH<\/p><p class=\"nm\">Generalized joint hypermobility<\/p><p class=\"d\"><span class=\"hmw-nrm\">Joints move through a bigger range than typical. It&#8217;s common, and on its own it isn&#8217;t a disorder. Many people have it and never have a problem because of it.<\/span><span class=\"hmw-pln\">Many joints bend further than usual. It&#8217;s common, and on its own it isn&#8217;t a disorder. Many people have it and never have a problem because of it.<\/span><\/p><\/div><\/li><li class=\"s s2\"><span class=\"node\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"11\" cy=\"14\" r=\"2.4\"\/><path d=\"M9.3 15.7L4.5 20.5M12.7 12.3L16 9\"\/><path d=\"M17.5 3.5v3M21 7h-3M20 4.5l-2 2\"\/><\/svg><\/span><div class=\"card\"><p class=\"k\">A condition with symptoms<\/p><p class=\"ab\">HSD<\/p><p class=\"nm\">Hypermobility spectrum disorder<\/p><p class=\"d\"><span class=\"hmw-nrm\">Joint hypermobility that causes symptoms but doesn&#8217;t meet the criteria for another specific condition. The symptoms can reach well beyond the joints.<\/span><span class=\"hmw-pln\">Flexible joints that cause symptoms, when no other specific condition fits. The symptoms can reach well beyond the joints.<\/span><\/p><\/div><\/li><li class=\"s s3\"><span class=\"node\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><rect x=\"5\" y=\"4.5\" width=\"14\" height=\"16\" rx=\"2.2\"\/><path d=\"M9 4.5V3.2h6v1.3\"\/><path d=\"M8.6 12.6l2.4 2.4 4.4-4.8\"\/><\/svg><\/span><div class=\"card\"><p class=\"k\">A specific diagnosis<\/p><p class=\"ab\">hEDS<\/p><p class=\"nm\">Hypermobile Ehlers-Danlos syndrome<\/p><p class=\"d\"><span class=\"hmw-nrm\">One of the Ehlers-Danlos syndromes, diagnosed clinically. Unlike the other types, there&#8217;s currently no established genetic test that confirms it on its own.<\/span><span class=\"hmw-pln\">One of the Ehlers-Danlos syndromes. A clinician diagnoses it by examining you and asking about your history. Unlike the other types, there&#8217;s currently no established genetic test that confirms it on its own.<\/span><\/p><\/div><\/li><\/ol><p class=\"ends\" aria-hidden=\"true\"><span>flexibility alone<\/span><span>symptoms across several systems<\/span><\/p><figcaption>The distinctions follow the 2017 international classification.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>,<a href=\"#ref-2\" aria-label=\"Reference 2\">2<\/a>]<\/sup><\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever been checked for hypermobility, it probably started with the Beighton score. It&#8217;s a nine point check of how far a handful of joints move: your little fingers, thumbs, elbows and knees on each side, plus bending forward to put your palms flat on the floor. <strong class=\"eqb\">It&#8217;s a screen rather than a diagnosis, and it only looks at a few joints.<\/strong> The video below shows a clinician doing it, and the tool further down lets you score yourself.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-beighton-score\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The Beighton score<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever been checked for hypermobility, it probably started with the Beighton score. It&#8217;s a nine point check of how far a handful of joints move: the little fingers, thumbs, elbows and knees on each side, plus bending forward to put your palms flat on the floor.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>]<\/sup> <strong class=\"eqb\">It&#8217;s a screen rather than a diagnosis, and it only looks at a few joints.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-2\" aria-label=\"Reference 2\">2<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:20px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Here&#8217;s a clinician doing the check, if you&#8217;d like to see what it looks like:<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\" style=\"margin-top:0;margin-bottom:10px\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"The Beighton Score | Generalized Joint Hypermobility (Laxity)\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/ZwWts_P-Xws?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep hmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-c0682441 wp-block-group-is-layout-constrained\" style=\"background-color:#fbf4e6;border-color:#eedcb9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:30px;margin-bottom:40px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">A high Beighton score on its own isn&#8217;t a diagnosis<\/strong>, and plenty of people score highly and have no symptoms at all. It also misses hypermobility in joints it doesn&#8217;t test, so a low score doesn&#8217;t rule anything out. Think of it as a starting point for a conversation with a clinician, not a result.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig bgt\" id=\"bgt\" hidden><div class=\"hd\"><p class=\"ti\">Score it yourself<\/p><p class=\"q\">The nine point Beighton check<\/p><\/div><p class=\"hint\"><span class=\"hmw-nrm\">Four of these are checked on each side, which is where the nine points come from. Everything except the forward bend is measured passively: the joint is taken to the end of its range rather than held there by its own muscles. Where a drawing has a dashed line, that&#8217;s the usual position.<\/span><span class=\"hmw-pln\">Four of these are checked on both sides, which makes nine points. For all but the forward bend, the joint is taken as far as it will go, and your own muscles don&#8217;t hold it there. A dashed line in a drawing shows the usual position.<\/span><\/p><ol class=\"mv\"><li><span class=\"pic\" aria-hidden=\"true\"><svg viewBox=\"0 0 48 48\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path class=\"rf\" d=\"M25 35H44\"\/><path d=\"M5 35H25\" stroke-width=\"6\"\/><path d=\"M25 35V11\" stroke-width=\"4.2\"\/><path class=\"ar\" d=\"M35 35A10 10 0 0 0 25 25\"\/><circle class=\"jt\" cx=\"25\" cy=\"35\" r=\"3.4\"\/><\/svg><\/span><p class=\"mq\">The little finger bends back to 90&deg; or more<\/p><div class=\"sd\"><label><input type=\"checkbox\" data-p=\"f5l\" aria-label=\"Little finger, left\"><span>Left<\/span><\/label><label><input type=\"checkbox\" data-p=\"f5r\" aria-label=\"Little finger, right\"><span>Right<\/span><\/label><\/div><\/li><li><span class=\"pic\" aria-hidden=\"true\"><svg viewBox=\"0 0 48 48\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path d=\"M3 20H27\" stroke-width=\"6\"\/><path d=\"M27 20L37 34\" stroke-width=\"5.5\"\/><path d=\"M32.5 27.5Q27 35 20.5 25.5\" stroke-width=\"3.6\"\/><circle class=\"tp\" cx=\"20\" cy=\"24.2\" r=\"2.3\"\/><circle class=\"jt\" cx=\"27\" cy=\"20\" r=\"3.4\"\/><\/svg><\/span><p class=\"mq\">The thumb can be pressed back to touch the inner side of the same forearm<\/p><div class=\"sd\"><label><input type=\"checkbox\" data-p=\"thl\" aria-label=\"Thumb, left\"><span>Left<\/span><\/label><label><input type=\"checkbox\" data-p=\"thr\" aria-label=\"Thumb, right\"><span>Right<\/span><\/label><\/div><\/li><li><span class=\"pic\" aria-hidden=\"true\"><svg viewBox=\"0 0 48 48\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path class=\"rf\" d=\"M24 27L43 35.5\"\/><path d=\"M4 18L24 27\" stroke-width=\"6\"\/><path d=\"M24 27L44 19\" stroke-width=\"5\"\/><path class=\"ar\" d=\"M33.1 31.1A10 10 0 0 0 33.3 23.3\"\/><circle class=\"jt\" cx=\"24\" cy=\"27\" r=\"3.4\"\/><\/svg><\/span><p class=\"mq\">The elbow bends back 10&deg; or more past straight<\/p><div class=\"sd\"><label><input type=\"checkbox\" data-p=\"ell\" aria-label=\"Elbow, left\"><span>Left<\/span><\/label><label><input type=\"checkbox\" data-p=\"elr\" aria-label=\"Elbow, right\"><span>Right<\/span><\/label><\/div><\/li><li><span class=\"pic\" aria-hidden=\"true\"><svg viewBox=\"0 0 48 48\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path class=\"rf\" d=\"M26 4V42\"\/><path d=\"M26 4L18 24\" stroke-width=\"6\"\/><path d=\"M18 24L26 42\" stroke-width=\"5\"\/><path d=\"M26 42H37\" stroke-width=\"4\"\/><circle class=\"jt\" cx=\"18\" cy=\"24\" r=\"3.4\"\/><\/svg><\/span><p class=\"mq\">The knee bends back 10&deg; or more past straight<\/p><div class=\"sd\"><label><input type=\"checkbox\" data-p=\"knl\" aria-label=\"Knee, left\"><span>Left<\/span><\/label><label><input type=\"checkbox\" data-p=\"knr\" aria-label=\"Knee, right\"><span>Right<\/span><\/label><\/div><\/li><li><span class=\"pic\" aria-hidden=\"true\"><svg viewBox=\"0 0 48 48\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"2.4\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path class=\"fl\" d=\"M3 45.5H45\"\/><path d=\"M14 44V21\" stroke-width=\"5\"\/><path d=\"M14 21L31 31\" stroke-width=\"6\"\/><circle class=\"hd\" cx=\"35.5\" cy=\"35.5\" r=\"4\"\/><path d=\"M29 30L26.5 42.5\" stroke-width=\"3.6\"\/><path d=\"M22.5 43.8H31\" stroke-width=\"3.6\"\/><circle class=\"jt\" cx=\"14\" cy=\"21\" r=\"3.4\"\/><\/svg><\/span><p class=\"mq\">With the feet together and the knees straight, both palms rest flat on the floor<\/p><div class=\"sd\"><label><input type=\"checkbox\" data-p=\"trk\" aria-label=\"Palms flat on the floor\"><span>Yes<\/span><\/label><\/div><\/li><\/ol><fieldset class=\"age\"><legend>Age<\/legend><div class=\"seg\"><label><input type=\"radio\" name=\"bgt-age\" value=\"child\"><span>Under 18<\/span><\/label><label><input type=\"radio\" name=\"bgt-age\" value=\"adult\"><span>18 to 50<\/span><\/label><label><input type=\"radio\" name=\"bgt-age\" value=\"older\"><span>Over 50<\/span><\/label><\/div><\/fieldset><div class=\"out\" role=\"status\" aria-live=\"polite\"><p class=\"sc\"><b>0<\/b>of 9<\/p><div class=\"meter\"><div class=\"dots\" aria-hidden=\"true\"><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><\/div><p class=\"tl\" aria-hidden=\"true\"><span><span class=\"hmw-nrm\">threshold<\/span><span class=\"hmw-pln\">cut-off<\/span><\/span><\/p><p class=\"rd\">Choose an age band and this will say where the score sits.<\/p><\/div><\/div><div class=\"foot\"><button type=\"button\" class=\"pdf\" hidden>Save as PDF<\/button><button type=\"button\" class=\"clr\">Clear the answers<\/button><\/div><figcaption><span class=\"hmw-nrm\">Nothing here is sent anywhere or saved, and the answers disappear when you leave the page. The thresholds are the ones in the 2017 international classification, which sets the bar higher before 18 and lower after 50, because how far a joint moves changes across a lifetime.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>]<\/sup><\/span><span class=\"hmw-pln\">Nothing you mark here is sent or saved, and it all disappears when you leave the page. The cut-offs come from the 2017 international classification. They&#8217;re higher for under 18s and lower for over 50s, because how far joints move changes with age.<\/span><\/figcaption><\/figure><script>(function(){var root=document.getElementById(\"bgt\");if(!root){return;}var boxes=root.querySelectorAll(\".sd input\");var ages=root.querySelectorAll(\"input[name=bgt-age]\");var scoreEl=root.querySelector(\".sc b\");var readEl=root.querySelector(\".rd\");var clr=root.querySelector(\".clr\");var pdfBtn=root.querySelector(\".pdf\");var dots=root.querySelectorAll(\".dots i\");var tl=root.querySelector(\".tl\");var tls=root.querySelector(\".tl span\");var CUT={child:6,adult:5,older:4};var PLN={\"none\":\"Pick your age group to see where your score sits.\",\"hi\":[\"That's at or above the cut-off of \",\" points used \",\". The 2017 classification calls this generalized joint hypermobility. It describes how your joints move and isn't a condition on its own. The next step is a clinician rather than a conclusion.\"],\"lo\":[\"That's below the cut-off of \",\" points used \",\". The score only checks these nine movements, so it can miss hypermobility elsewhere in the body, and a low number doesn't rule anything out.\"]};var P_ON=function(){var r=document.querySelector(\".hmw-post\");if(r){return r.classList.contains(\"hmw-plain\");}return false;};var LAB={child:\"for anyone under 18\",adult:\"from 18 to 50\",older:\"after 50\"};function state(){var s={p:{},age:\"\"};for(var i=0;i<boxes.length;i++){if(boxes[i].checked){s.p[boxes[i].getAttribute(\"data-p\")]=1;}}for(var j=0;j<ages.length;j++){if(ages[j].checked){s.age=ages[j].value;}}return s;}function count(s){var n=0,k;for(k in s.p){if(s.p[k]===1){n++;}}return n;}function paint(n,T){for(var d=0;d<dots.length;d++){var c=d<n?\"on\":\"\";if(T){if(d===T-1){c=c?c+\" th\":\"th\";}}dots[d].className=c;}if(T){tl.className=\"tl vis\";tls.style.gridColumn=String(T);}else{tl.className=\"tl\";}}function render(){var s=state(),n=count(s);scoreEl.textContent=String(n);pdfBtn.hidden=!s.age;if(!s.age){paint(n,0);readEl.textContent=P_ON()?PLN.none:\"Choose an age band and this will say where the score sits.\";return;}var T=CUT[s.age];paint(n,T);if(P_ON()){if(n>=T){readEl.textContent=PLN.hi[0]+T+PLN.hi[1]+LAB[s.age]+PLN.hi[2];}else{readEl.textContent=PLN.lo[0]+T+PLN.lo[1]+LAB[s.age]+PLN.lo[2];}}else if(n>=T){readEl.textContent=\"That's at or above the \"+T+\" point threshold used \"+LAB[s.age]+\", which is what the 2017 classification calls generalized joint hypermobility. It's a physical finding rather than a condition, and the next step is a clinician rather than a conclusion.\";}else{readEl.textContent=\"That's below the \"+T+\" point threshold used \"+LAB[s.age]+\". The score only asks about these nine movements, so it can miss hypermobility elsewhere in the body, and a low number doesn't rule anything out.\";}}root.addEventListener(\"change\",render);document.addEventListener(\"hmw-plain-change\",render);clr.addEventListener(\"click\",function(){for(var i=0;i<boxes.length;i++){boxes[i].checked=false;}for(var j=0;j<ages.length;j++){ages[j].checked=false;}render();});var CAV1=\"A high Beighton score on its own \";var CAVB=\"isn't a diagnosis\";var CAV2=\", and plenty of people score highly and have no symptoms at all. It also misses hypermobility in joints it doesn't test, so a low score doesn't rule anything out. Think of it as a starting point for a conversation with a clinician, not a result.\";function el(t,c,x){var e=document.createElement(t);if(c){e.className=c;}if(x){e.textContent=x;}return e;}function marked(){var rows=root.querySelectorAll(\".mv li\"),list=[];for(var i=0;i<rows.length;i++){var labs=rows[i].querySelectorAll(\".sd label\"),sides=[];for(var j=0;j<labs.length;j++){if(labs[j].querySelector(\"input\").checked){sides.push(labs[j].querySelector(\"span\").textContent.toLowerCase());}}if(!sides.length){continue;}var txt=rows[i].querySelector(\".mq\").textContent;if(sides[0]!==\"yes\"){txt=txt+\" (\"+sides.join(\", \")+\")\";}list.push(txt);}return list;}function sheet(){var s=state(),n=count(s);var d=el(\"div\",\"bgt-sheet\");d.appendChild(el(\"h1\",\"\",\"Beighton score\"));var dt=el(\"p\",\"dt\");try{dt.textContent=new Date().toLocaleDateString(undefined,{year:\"numeric\",month:\"long\",day:\"numeric\"});}catch(e){}d.appendChild(dt);var hd=el(\"div\",\"hd\");hd.appendChild(el(\"p\",\"big\",String(n)));hd.appendChild(el(\"p\",\"of\",\"of 9\"));d.appendChild(hd);d.appendChild(el(\"p\",\"th\",\"Threshold used \"+LAB[s.age]+\": \"+CUT[s.age]+\" of 9.\"));d.appendChild(el(\"p\",\"rd\",readEl.textContent));d.appendChild(el(\"h2\",\"\",\"What was marked\"));var list=marked();if(list.length){var ul=el(\"ul\");for(var m=0;m<list.length;m++){ul.appendChild(el(\"li\",\"\",list[m]));}d.appendChild(ul);}else{d.appendChild(el(\"p\",\"none\",\"Nothing was marked.\"));}var cv=el(\"p\",\"cv\");cv.appendChild(document.createTextNode(CAV1));cv.appendChild(el(\"b\",\"\",CAVB));cv.appendChild(document.createTextNode(CAV2));d.appendChild(cv);d.appendChild(el(\"p\",\"ft\",\"equilibriumpsychotherapy.net\"));return d;}pdfBtn.addEventListener(\"click\",function(){var d=sheet();document.body.appendChild(d);document.documentElement.classList.add(\"bgt-printing\");var cleaned=false;function done(){if(cleaned){return;}cleaned=true;document.documentElement.classList.remove(\"bgt-printing\");if(d.parentNode){d.parentNode.removeChild(d);}window.removeEventListener(\"afterprint\",done);}window.addEventListener(\"afterprint\",done);setTimeout(function(){window.print();},40);setTimeout(done,120000);});root.hidden=false;render();})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<style>.eqp .eq-kp{display:grid;grid-template-columns:auto minmax(0,1fr);gap:4px 16px;align-items:start;background:#e9f3f3;border:0;border-left:4px solid #1d5f66;border-radius:4px 18px 18px 4px;padding:20px 26px;margin:6px 0 34px}.eqp .eq-kp .mk{grid-row:1\/3;width:40px;height:40px;border-radius:50%;background:#fff;color:#1d5f66;display:flex;align-items:center;justify-content:center}.eqp .eq-kp .mk svg{width:21px;height:21px}.eqp .eq-kp .k{font-family:\"Work Sans\",sans-serif;font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66;margin:2px 0 4px}.eqp .eq-kp .t{font-family:\"Work Sans\",sans-serif;font-size:clamp(15px,calc(10.6px + .72vw),19px);font-weight:500;line-height:1.55;color:#2a2622;margin:0}@media(max-width:560px){.eqp .eq-kp{grid-template-columns:minmax(0,1fr);padding:18px 20px}.eqp .eq-kp .mk{grid-row:auto;width:34px;height:34px}}<\/style><aside class=\"eq-kp\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M6.5 3.5h11a1 1 0 0 1 1 1v15.6a.5.5 0 0 1-.78.42L12 16.4l-5.72 4.12a.5.5 0 0 1-.78-.42V4.5a1 1 0 0 1 1-1z\"\/><\/svg><\/span><p class=\"k\">Worth noting<\/p><p class=\"t\">Being hypermobile isn&#8217;t a diagnosis. What matters is what it means for you: whether it comes with pain, unstable joints, tiredness or other symptoms.<\/p><\/aside>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"7\" cy=\"44\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"nw\" cx=\"7\" cy=\"44\" r=\"4.4\"\/><circle class=\"up\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"up\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"up\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 2 of 9<\/p><h2 id=\"part-2\">How your body keeps track of itself<\/h2><p class=\"sb\">Your sense of position, the work of staying steady, and why it&#8217;s rarely only the joints<\/p><\/div><div class=\"no\" aria-hidden=\"true\">02<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Try this. Close your eyes and lift your arm. You still know where it is. That sense of where your body is and how it&#8217;s moving is called proprioception. Sensors in your muscles, tendons, joints and other tissues feed it, and your nervous system uses it to make small corrections all day without you thinking about it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">When a joint moves further than expected, your nervous system still has to control it.<\/strong> When researchers pooled several studies, they found that people diagnosed with benign joint hypermobility syndrome, an older name for hypermobility that causes symptoms, were less accurate than other people at sensing where their leg joints were and how they were moving. For the arms, the results were mixed. That doesn&#8217;t mean every hypermobile person has a poor sense of position, or that it explains every symptom. It&#8217;s one possible piece of the puzzle.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So your body makes up for it. Your muscles may work harder, you may rely more on your eyes, or you may feel less secure in some positions and move in more careful ways. Much of this happens without you deciding it. <strong class=\"eqb\">Your nervous system is simply trying to solve a mechanical problem with the information it has.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Staying steady is work too. When you stand on one leg, your ankle, knee, hip and trunk keep making tiny adjustments. If holding still takes more of them, that may be one reason you feel tired even when your day looks easy. Your tiredness shouldn&#8217;t be written off as laziness, poor motivation or a lack of fitness. <strong class=\"eqb\">There may be a real physical cost to staying steady.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s rarely one straight line from flexible joints to pain to tiredness. Pain changes how you move, movement changes the signals coming back from your body, and each can feed the others. That&#8217;s one reason <strong class=\"eqb\">researchers increasingly see hypermobility with symptoms as a multisystem condition<\/strong>, meaning it can involve several of the body&#8217;s systems at once, not only the joints. Reviews keep finding links with dizziness when you stand, gut problems, anxiety and more, though the evidence is stronger for some symptoms than others.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The map below groups the symptoms this article covers. Tick the ones you recognize, and it will point you to the part that explains each one.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"your-brain-needs-to-know-where-your-body-is\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Your brain needs to know where your body is<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Try this. Close your eyes and lift your arm. You don&#8217;t need to look to know where it is, whether your elbow is bent, or roughly where your hand is in space. You can probably touch your nose with your eyes closed, too.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s <em class=\"eqi\">proprioception<\/em>: your sense of where your body is and how it&#8217;s moving. It&#8217;s part of what lets you walk without watching your feet, hold your posture and coordinate your muscles, and it lets your nervous system make constant small corrections without you having to think about them. Much of the information comes from sensors in your muscles, tendons, joints and other tissues.<sup class=\"eq-cite\">[<a href=\"#ref-22\" aria-label=\"Reference 22\">22<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Now think about what happens when those tissues behave differently. <strong class=\"eqb\">If a joint moves further than expected, your nervous system still has to control it.<\/strong> To do that, it needs to know where the joint is, how fast it&#8217;s moving, how much force is on it and how stable it is. That&#8217;s why proprioception is so interesting in hypermobility.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-the-signal-is-less-precise\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When the signal is less precise<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Research suggests proprioception can be different when hypermobility causes symptoms. When researchers pooled several studies, people diagnosed with <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-1\"><em class=\"eqi\">benign joint hypermobility syndrome<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-1\"><b>benign joint hypermobility syndrome<\/b>An older name for joint hypermobility that causes symptoms, also called joint hypermobility syndrome. Since the 2017 classification, people who had this label would usually be described as having HSD or hEDS.<\/span><\/span> turned out to be less accurate than other people at sensing the position and movement of their leg joints. For the arms, the results were mixed.<sup class=\"eq-cite\">[<a href=\"#ref-7\" aria-label=\"Reference 7\">7<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That doesn&#8217;t mean every hypermobile person has poor proprioception, and it doesn&#8217;t mean proprioception explains every symptom. But it&#8217;s one possible piece of the puzzle.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Imagine your ankle, knee or shoulder can move through a bigger range than average, and the information your nervous system gets about it is a little less precise. Your body finds ways to compensate. Your muscles may work harder. You may control movements more deliberately, rely more on your eyes, or feel less secure in certain positions. You may develop protective ways of moving. None of this has to be a conscious choice. <strong class=\"eqb\">Your nervous system is simply trying to solve a mechanical problem with the information it has.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"staying-steady-can-be-tiring-work\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Staying steady can be tiring work<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">We usually think of effort as the obvious things: lifting something heavy, running, climbing stairs, exercising. But there&#8217;s a less obvious kind of effort that&#8217;s much harder to see, and that&#8217;s the work of staying stable.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Stand on one leg for a moment. Your ankle, knee, hip and trunk are making tiny adjustments the whole time, and you never have to tell a single muscle what to do. Now imagine that holding a position steady takes more frequent or bigger corrections. From the outside, nothing looks unusual. On the inside, it may be taking more work.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s one possible reason why some people with symptomatic hypermobility feel so tired even when their day doesn&#8217;t look demanding. If that&#8217;s you, your tiredness shouldn&#8217;t be written off as laziness, poor motivation or a lack of fitness. <strong class=\"eqb\">There may be a real physical cost to staying steady.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-23\" aria-label=\"Reference 23\">23<\/a>]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"its-rarely-only-about-the-joints\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">It&#8217;s rarely only about the joints<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It would be tempting to line it all up in one simple chain:<\/p>\n\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><p class=\"hm-chain\" aria-label=\"hypermobility, then less precise proprioception, then pain, then fatigue\"><span>hypermobility<\/span><i aria-hidden=\"true\">&rarr;<\/i><span>less precise proprioception<\/span><i aria-hidden=\"true\">&rarr;<\/i><span>pain<\/span><i aria-hidden=\"true\">&rarr;<\/i><span>fatigue<\/span><\/p><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But bodies rarely work that neatly. Pain changes how you move. The way you move changes which muscles work, and that changes the signals coming back from your body. Fatigue changes movement too. Pain pulls your attention, and attention changes what you notice. Each of these can feed the others.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s one reason <strong class=\"eqb\">researchers increasingly see symptomatic hypermobility as a <em class=\"eqi\">multisystem<\/em> condition<\/strong>, meaning it can involve several of the body&#8217;s systems at once, rather than as a problem with joints alone. Recent reviews keep finding links with muscle and joint problems, autonomic symptoms such as dizziness on standing, digestive problems, anxiety and more, although the quality and consistency of the evidence varies from one symptom to the next.<sup class=\"eq-cite\">[<a href=\"#ref-19\" aria-label=\"Reference 19\">19<\/a>,<a href=\"#ref-24\" aria-label=\"Reference 24\">24<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The map below groups the kinds of symptoms this article covers by body system. Tick the ones you recognize, and it will point you to the part that explains each one.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-sm\" id=\"hm-sm\"><div class=\"hd\"><p class=\"ti\">Which of these do you recognize?<\/p><p class=\"q\">Tick anything that sounds like you<\/p><\/div><div class=\"sys\"><div class=\"grp\" data-g=\"0\"><div class=\"gh\"><span class=\"gi\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"12\" cy=\"12\" r=\"2.6\"\/><path d=\"M10.2 13.8L5 19M13.8 10.2L19 5\"\/><path d=\"M3.2 17.4l3.4 3.4M17.4 3.2l3.4 3.4\"\/><\/svg><\/span><p class=\"gn\">Joints and muscles<\/p><p class=\"gp\">Parts two and three<\/p><\/div><div class=\"chips\"><button type=\"button\" aria-pressed=\"false\">joint pain<\/button><button type=\"button\" aria-pressed=\"false\">joints that feel unstable<\/button><button type=\"button\" aria-pressed=\"false\">injuries that keep happening<\/button><button type=\"button\" aria-pressed=\"false\">muscles working overtime<\/button><button type=\"button\" aria-pressed=\"false\">unsure where your limbs are<\/button><\/div><\/div><div class=\"grp\" data-g=\"1\"><div class=\"gh\"><span class=\"gi\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M12 19.5s-7-4.3-7-9.6A3.9 3.9 0 0 1 12 7.6a3.9 3.9 0 0 1 7 2.3c0 5.3-7 9.6-7 9.6z\"\/><\/svg><\/span><p class=\"gn\">Standing and heart<\/p><p class=\"gp\">Part four<\/p><\/div><div class=\"chips\"><button type=\"button\" aria-pressed=\"false\">dizziness when you stand<\/button><button type=\"button\" aria-pressed=\"false\">a racing heart when upright<\/button><button type=\"button\" aria-pressed=\"false\">feeling faint<\/button><button type=\"button\" aria-pressed=\"false\">shaky or weak when upright<\/button><\/div><\/div><div class=\"grp\" data-g=\"2\"><div class=\"gh\"><span class=\"gi\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><rect x=\"3\" y=\"7.5\" width=\"15.5\" height=\"9\" rx=\"2.2\"\/><path d=\"M21 10.8v2.4\"\/><path d=\"M6.3 10.5v3\"\/><\/svg><\/span><p class=\"gn\">Energy and sleep<\/p><p class=\"gp\">Part six<\/p><\/div><div class=\"chips\"><button type=\"button\" aria-pressed=\"false\">fatigue<\/button><button type=\"button\" aria-pressed=\"false\">poor sleep<\/button><\/div><\/div><div class=\"grp\" data-g=\"3\"><div class=\"gh\"><span class=\"gi\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M8.5 20v-3.1A6.6 6.6 0 1 1 18.4 11l1.5 3.2h-1.8V16a2 2 0 0 1-2 2h-1.8v2\"\/><path d=\"M9.6 9.6h4.6M9.6 12.4h3\"\/><\/svg><\/span><p class=\"gn\">Head and thinking<\/p><p class=\"gp\">Part six<\/p><\/div><div class=\"chips\"><button type=\"button\" aria-pressed=\"false\">headaches or migraine<\/button><button type=\"button\" aria-pressed=\"false\">brain fog<\/button><button type=\"button\" aria-pressed=\"false\">trouble concentrating<\/button><\/div><\/div><div class=\"grp\" data-g=\"4\"><div class=\"gh\"><span class=\"gi\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M9 3.5v3.2A3.3 3.3 0 0 1 5.7 10 2.7 2.7 0 0 0 3 12.7c0 4.3 3.4 7.8 7.7 7.8H12a8 8 0 0 0 8-8V9.2a3.1 3.1 0 0 0-6.2 0v1.6\"\/><\/svg><\/span><p class=\"gn\">Gut<\/p><p class=\"gp\">Part six<\/p><\/div><div class=\"chips\"><button type=\"button\" aria-pressed=\"false\">long-term digestive symptoms<\/button><button type=\"button\" aria-pressed=\"false\"><span class=\"hmw-nrm\">reflux<\/span><span class=\"hmw-pln\">reflux (acid coming back up)<\/span><\/button><\/div><\/div><div class=\"grp\" data-g=\"5\"><div class=\"gh\"><span class=\"gi\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M2.5 12s3.5-6.2 9.5-6.2S21.5 12 21.5 12s-3.5 6.2-9.5 6.2S2.5 12 2.5 12z\"\/><circle cx=\"12\" cy=\"12\" r=\"2.7\"\/><\/svg><\/span><p class=\"gn\">Feelings and attention<\/p><p class=\"gp\">Part five<\/p><\/div><div class=\"chips\"><button type=\"button\" aria-pressed=\"false\">anxiety<\/button><button type=\"button\" aria-pressed=\"false\">checking your body constantly<\/button><button type=\"button\" aria-pressed=\"false\">avoiding things you used to do<\/button><\/div><\/div><\/div><div class=\"out\"><div class=\"mtr\"><p class=\"ml\"><span class=\"hmw-nrm\">Body systems ticked<\/span><span class=\"hmw-pln\">Body areas ticked<\/span><\/p><div class=\"seg6\" aria-hidden=\"true\"><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><\/div><\/div><div class=\"msg\" role=\"status\" aria-live=\"polite\"><p id=\"hm-sm-t\">Tick anything you recognize. Nothing you tick is saved or sent anywhere.<\/p><ul class=\"where\" id=\"hm-sm-w\"><\/ul><\/div><\/div><div class=\"ft\"><p class=\"nd\"><b>This isn&#8217;t a diagnosis or a screening test.<\/b> Every one of these can have other causes, and many are common in people who aren&#8217;t hypermobile. If they&#8217;re affecting your life, they deserve a proper medical assessment.<\/p><button type=\"button\" class=\"clr\" id=\"hm-sm-c\">Clear<\/button><\/div><figcaption><span class=\"hmw-nrm\">The symptoms this article covers, grouped by body system. <b>In symptomatic hypermobility, symptoms often reach across several systems at once<\/b>, which is why researchers describe it as multisystem, and why looking at the whole picture matters more than treating each symptom on its own.<sup class=\"eq-cite\">[<a href=\"#ref-19\" aria-label=\"Reference 19\">19<\/a>,<a href=\"#ref-25\" aria-label=\"Reference 25\">25<\/a>]<\/sup><\/span><span class=\"hmw-pln\">The symptoms this article covers, grouped by body area. <b>With hypermobility that causes symptoms, they often show up in several areas at once.<\/b> That&#8217;s why researchers call it multisystem, and why looking at the whole picture matters more than treating each symptom on its own.<\/span><\/figcaption><\/figure><script>(function(){var f=document.getElementById(\"hm-sm\");if(!f){return;}var t=document.getElementById(\"hm-sm-t\"),w=document.getElementById(\"hm-sm-w\"),c=document.getElementById(\"hm-sm-c\");var segs=f.querySelectorAll(\".seg6 i\");var PARTN=[\"\",\"one\",\"two\",\"three\",\"four\",\"five\",\"six\",\"seven\",\"eight\",\"nine\"];var PLN={\"one\":\"You ticked something in <b>one<\/b> body area. This is where the article explains it:\",\"many\":[\"You ticked things in <b>\",\" of 6<\/b> body areas. When symptoms show up in several areas at once, researchers call it multisystem. That's why this article covers much more than joints. These parts explain each one:\"]};var P_ON=function(){var r=document.querySelector(\".hmw-post\");if(r){return r.classList.contains(\"hmw-plain\");}return false;};var G=[{\"n\":\"Joints and muscles\",\"p\":2},{\"n\":\"Standing and heart\",\"p\":4},{\"n\":\"Energy and sleep\",\"p\":6},{\"n\":\"Head and thinking\",\"p\":6},{\"n\":\"Gut\",\"p\":6},{\"n\":\"Feelings and attention\",\"p\":5}];var grps=f.querySelectorAll(\".grp\");function render(){var hit=0,parts={},order=[];for(var i=0;i<grps.length;i++){var on=grps[i].querySelectorAll(\"button[aria-pressed=true]\").length;if(on>0){hit++;grps[i].className=\"grp on\";var p=G[i].p;if(p===2){if(!parts[3]){parts[3]=1;order.push(3);}}if(!parts[p]){parts[p]=1;order.push(p);}}else{grps[i].className=\"grp\";}}for(var s=0;s<segs.length;s++){segs[s].className=s<hit?\"on\":\"\";}order.sort(function(a,b){return a-b;});if(hit===0){t.innerHTML=\"Tick anything you recognize. Nothing you tick is saved or sent anywhere.\";w.innerHTML=\"\";return;}if(hit===1){t.innerHTML=P_ON()?PLN.one:\"You ticked something in <b>one<\/b> body system. Here's where the article explains it:\";}else{if(P_ON()){t.innerHTML=PLN.many[0]+hit+PLN.many[1];}else{t.innerHTML=\"You ticked things in <b>\"+hit+\" of 6<\/b> body systems. Symptoms that reach across several systems at once are what researchers mean by multisystem, and they are why this article covers so much more than joints. Here's where each one is explained:\";}}var h=\"\";for(var k=0;k<order.length;k++){h+=\"<li><a href=\\\"#part-\"+order[k]+\"\\\">Part \"+PARTN[order[k]]+\"<\/a><\/li>\";}w.innerHTML=h;}var bs=f.querySelectorAll(\".chips button\");for(var i=0;i<bs.length;i++){bs[i].addEventListener(\"click\",function(){this.setAttribute(\"aria-pressed\",this.getAttribute(\"aria-pressed\")===\"true\"?\"false\":\"true\");render();});}c.addEventListener(\"click\",function(){for(var j=0;j<bs.length;j++){bs[j].setAttribute(\"aria-pressed\",\"false\");}render();});document.addEventListener(\"hmw-plain-change\",render);})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"48\" cy=\"38\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"nw\" cx=\"48\" cy=\"38\" r=\"4.4\"\/><circle class=\"up\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"up\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 3 of 9<\/p><h2 id=\"part-3\">Pain that outlasts the injury<\/h2><p class=\"sb\">Why pain becomes so central, and why pain your nervous system helps produce is still real<\/p><\/div><div class=\"no\" aria-hidden=\"true\">03<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you live with hypermobility and pain, the pain may not always seem to match what&#8217;s going on. That&#8217;s partly because it can come from several places at once: unstable joints, repeated injuries, overworked muscles, irritated tissue, nerve involvement, headaches and changes in how your nervous system processes pain.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Pain also isn&#8217;t a simple damage meter. How much something hurts depends on the signals coming in and on how your nervous system handles them, along with your past experience, your attention and the situation you&#8217;re in. That isn&#8217;t a way of saying pain is psychological. <strong class=\"eqb\">It&#8217;s a way of saying the nervous system is part of the biology of pain.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s a term you may have come across: central sensitization. Think of a smoke alarm that gets more and more sensitive, until it responds to tiny amounts of smoke. That doesn&#8217;t mean the alarm is faulty, and there may well have been a real fire. The system has become more responsive. <strong class=\"eqb\">After pain that lasts or keeps coming back, your nervous system can become more responsive to incoming signals.<\/strong> That&#8217;s what central sensitization describes. &#8220;Central&#8221; means your brain and spinal cord.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers have found signs of it in people with hEDS and related conditions. In one recent clinic study, people with more signs of it also tended to have more symptoms across the body, especially pain, tiredness and heart-related problems of the kind part four looks at. <strong class=\"eqb\">It doesn&#8217;t mean every symptom comes from it, and it doesn&#8217;t mean problems in the joints and tissues don&#8217;t matter.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever been told &#8220;it&#8217;s all in your head&#8221;, this part is for you. Your brain and spinal cord are organs, part of your physical body. <strong class=\"eqb\">If your nervous system is involved in producing your pain, that doesn&#8217;t make the pain imaginary.<\/strong> You can have real joint problems and real pain, and also develop changes in how your nervous system processes pain. These things can exist together.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"pain-isnt-a-damage-meter\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Pain isn&#8217;t a damage meter<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:16px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you live with hypermobility and pain, you may have noticed that the pain doesn&#8217;t always seem to match what&#8217;s going on. That makes more sense once you know that pain in hypermobility doesn&#8217;t have to come from one place. It may be linked with:<\/p>\n\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><ul class=\"hm-chips\"><li>joint instability<\/li><li>recurrent injuries<\/li><li>muscle overuse<\/li><li>altered movement patterns<\/li><li>tissue irritation<\/li><li>nerve involvement<\/li><li>headaches<\/li><li>changes in pain processing<\/li><\/ul><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Several of these can be going on in the same person at once.<sup class=\"eq-cite\">[<a href=\"#ref-9\" aria-label=\"Reference 9\">9<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">We tend to imagine pain as a direct measure of physical damage: more damage, more pain; less damage, less pain. But the nervous system doesn&#8217;t work like a simple damage meter. Pain comes from the incoming signals, from how your nervous system processes them, and from your past experience, your attention, the context you&#8217;re in and more.<sup class=\"eq-cite\">[<a href=\"#ref-26\" aria-label=\"Reference 26\">26<\/a>]<\/sup> That isn&#8217;t a way of saying pain is psychological. <strong class=\"eqb\">It&#8217;s a way of saying the nervous system is part of the biology of pain.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-smoke-alarm\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The smoke alarm<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s a term you may have come across: <em class=\"eqi\">central sensitization<\/em>. It sounds complicated, but the idea behind it is fairly intuitive.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Think of a smoke alarm. Normally it goes off when there&#8217;s enough smoke to suggest a fire. Now imagine it gets more and more sensitive, until it responds to tiny amounts of smoke. That doesn&#8217;t mean the alarm is faulty, and there may well have been a real fire. The problem is that the system has become more responsive.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Something similar can happen with pain. <strong class=\"eqb\">After pain that lasts or keeps coming back, the nervous system can become more responsive to incoming signals.<\/strong> That&#8217;s what central sensitization describes: the central nervous system, meaning your brain and spinal cord, reacting more strongly than before.<sup class=\"eq-cite\">[<a href=\"#ref-27\" aria-label=\"Reference 27\">27<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers have found signs of this in people with hEDS and related hypermobility conditions, including greater sensitivity to pain and widespread changes in how pain is processed.<sup class=\"eq-cite\">[<a href=\"#ref-8\" aria-label=\"Reference 8\">8<\/a>]<\/sup> In a recent study at a specialist clinic, the people with more signs of central sensitization also tended to have more symptoms across the body, especially pain, fatigue and heart-related autonomic problems.<sup class=\"eq-cite\">[<a href=\"#ref-18\" aria-label=\"Reference 18\">18<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s an important area of research, but it shouldn&#8217;t become another overly simple explanation. <strong class=\"eqb\">Central sensitization doesn&#8217;t mean every symptom in hypermobility comes from central sensitization, and it certainly doesn&#8217;t mean structural or mechanical problems don&#8217;t matter.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"real-pain-even-when-your-nervous-system-is-involved\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Real pain, even when your nervous system is involved<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever been told &#8220;it&#8217;s all in your head&#8221;, this part is for you. <strong class=\"eqb\">If your nervous system is involved in producing your pain, that doesn&#8217;t make the pain imaginary.<\/strong> Your nervous system is part of your physical body. Your brain is an organ. Your spinal cord is an organ. Pain processing is a biological process.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can have genuine joint instability, genuine tissue problems, genuine injuries and genuine pain, and also develop changes in how your nervous system processes pain. These things can exist together. Knowing that gives you a much more useful way to think about your pain than being forced to choose between &#8220;it&#8217;s physical&#8221; and &#8220;it&#8217;s psychological.&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<style>.eqp .eq-kp{display:grid;grid-template-columns:auto minmax(0,1fr);gap:4px 16px;align-items:start;background:#e9f3f3;border:0;border-left:4px solid #1d5f66;border-radius:4px 18px 18px 4px;padding:20px 26px;margin:6px 0 34px}.eqp .eq-kp .mk{grid-row:1\/3;width:40px;height:40px;border-radius:50%;background:#fff;color:#1d5f66;display:flex;align-items:center;justify-content:center}.eqp .eq-kp .mk svg{width:21px;height:21px}.eqp .eq-kp .k{font-family:\"Work Sans\",sans-serif;font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66;margin:2px 0 4px}.eqp .eq-kp .t{font-family:\"Work Sans\",sans-serif;font-size:clamp(15px,calc(10.6px + .72vw),19px);font-weight:500;line-height:1.55;color:#2a2622;margin:0}@media(max-width:560px){.eqp .eq-kp{grid-template-columns:minmax(0,1fr);padding:18px 20px}.eqp .eq-kp .mk{grid-row:auto;width:34px;height:34px}}<\/style><aside class=\"eq-kp\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M6.5 3.5h11a1 1 0 0 1 1 1v15.6a.5.5 0 0 1-.78.42L12 16.4l-5.72 4.12a.5.5 0 0 1-.78-.42V4.5a1 1 0 0 1 1-1z\"\/><\/svg><\/span><p class=\"k\">Worth remembering<\/p><p class=\"t\">If your nervous system is part of why something hurts, the pain is still real. Your nervous system is part of your body, so this is biology, not imagination.<\/p><\/aside>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"12\" cy=\"38\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"nw\" cx=\"12\" cy=\"38\" r=\"4.4\"\/><circle class=\"up\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 4 of 9<\/p><h2 id=\"part-4\">Standing up<\/h2><p class=\"sb\">Your autonomic nervous system, POTS, and why it gets mistaken for anxiety<\/p><\/div><div class=\"no\" aria-hidden=\"true\">04<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your heart pounds when you get up, or you&#8217;ve had to hold on to the kitchen counter until the dizziness passed, this part is about you. <strong class=\"eqb\">It&#8217;s probably where the link between hypermobility and the nervous system is strongest.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Part of your nervous system runs things you never have to think about, like your heart rate, blood pressure, blood vessels, digestion, sweating, body temperature and bladder. It&#8217;s called the autonomic nervous system. You don&#8217;t tell your blood vessels to tighten when you stand. Your autonomic nervous system makes those adjustments for you, and that matters the moment you get up.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Getting up from a chair seems too ordinary to think about. For your body, though, it&#8217;s a series of quick adjustments.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Some people&#8217;s bodies struggle with being upright. This is called orthostatic intolerance. Standing can bring dizziness, a racing or pounding heart (palpitations), weakness, nausea, shakiness, changes in your vision, tiredness or trouble concentrating. <strong class=\"eqb\">Suddenly, something as ordinary as standing in line can be physically demanding.<\/strong> The drawing below steps through what standing asks of your body, and how it can feel when your body struggles to keep up.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-part-of-your-nervous-system-that-runs-itself\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The part of your nervous system that runs itself<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve ever felt your heart pound as you got up, or had to hold on to the kitchen counter until the dizziness passed, this part is about you. <strong class=\"eqb\">It&#8217;s probably where the link between hypermobility and the nervous system is strongest.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-3\" aria-label=\"Reference 3\">3<\/a>,<a href=\"#ref-4\" aria-label=\"Reference 4\">4<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:16px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your autonomic nervous system runs the things that happen without you deciding them. It helps regulate:<\/p>\n\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><ul class=\"hm-chips\"><li>heart rate<\/li><li>blood pressure<\/li><li>blood vessel tone<\/li><li>digestion<\/li><li>sweating<\/li><li>body temperature<\/li><li>bladder function<\/li><li>aspects of sexual function<\/li><\/ul><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You don&#8217;t tell your blood vessels to tighten when you stand, and you don&#8217;t think &#8220;my heart should speed up a little now.&#8221; Your autonomic nervous system makes those adjustments for you, and that becomes important the moment you get up.<sup class=\"eq-cite\">[<a href=\"#ref-28\" aria-label=\"Reference 28\">28<\/a>]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-standing-up-asks-of-your-body\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What standing up asks of your body<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Getting up from a chair seems too ordinary to think about. For your body, though, it&#8217;s a series of quick adjustments. Gravity pulls blood toward the lower part of your body, so your circulation has to compensate. Blood vessels tighten, your heart rate changes, your blood pressure is adjusted and blood flow is redistributed. Your autonomic nervous system coordinates much of this, and for most people it happens so smoothly that they barely notice.<sup class=\"eq-cite\">[<a href=\"#ref-29\" aria-label=\"Reference 29\">29<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:16px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you have <em class=\"eqi\">orthostatic intolerance<\/em>, which means your body struggles with being upright, standing can bring real symptoms.<sup class=\"eq-cite\">[<a href=\"#ref-4\" aria-label=\"Reference 4\">4<\/a>,<a href=\"#ref-29\" aria-label=\"Reference 29\">29<\/a>]<\/sup> They can include:<\/p>\n\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><ul class=\"hm-chips\"><li>dizziness<\/li><li>lightheadedness<\/li><li>weakness<\/li><li>palpitations<\/li><li>racing heart<\/li><li>nausea<\/li><li>shakiness<\/li><li>visual disturbances<\/li><li>fatigue<\/li><li>difficulty concentrating<\/li><\/ul><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Suddenly, something as ordinary as standing in line can be physically demanding.<\/strong> The drawing below steps through what standing asks of your body, and how it can feel when your body struggles to keep up.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-st\" id=\"hm-st\" data-s=\"u\"><div class=\"hd\"><p class=\"ti\">Standing up<\/p><p class=\"q\">What standing asks of your body<\/p><\/div><div class=\"ctl\"><div class=\"ra-seg\" role=\"group\" aria-label=\"Which body\"><button type=\"button\" data-s=\"u\" aria-pressed=\"true\">usually<\/button><button type=\"button\" data-s=\"p\" aria-pressed=\"false\">with POTS<\/button><\/div><\/div><div class=\"lay\"><div class=\"plot\"><p class=\"yl\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M2.5 12.5h4l2-5.5 3.6 11 2.3-5.5h7.1\"\/><\/svg><span>Heart rate<\/span><\/p><div class=\"cv\"><svg viewBox=\"0 0 600 220\" preserveAspectRatio=\"none\" aria-hidden=\"true\" focusable=\"false\"><path class=\"bd\" d=\"M0,219.5 L600,219.5\"\/><path class=\"bd\" d=\"M0.5,0 L0.5,220\"\/><path class=\"gl\" d=\"M0,60 L600,60\"\/><path class=\"gl\" d=\"M0,145 L600,145\"\/><path class=\"mk\" d=\"M180,0 L180,219\"\/><path class=\"au\" d=\"M0,170 L180,170 C212,170 222,140 262,141 S340,145 600,145 L600,220 L0,220 Z\"\/><path class=\"ap\" d=\"M0,170 L180,170 C206,170 220,62 262,58 S340,60 600,60 L600,220 L0,220 Z\"\/><path class=\"pu\" d=\"M0,170 L180,170 C212,170 222,140 262,141 S340,145 600,145\"\/><path class=\"pp\" d=\"M0,170 L180,170 C206,170 220,62 262,58 S340,60 600,60\"\/><\/svg><p class=\"tg u\">usually<\/p><p class=\"tg p\">in POTS<\/p><\/div><div class=\"xl\"><p class=\"a\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"9\" cy=\"5\" r=\"1.9\"\/><path d=\"M9 8.5v5.5h6.5l1.5 6\"\/><path d=\"M5.5 11v7.5M5.5 14h3.5\"\/><\/svg><span>sitting<\/span><\/p><p class=\"b\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"12\" cy=\"4.6\" r=\"1.9\"\/><path d=\"M12 8v7.5M12 15.5l-2.6 5M12 15.5l2.6 5M8.5 11h7\"\/><\/svg><span>you stand up<\/span><\/p><p class=\"c\"><span>minutes upright<\/span><\/p><\/div><\/div><ol class=\"steps\"><li><span class=\"si\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M12 3.5v12.5\"\/><path d=\"M7 11.5l5 5 5-5\"\/><path d=\"M5 20.5h14\"\/><\/svg><\/span><span><span class=\"hmw-nrm\">Gravity pulls blood toward the lower part of your body.<\/span><span class=\"hmw-pln\">Gravity pulls blood down toward your legs.<\/span><\/span><\/li><li><span class=\"si\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M3 7.5c4.6 0 5.8 3.6 9 3.6s4.4-3.6 9-3.6\"\/><path d=\"M3 16.5c4.6 0 5.8-3.6 9-3.6s4.4 3.6 9 3.6\"\/><\/svg><\/span><span>Blood vessels tighten and your heart rate changes.<\/span><\/li><li><span class=\"si\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 17.5a8 8 0 1 1 16 0\"\/><path d=\"M12 17.5l3.6-5\"\/><circle cx=\"12\" cy=\"17.5\" r=\"1.1\"\/><\/svg><\/span><span><span class=\"hmw-nrm\">Blood pressure is adjusted and blood flow is redistributed.<\/span><span class=\"hmw-pln\">Your blood pressure adjusts and blood flow shifts around your body.<\/span><\/span><\/li><li class=\"last\"><span class=\"si\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M5 12a7 7 0 0 1 12.2-4.7\"\/><path d=\"M19 12a7 7 0 0 1-12.2 4.7\"\/><path d=\"M17.8 3.6v3.9h-3.9M6.2 20.4v-3.9h3.9\"\/><\/svg><\/span><span id=\"hm-st-l\">For most people, it happens so smoothly that they <b>barely notice any of it<\/b>.<\/span><\/li><\/ol><\/div><figcaption><span class=\"hmw-nrm\"><b>A sketch, not a measurement.<\/b> The drawing has no numbers on purpose: it can&#8217;t tell you whether you have POTS, and a racing heart or dizziness when you stand is worth raising with a doctor.<\/span><span class=\"hmw-pln\"><b>This is a drawing, and it doesn&#8217;t measure anything.<\/b> The drawing has no numbers on purpose: it can&#8217;t tell you whether you have POTS, and a racing heart or dizziness when you stand is worth raising with a doctor.<\/span><\/figcaption><\/figure><script>(function(){var f=document.getElementById(\"hm-st\");if(!f){return;}var l=document.getElementById(\"hm-st-l\");var T={u:\"For most people, it happens so smoothly that they <b>barely notice any of it<\/b>.\",p:\"In POTS, <b>heart rate rises too much<\/b>, and being upright can bring dizziness, a racing heart, weakness, nausea or trouble concentrating.\"};var bs=f.querySelectorAll(\".ra-seg button\");for(var i=0;i<bs.length;i++){bs[i].addEventListener(\"click\",function(){var s=this.getAttribute(\"data-s\");for(var j=0;j<bs.length;j++){bs[j].setAttribute(\"aria-pressed\",bs[j]===this?\"true\":\"false\");}f.setAttribute(\"data-s\",s);l.innerHTML=T[s];});}})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One kind is POTS, short for postural orthostatic tachycardia syndrome. Tachycardia means a fast heart rate. In POTS, your heart rate rises too much when you stand, along with those symptoms. <strong class=\"eqb\">POTS is a medical condition.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s worth saying clearly, because some of its symptoms look a lot like anxiety, such as a racing heart, trembling, sweating, shortness of breath, dizziness, feeling faint and a sense that something&#8217;s wrong. Those can happen in panic. <strong class=\"eqb\">They can also happen because of a physical problem with how your body adjusts to being upright.<\/strong> If you&#8217;ve been told it&#8217;s just nerves, that difference matters.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">How often POTS and hypermobility go together depends a lot on which study you read. When one recent review gathered the research on people with EDS or POTS, the overlap ranged enormously from one study to the next. The chart below shows just how wide!<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"pots-and-why-it-can-look-like-panic\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">POTS, and why it can look like panic<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One form of orthostatic intolerance is postural orthostatic tachycardia syndrome, usually called POTS. Tachycardia means a fast heart rate. In POTS, your heart rate rises too much when you move into an upright position, together with the typical symptoms of orthostatic intolerance. <strong class=\"eqb\">POTS is a medical condition.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-30\" aria-label=\"Reference 30\">30<\/a>,<a href=\"#ref-31\" aria-label=\"Reference 31\">31<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s worth saying clearly, because some of its symptoms look remarkably like anxiety: a racing heart, trembling, sweating, shortness of breath, dizziness, feeling faint, and a sense that something is wrong. Those sensations can happen during panic.<sup class=\"eq-cite\">[<a href=\"#ref-32\" aria-label=\"Reference 32\">32<\/a>]<\/sup> <strong class=\"eqb\">They can also happen because of a physical problem with how your body adjusts to being upright.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-31\" aria-label=\"Reference 31\">31<\/a>]<\/sup> If you&#8217;ve been told it&#8217;s just nerves, that difference matters.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"how-often-pots-and-hypermobility-go-together\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">How often POTS and hypermobility go together<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So how often do they go together? That depends a lot on which study you read. When one recent review gathered the research on people with EDS or POTS, the overlap ranged enormously from one study to the next. The chart below shows just how wide!<sup class=\"eq-cite\">[<a href=\"#ref-6\" aria-label=\"Reference 6\">6<\/a>]<\/sup><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-rg\" id=\"hm-rg\"><div class=\"hd\"><p class=\"ti\">What the studies found<\/p><p class=\"q\"><span class=\"hmw-nrm\">The overlap is real. Its size isn&#8217;t settled<\/span><span class=\"hmw-pln\">They often go together. How often is still unclear<\/span><\/p><\/div><div class=\"plot\"><div class=\"grid\" aria-hidden=\"true\"><i style=\"left:0\"><\/i><i style=\"left:25%\"><\/i><i style=\"left:50%\"><\/i><i style=\"left:75%\"><\/i><i style=\"left:100%\"><\/i><\/div><div class=\"rw\"><p class=\"bl\">How many people with EDS also had POTS<\/p><div class=\"tr\"><span class=\"rb\" style=\"left:17.5%;width:75.2%\"><\/span><span class=\"e\" style=\"left:17.5%\"><\/span><span class=\"e\" style=\"left:92.7%\"><\/span><span class=\"v\" style=\"left:17.5%\">17.5%<\/span><span class=\"v\" style=\"left:92.7%\">92.7%<\/span><\/div><\/div><div class=\"rw\"><p class=\"bl\">How many people with POTS also had EDS<\/p><div class=\"tr\"><span class=\"rb\" style=\"left:17.9%;width:32.1%\"><\/span><span class=\"e\" style=\"left:17.9%\"><\/span><span class=\"e\" style=\"left:50%\"><\/span><span class=\"v\" style=\"left:17.9%\">17.9%<\/span><span class=\"v\" style=\"left:50%\">50%<\/span><\/div><\/div><div class=\"ax\" aria-hidden=\"true\"><span style=\"left:0\">0%<\/span><span style=\"left:25%\">25%<\/span><span style=\"left:50%\">50%<\/span><span style=\"left:75%\">75%<\/span><span style=\"left:100%\">100%<\/span><\/div><\/div><p class=\"key\" aria-hidden=\"true\"><span class=\"k1\"><\/span><span class=\"hmw-nrm\">lowest study<\/span><span class=\"hmw-pln\">lowest result<\/span><span class=\"k2\"><\/span><span class=\"hmw-nrm\">the spread between studies<\/span><span class=\"hmw-pln\">the range across studies<\/span><span class=\"k1\"><\/span><span class=\"hmw-nrm\">highest study<\/span><span class=\"hmw-pln\">highest result<\/span><\/p><figcaption><span class=\"hmw-nrm\">Across the 30 studies in a 2026 review, the share of people with EDS who also had POTS ran from 17.5% to 92.7%, and the share of people with POTS who also had EDS from 17.9% to 50%.<sup class=\"eq-cite\">[<a href=\"#ref-6\" aria-label=\"Reference 6\">6<\/a>]<\/sup> <b>Each span is the spread between studies, not a margin of error.<\/b> It reflects which people and clinics were studied, which is why a single confident number, in either direction, deserves some suspicion.<\/span><span class=\"hmw-pln\">In a 2026 review of 30 studies, the share of people with EDS who also had POTS ran from 17.5% to 92.7%. The share of people with POTS who also had EDS ran from 17.9% to 50%. <b>Each bar shows how far apart the studies landed, and it isn&#8217;t a margin of error.<\/b> That depends on which people and clinics were studied, so a single confident number, in either direction, deserves some suspicion.<\/span><\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">What the studies do agree on is that <strong class=\"eqb\">POTS and EDS or hypermobility often go together.<\/strong> What can&#8217;t be said is that everyone with hypermobility has POTS, or that hypermobility always causes it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers are looking at several possible explanations, including how blood vessels behave, blood pooling in the lower body, how the autonomic nervous system controls things, blood volume and nerve-related causes. There may not be one single cause, and <strong class=\"eqb\">different people may arrive at similar symptoms by different routes.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A racing heart can also set off fear. Picture it. You stand up, and your heart suddenly races. You feel lightheaded, and you notice your breathing. Your brain tries to work out what&#8217;s happening, and if the feeling is frightening, it may read it as a threat. Your heart may beat faster, your muscles tense and your attention locks onto your body. Now there&#8217;s even more to notice, and the fear can grow.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The loop below shows how that builds. It&#8217;s a genuine mind-body process. <strong class=\"eqb\">But it doesn&#8217;t mean anxiety caused the original physical symptom.<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">What the studies do agree on is that <strong class=\"eqb\">POTS and EDS or hypermobility often occur together.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-4\" aria-label=\"Reference 4\">4<\/a>,<a href=\"#ref-5\" aria-label=\"Reference 5\">5<\/a>,<a href=\"#ref-6\" aria-label=\"Reference 6\">6<\/a>]<\/sup> What can&#8217;t be said is that everyone with hypermobility has POTS, or that hypermobility always causes it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers are looking at several possible explanations, including how blood vessels behave, blood pooling in the lower body, autonomic control, blood volume and nerve-related mechanisms.<sup class=\"eq-cite\">[<a href=\"#ref-3\" aria-label=\"Reference 3\">3<\/a>,<a href=\"#ref-31\" aria-label=\"Reference 31\">31<\/a>]<\/sup> There may not be one single mechanism. <strong class=\"eqb\">Different people may arrive at similar symptoms by different routes.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"how-a-racing-heart-turns-into-fear\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">How a racing heart turns into fear<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Picture it. You stand up, and your heart suddenly races. You feel lightheaded, your chest feels strange, and you become aware of your breathing. Your brain now has a problem to solve: what&#8217;s happening?<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your brain is always trying to interpret signals from your body. If a sensation is unfamiliar or frightening, it may read it as a threat, and that reading can raise your arousal further. Your heart may beat faster, your muscles tense, your breathing changes and your attention locks onto your body. Now there&#8217;s even more to notice. You think &#8220;why is my heart beating even faster?&#8221;, which raises the fear, which raises the checking, which makes the sensations more noticeable still.<sup class=\"eq-cite\">[<a href=\"#ref-33\" aria-label=\"Reference 33\">33<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The loop below shows how that can build. It&#8217;s a genuine mind-body process. <strong class=\"eqb\">But it doesn&#8217;t mean anxiety caused the original physical symptom.<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-lp\" id=\"hm-lp\"><div class=\"hd\"><p class=\"ti\">A loop, not a line<\/p><p class=\"q\"><span class=\"hmw-nrm\">How a physical symptom can become an anxiety trigger<\/span><span class=\"hmw-pln\">How a body symptom can start to set off anxiety<\/span><\/p><\/div><div class=\"lay\"><div class=\"ringbox\"><svg class=\"rg\" viewBox=\"0 0 100 100\" aria-hidden=\"true\" focusable=\"false\"><defs><marker id=\"hm-lp-ah\" viewBox=\"0 0 10 10\" refX=\"7\" refY=\"5\" markerUnits=\"userSpaceOnUse\" markerWidth=\"3.6\" markerHeight=\"3.6\" orient=\"auto\"><path d=\"M1.5 1.5L8 5L1.5 8.5\" fill=\"none\" stroke=\"#1d5f66\" stroke-width=\"1.8\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/><\/marker><\/defs><circle class=\"trk\" cx=\"50\" cy=\"50\" r=\"36\"\/><path class=\"arc\" data-i=\"0\" d=\"M62.9,16.39 A36,36 0 0 1 77.98,27.34\" marker-end=\"url(#hm-lp-ah)\"\/><path class=\"arc\" data-i=\"1\" d=\"M85.95,51.88 A36,36 0 0 1 80.19,69.61\" marker-end=\"url(#hm-lp-ah)\"\/><path class=\"arc\" data-i=\"2\" d=\"M59.32,84.77 A36,36 0 0 1 40.68,84.77\" marker-end=\"url(#hm-lp-ah)\"\/><path class=\"arc\" data-i=\"3\" d=\"M19.81,69.61 A36,36 0 0 1 14.05,51.88\" marker-end=\"url(#hm-lp-ah)\"\/><path class=\"arc\" data-i=\"4\" d=\"M22.02,27.34 A36,36 0 0 1 37.1,16.39\" marker-end=\"url(#hm-lp-ah)\"\/><\/svg><ol class=\"nodes\" aria-hidden=\"true\"><li class=\"nd on\" style=\"left:50%;top:14%\"><b>1<\/b><span class=\"hmw-nrm\">A sensation<\/span><span class=\"hmw-pln\">A sensation<\/span><\/li><li class=\"nd\" style=\"left:84.24%;top:38.88%\"><b>2<\/b><span class=\"hmw-nrm\">Read as a threat<\/span><span class=\"hmw-pln\">Seen as danger<\/span><\/li><li class=\"nd\" style=\"left:71.16%;top:79.12%\"><b>3<\/b><span class=\"hmw-nrm\">Arousal rises<\/span><span class=\"hmw-pln\">Body on alert<\/span><\/li><li class=\"nd\" style=\"left:28.84%;top:79.12%\"><b>4<\/b><span class=\"hmw-nrm\">Sensations grow<\/span><span class=\"hmw-pln\">Sensations grow<\/span><\/li><li class=\"nd\" style=\"left:15.76%;top:38.88%\"><b>5<\/b><span class=\"hmw-nrm\">More checking<\/span><span class=\"hmw-pln\">More checking<\/span><\/li><\/ol><div class=\"core\" aria-hidden=\"true\"><span class=\"hb\" id=\"hm-lp-h\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M12 19.5s-7-4.3-7-9.6A3.9 3.9 0 0 1 12 7.6a3.9 3.9 0 0 1 7 2.3c0 5.3-7 9.6-7 9.6z\"\/><\/svg><\/span><p class=\"lp\" id=\"hm-lp-lap\">Round 1<\/p><\/div><\/div><div class=\"side\"><ol class=\"ring\"><li class=\"on\"><p class=\"n\">1<\/p><div><p class=\"nm\"><span class=\"hmw-nrm\">A bodily sensation<\/span><span class=\"hmw-pln\">A feeling in your body<\/span><\/p><p class=\"tx\">Your heart races. You feel lightheaded as you stand.<\/p><\/div><\/li><li><p class=\"n\">2<\/p><div><p class=\"nm\"><span class=\"hmw-nrm\">Your brain reads a threat<\/span><span class=\"hmw-pln\">It feels like danger<\/span><\/p><p class=\"tx\">&#8220;What&#8217;s happening? Is something wrong?&#8221;<\/p><\/div><\/li><li><p class=\"n\">3<\/p><div><p class=\"nm\"><span class=\"hmw-nrm\">Arousal rises<\/span><span class=\"hmw-pln\">Your body goes on alert<\/span><\/p><p class=\"tx\">Your muscles tense and your breathing changes.<\/p><\/div><\/li><li><p class=\"n\">4<\/p><div><p class=\"nm\"><span class=\"hmw-nrm\">Sensations get stronger<\/span><span class=\"hmw-pln\">Sensations get stronger<\/span><\/p><p class=\"tx\">Now there&#8217;s more to notice, and it feels more urgent.<\/p><\/div><\/li><li><p class=\"n\">5<\/p><div><p class=\"nm\"><span class=\"hmw-nrm\">Checking increases<\/span><span class=\"hmw-pln\">You check more<\/span><\/p><p class=\"tx\">Your attention locks onto your body.<\/p><\/div><\/li><\/ol><div class=\"mt\"><p class=\"ml\">How noticeable the sensation feels<\/p><div class=\"mtr\"><i id=\"hm-lp-m\"><\/i><\/div><\/div><p class=\"st\" id=\"hm-lp-s\" role=\"status\" aria-live=\"polite\"><b>Step one.<\/b> A real sensation, such as a racing heart when you stand.<\/p><div class=\"ctl\"><button type=\"button\" id=\"hm-lp-n\">Next step<\/button><button type=\"button\" class=\"sec\" id=\"hm-lp-r\">Start again<\/button><\/div><\/div><\/div><figcaption><span class=\"hmw-nrm\"><b>Each step is an ordinary response. The trouble is that the last one feeds the first.<\/b> The original sensation can be entirely real; the loop is what builds around it.<sup class=\"eq-cite\">[<a href=\"#ref-33\" aria-label=\"Reference 33\">33<\/a>]<\/sup> That&#8217;s why it can be worked on psychologically without anyone claiming the symptom was imaginary.<\/span><span class=\"hmw-pln\"><b>Each step is a normal reaction. The trouble is that the last step feeds the first.<\/b> The first feeling can be completely real, and the loop builds around it. That&#8217;s why it can be worked on psychologically without anyone saying the symptom was imaginary.<\/span><\/figcaption><\/figure><script>(function(){var f=document.getElementById(\"hm-lp\");if(!f){return;}var li=f.querySelectorAll(\".ring li\"),nd=f.querySelectorAll(\".nodes li\"),arcs=f.querySelectorAll(\".arc\"),m=document.getElementById(\"hm-lp-m\"),s=document.getElementById(\"hm-lp-s\");var hb=document.getElementById(\"hm-lp-h\"),lp=document.getElementById(\"hm-lp-lap\");var S=[\"<b>Step one.<\/b> A real sensation, such as a racing heart when you stand.\",\"<b>Step two.<\/b> Your brain tries to make sense of it, and an unfamiliar sensation can read as a threat.\",\"<b>Step three.<\/b> That reading raises your arousal: muscles tense, breathing changes.\",\"<b>Step four.<\/b> Now the sensations are stronger, and there's more to notice.\",\"<b>Step five.<\/b> You check more, and checking brings you straight back to step one.\"];var i=0,lap=0;var SP=[\"<b>Step one.<\/b> A real feeling in your body, such as a racing heart when you stand.\",\"<b>Step two.<\/b> Your brain tries to make sense of it. 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It can look like anxiety, and it can set anxiety off, but that doesn&#8217;t mean anxiety caused it.<\/p><\/aside>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"43\" cy=\"30\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"nw\" cx=\"43\" cy=\"30\" r=\"4.4\"\/><circle class=\"up\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"up\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 5 of 9<\/p><h2 id=\"part-5\">When your body teaches your brain what to fear<\/h2><p class=\"sb\">Worry, checking, anxiety, and being told it&#8217;s all anxiety<\/p><\/div><div class=\"no\" aria-hidden=\"true\">05<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Say your heart races every time you stand. Then it happens while you&#8217;re out, you get dizzy, and you get scared. &#8220;What if I faint?&#8221; Then &#8220;What if it happens somewhere I can&#8217;t sit down?&#8221; Then &#8220;What if I&#8217;m alone?&#8221; And eventually, &#8220;Maybe I shouldn&#8217;t go out.&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The first symptom may have been completely real. But now a psychological layer has grown around it. If you start avoiding the places where it happened, your nervous system learns that they&#8217;re dangerous, and the fear gets stronger. <strong class=\"eqb\">This is how a physical symptom can become psychologically disabling without ever being psychologically imaginary.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your brain learns from experience. Say you&#8217;ve felt dizzy in the supermarket a few times. Soon, just walking in makes you anxious, and you start checking yourself. That&#8217;s a very normal kind of learning. <strong class=\"eqb\">The difficulty is that the protective response can grow bigger than the original problem<\/strong>, until you avoid the supermarket even on days when your body might have managed it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your body has surprised you again and again, it makes sense to pay attention. <strong class=\"eqb\">The trouble starts when watching your body becomes constant<\/strong>, which is sometimes called hypervigilance. At that point, the attention itself becomes exhausting. That&#8217;s one of the places where psychological help can be useful. The sensations aren&#8217;t imaginary, but your relationship with them has become threatening.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sensing what&#8217;s going on inside your body, like your heartbeat or breathing, is called interoception. <strong class=\"eqb\">The body is part of the emotional experience<\/strong>: anxiety can come with a racing heart, a tight chest and tense muscles. Noticing a signal strongly isn&#8217;t the same as reading it correctly. You can be very aware of your heartbeat without knowing why it&#8217;s beating faster. Research has found links between hypermobility, anxiety and how the brain handles these signals.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Anxiety and hypermobility often show up together, particularly panic disorder and agoraphobia, which is anxiety about being somewhere that would be hard to leave, or where help might be hard to reach. A large recent review found that <strong class=\"eqb\">anxiety was especially raised in people whose hypermobility causes symptoms<\/strong>, with smaller differences in people who are hypermobile without symptoms.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s probably more than one reason. The two may share some of the same body machinery. Pain, dizziness, tiredness and symptoms you can&#8217;t predict are stressful in themselves. If moving keeps hurting, you can become afraid of moving. And living with a poorly understood condition is exhausting, and <strong class=\"eqb\">being told your symptoms are &#8220;just anxiety&#8221; can make you question your own perception.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your body has behaved unpredictably again and again, a new question arrives: can I trust my body? You may become more cautious, check yourself more closely or avoid things you used to do. You may feel grief, anger, or even betrayal. <strong class=\"eqb\">These reactions are understandable, and they matter.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">People with complex symptoms can spend a long time trying to understand what&#8217;s happening to them. Sometimes the tests come back normal, or symptoms get put down to stress or anxiety too quickly. Sometimes people do have anxiety alongside their physical symptoms. <strong class=\"eqb\">The problem comes when a psychological explanation replaces a proper physical investigation instead of sitting alongside it.<\/strong> Being told &#8220;it&#8217;s probably anxiety&#8221; can leave you feeling dismissed, and doubting your own body. If that&#8217;s happened to you, the box below is a good place to start.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"from-thats-strange-to-maybe-i-shouldnt-go-out\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">From &#8220;that&#8217;s strange&#8221; to &#8220;maybe I shouldn&#8217;t go out&#8221;<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Imagine your heart races every time you stand. At first you just find it strange. Then it happens while you&#8217;re out. You get dizzy, and you get frightened. Before long, the thoughts start:<\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#d9e7e6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;What if I faint?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Then:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;What if it happens somewhere I can&#8217;t sit down?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Then:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;What if I&#8217;m alone?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And eventually:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;Maybe I shouldn&#8217;t go out.&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The original symptom may have been completely real. But now a psychological layer has grown around it. You might start avoiding the places where it happened, and the avoiding can make the fear stronger, because your nervous system learns &#8220;that situation is dangerous.&#8221; Slowly, life can start to organize itself around avoiding it.<sup class=\"eq-cite\">[<a href=\"#ref-34\" aria-label=\"Reference 34\">34<\/a>]<\/sup> <strong class=\"eqb\">This is how a physical symptom can become psychologically disabling without ever being psychologically imaginary.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-supermarket-problem\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The supermarket problem<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your brain is a prediction machine. It learns from experience, and if a situation keeps coming before pain, dizziness, instability or another frightening sensation, your brain starts to expect it.<sup class=\"eq-cite\">[<a href=\"#ref-35\" aria-label=\"Reference 35\">35<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Say you&#8217;ve felt dizzy in the supermarket a few times. Soon, just walking in makes you anxious, and you start scanning yourself. How do I feel? Is my heart okay? Am I getting dizzy? Where&#8217;s the nearest place to sit? The supermarket has become linked with danger.<sup class=\"eq-cite\">[<a href=\"#ref-34\" aria-label=\"Reference 34\">34<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s a very normal kind of learning. <strong class=\"eqb\">The difficulty is that the protective response can grow bigger than the original problem<\/strong>, until you avoid the supermarket even on days when your body might have managed it.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"paying-attention-isnt-the-same-as-imagining-it\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Paying attention isn&#8217;t the same as imagining it<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your body has surprised you with pain, dizziness, instability or other symptoms again and again, it makes sense to pay attention. If a sensation has been followed by something frightening before, noticing it early can even feel protective. <strong class=\"eqb\">The trouble starts when watching your body becomes constant<\/strong>, which is sometimes called <em class=\"eqi\">hypervigilance<\/em>.<sup class=\"eq-cite\">[<a href=\"#ref-36\" aria-label=\"Reference 36\">36<\/a>]<\/sup><\/p>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#d9e7e6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">Instead of:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;I notice that my heart is beating faster.&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">it becomes:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;My heart is beating faster. Why? Is something wrong? What if I faint? What if this gets worse?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And then:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;I need to keep checking.&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.5\">And eventually:<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;I can&#8217;t stop monitoring my body.&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At that point, the attention itself becomes exhausting. That&#8217;s one of the places where psychological help can be useful. Not because the sensations are imaginary, but because your relationship with them has become threatening.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"feeling-the-inside-of-your-body\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Feeling the inside of your body<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There&#8217;s a name for how you sense what&#8217;s going on inside you: <em class=\"eqi\">interoception<\/em>. It covers how signals from inside your body are sensed, processed and interpreted: your heartbeat, your breathing, hunger, thirst, temperature, nausea, muscle sensations and changes in your internal organs.<sup class=\"eq-cite\">[<a href=\"#ref-37\" aria-label=\"Reference 37\">37<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">We don&#8217;t experience emotions only as thoughts. We feel them in the body too. Anxiety, for example, can come with a racing heart, a tight chest, butterflies in the stomach, muscle tension, changes in breathing, sweating and restlessness. <strong class=\"eqb\">The body is part of the emotional experience.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-38\" aria-label=\"Reference 38\">38<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Researchers have also found links between joint hypermobility, anxiety and the way body signals and emotions are processed, including differences in the brain areas that handle information from the body.<sup class=\"eq-cite\">[<a href=\"#ref-10\" aria-label=\"Reference 10\">10<\/a>,<a href=\"#ref-39\" aria-label=\"Reference 39\">39<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It helps to be careful here, because interoception isn&#8217;t simply &#8220;body awareness.&#8221; You can be very aware of your heartbeat without knowing why it&#8217;s beating faster. You can notice sensations intensely without reading them accurately.<sup class=\"eq-cite\">[<a href=\"#ref-40\" aria-label=\"Reference 40\">40<\/a>]<\/sup> And you can be barely aware of some signals while still having significant symptoms. So what matters is less whether you&#8217;re &#8220;in touch with your body&#8221; and more how your body&#8217;s signals are detected, interpreted and given meaning.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"why-anxiety-and-hypermobility-show-up-together\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why anxiety and hypermobility show up together<\/h3>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-c0682441 wp-block-group-is-layout-constrained\" style=\"background-color:#f1f6f6;border-color:#d9e7e6;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:30px;margin-bottom:40px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THE RESEARCH HAS FOUND<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;re hypermobile and anxious, you&#8217;re part of a pattern researchers have been noticing for decades. Earlier studies found anxiety linked with joint hypermobility, particularly panic disorder and <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-2\"><em class=\"eqi\">agoraphobia<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-2\"><b>agoraphobia<\/b>Anxiety about being somewhere that would be hard to leave, or where help might be hard to reach. It&#8217;s often described as a fear of open spaces, which isn&#8217;t quite it: the fear is about being unable to get out.<\/span><\/span>.<sup class=\"eq-cite\">[<a href=\"#ref-11\" aria-label=\"Reference 11\">11<\/a>,<a href=\"#ref-41\" aria-label=\"Reference 41\">41<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Newer research still supports the link. A large recent review found that <strong class=\"eqb\">anxiety was especially raised in people whose hypermobility causes symptoms<\/strong>, with smaller differences in people who are hypermobile without symptoms. Anxiety also seemed to rise with how pronounced the hypermobility was.<sup class=\"eq-cite\">[<a href=\"#ref-16\" aria-label=\"Reference 16\">16<\/a>]<\/sup><\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That still leaves the most important question: why? The answer is probably not one thing, and several routes can be true at once.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">One route is biological. The two may share some of the same machinery: how the autonomic nervous system works, how signals from inside the body are read, or how the senses are processed. Another is physical: chronic pain, dizziness, fatigue and unpredictable symptoms are stressful in themselves.<sup class=\"eq-cite\">[<a href=\"#ref-12\" aria-label=\"Reference 12\">12<\/a>,<a href=\"#ref-39\" aria-label=\"Reference 39\">39<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Another is behavioral. If moving keeps causing pain, you may become afraid of moving. If standing keeps making you dizzy, you may become afraid of standing. If exercise keeps triggering flares, you may start avoiding exercise.<sup class=\"eq-cite\">[<a href=\"#ref-36\" aria-label=\"Reference 36\">36<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">And another is social. Living with a condition that&#8217;s poorly understood is frustrating, explaining your symptoms again and again is exhausting, and <strong class=\"eqb\">being told your symptoms are &#8220;just anxiety&#8221; can make you question your own perception<\/strong>.<sup class=\"eq-cite\">[<a href=\"#ref-42\" aria-label=\"Reference 42\">42<\/a>,<a href=\"#ref-43\" aria-label=\"Reference 43\">43<\/a>]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"when-your-body-stops-being-predictable\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When your body stops being predictable<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Most of us walk around assuming our bodies are fairly predictable. You don&#8217;t usually wonder whether your knee will stay stable as you cross the room, whether standing in line will make you dizzy, whether carrying the groceries will hurt later, or whether you&#8217;ll have enough energy to get through the afternoon.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If your body has behaved unpredictably again and again, that assumption can change, and a new question arrives: can I trust my body? That question can reach into almost everything. You may become more cautious, check yourself more closely, stop making plans too far ahead or avoid things you used to do. You may feel frustrated, feel grief, feel angry with your body, or even feel betrayed by it.<sup class=\"eq-cite\">[<a href=\"#ref-42\" aria-label=\"Reference 42\">42<\/a>]<\/sup> <strong class=\"eqb\">These reactions are understandable, and they matter.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"having-to-prove-that-something-is-wrong\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Having to prove that something is wrong<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">People with complex symptoms across several body systems can spend a long time trying to understand what&#8217;s happening to them. Sometimes each symptom is treated separately. Sometimes there&#8217;s no clear explanation, or the tests come back normal. Sometimes symptoms are put down to stress or anxiety too quickly. And sometimes people genuinely do have anxiety alongside their physical symptoms.<sup class=\"eq-cite\">[<a href=\"#ref-12\" aria-label=\"Reference 12\">12<\/a>,<a href=\"#ref-43\" aria-label=\"Reference 43\">43<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The problem comes when a psychological explanation replaces a proper physical investigation instead of sitting alongside it.<\/strong> Being told &#8220;it&#8217;s probably anxiety&#8221; when you have a genuine physical problem can leave you feeling dismissed and unheard. It can also leave you doubting your own body. You start wondering:<\/p>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-66cb9a2b wp-block-group-is-layout-constrained\" style=\"border-left-color:#d9e7e6;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:30px;margin-bottom:30px;padding:2px 0px 2px 26px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;Am I imagining this?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:8px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;Am I exaggerating?&#8221;<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#1d5f66;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.625), 19.5px);font-weight:600;line-height:1.5\">&#8220;Maybe I really am just anxious.&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That uncertainty can become a source of distress of its own.<\/p>\n\n\n\n<div class=\"wp-block-group has-background hmw-keep hmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-61bc63ed wp-block-group-is-layout-constrained\" style=\"background-color:#fcf2e6;border-radius:18px;margin-top:4px;margin-bottom:34px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hm-lead wp-block-paragraph\" style=\"color:#6e3f10;margin-top:0;margin-bottom:12px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.341), 17px);font-weight:700;line-height:1.4\">If you&#8217;ve been told it&#8217;s just anxiety<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Remember that anxiety and a physical problem can both be true at the same time.<\/li>\n\n\n\n<li>It&#8217;s reasonable to ask whether the physical side has been looked into as well as the psychological one.<\/li>\n\n\n\n<li>Pain, dizziness, palpitations and fatigue deserve a proper medical assessment, even if you also feel anxious.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-keep hmw-nopill wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you can&#8217;t get that assessment soon, or you&#8217;ve been sent away before, a physical therapist who knows hypermobility or a patient organization for hypermobility or Ehlers-Danlos syndromes can help you find someone who does. Chest pain, fainting or a racing heart that won&#8217;t settle need urgent care or your local emergency number.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<style>.eqp .eq-kp{display:grid;grid-template-columns:auto minmax(0,1fr);gap:4px 16px;align-items:start;background:#e9f3f3;border:0;border-left:4px solid #1d5f66;border-radius:4px 18px 18px 4px;padding:20px 26px;margin:6px 0 34px}.eqp .eq-kp .mk{grid-row:1\/3;width:40px;height:40px;border-radius:50%;background:#fff;color:#1d5f66;display:flex;align-items:center;justify-content:center}.eqp .eq-kp .mk svg{width:21px;height:21px}.eqp .eq-kp .k{font-family:\"Work Sans\",sans-serif;font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66;margin:2px 0 4px}.eqp .eq-kp .t{font-family:\"Work Sans\",sans-serif;font-size:clamp(15px,calc(10.6px + .72vw),19px);font-weight:500;line-height:1.55;color:#2a2622;margin:0}@media(max-width:560px){.eqp .eq-kp{grid-template-columns:minmax(0,1fr);padding:18px 20px}.eqp .eq-kp .mk{grid-row:auto;width:34px;height:34px}}<\/style><aside class=\"eq-kp\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M6.5 3.5h11a1 1 0 0 1 1 1v15.6a.5.5 0 0 1-.78.42L12 16.4l-5.72 4.12a.5.5 0 0 1-.78-.42V4.5a1 1 0 0 1 1-1z\"\/><\/svg><\/span><p class=\"k\">Worth remembering<\/p><p class=\"t\">A symptom can be completely physical and still grow a layer of fear, checking and avoiding around it. Working on that layer doesn&#8217;t mean the symptom was ever imaginary.<\/p><\/aside>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"17\" cy=\"30\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"nw\" cx=\"17\" cy=\"30\" r=\"4.4\"\/><circle class=\"up\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 6 of 9<\/p><h2 id=\"part-6\">The symptoms nobody can see<\/h2><p class=\"sb\">Pain in daily life, fatigue, sleep, brain fog, headaches and the gut<\/p><\/div><div class=\"no\" aria-hidden=\"true\">06<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Pain that goes on for months, called chronic pain, can change how you move, sleep and make plans. <strong class=\"eqb\">Over time, pain can touch your sense of who you are.<\/strong> Someone who saw themselves as active may start to think of themselves as &#8220;someone with a bad body.&#8221; Someone who valued independence may have to depend on others.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If a movement hurts, you stop doing it, and that eases the pain in the short term. If the movement is safe and only uncomfortable, though, avoiding it for a long time can slowly make your world smaller. You lose confidence, you do less, your physical conditioning changes and the activity starts to look even more daunting. That doesn&#8217;t mean you should simply push through pain. With hypermobility, some movements genuinely may be wrong for you or need changing. <strong class=\"eqb\">The real question is what&#8217;s actually unsafe, and what has become frightening because of what your body has been through.<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"how-long-term-pain-changes-daily-life\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">How long-term pain changes daily life<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Pain rarely stays in the moment it hurts. If you live with chronic pain, meaning pain that goes on for months,<sup class=\"eq-cite\">[<a href=\"#ref-44\" aria-label=\"Reference 44\">44<\/a>]<\/sup> you may move differently, sleep differently, exercise less, cancel plans or become more careful. You may think about your body more, and feel frustrated when other people don&#8217;t understand your limits.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Over time, pain can touch your sense of who you are.<\/strong> Someone who saw themselves as active may start to think of themselves as &#8220;someone with a bad body.&#8221; Someone spontaneous may become very cautious. Someone who valued independence may have to depend on others. These changes can matter a great deal psychologically, even when the physical condition itself is well understood.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"the-pain-and-avoidance-cycle\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The pain and avoidance cycle<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Say a certain movement hurts every time. Naturally, you stop doing it, and avoiding it eases the pain in the short term. Your brain learns from that: if avoiding something makes you feel better right away, you&#8217;re more likely to avoid it again.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But if the movement itself is safe and only uncomfortable, avoiding it for a long time can slowly make your world smaller. You lose confidence, you do less, your physical conditioning changes, and the activity starts to look even more daunting. And the cycle goes on.<sup class=\"eq-cite\">[<a href=\"#ref-36\" aria-label=\"Reference 36\">36<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That doesn&#8217;t mean you should simply push through pain. With hypermobility, some movements genuinely may be wrong for you or need changing.<sup class=\"eq-cite\">[<a href=\"#ref-45\" aria-label=\"Reference 45\">45<\/a>]<\/sup> <strong class=\"eqb\">The real question is what&#8217;s actually unsafe, and what has become frightening because of what your body has been through.<\/strong><\/p>\n\n\n\n<div class=\"wp-block-group has-background hmw-keep hmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-61bc63ed wp-block-group-is-layout-constrained\" style=\"background-color:#fcf2e6;border-radius:18px;margin-top:4px;margin-bottom:34px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hm-lead wp-block-paragraph\" style=\"color:#6e3f10;margin-top:0;margin-bottom:12px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.341), 17px);font-weight:700;line-height:1.4\">Before you give up an activity<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Ask whether the movement is actually unsafe, or whether it has become frightening because of what happened before.<\/li>\n\n\n\n<li>Ask whether a changed version of it could work for you.<\/li>\n\n\n\n<li>Make that call carefully, and where you can, together with your doctor, a physical therapist or another rehabilitation professional.<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can look well, go to work, see friends, and still be exhausted. If people have doubted your tiredness, or you&#8217;ve doubted it yourself, it helps to know that <strong class=\"eqb\">fatigue with hypermobility can have several sources at once.<\/strong> Pain is tiring. Keeping your joints steady can take physical effort. Problems with your autonomic nervous system, the part that runs things like heart rate, can make being upright more demanding. Poor sleep cuts into recovery, migraine can be exhausting, and distress uses up mental energy. Doing less can also lead to deconditioning, which is losing strength and stamina after a long stretch of moving less.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fatigue keeps turning up among the common complaints in hEDS and HSD. <strong class=\"eqb\">There&#8217;s rarely one neat explanation.<\/strong> If movement is part of it for you, <a href=\"\/exercise-and-mental-health\/#if-your-body-needs-a-different-plan\" style=\"color:#6e3f10;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#ecd2ae\">our article on exercise and mental health<\/a> has a section on moving with hypermobility. Pick a symptom in the figure below to see how many things can feed it.<\/p>\n\n\n<\/div>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"the-tiredness-nobody-believes\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The tiredness nobody believes<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fatigue is easy to underestimate because nobody can see it. You may look perfectly healthy. You may work, exercise now and then and see friends, and still feel exhausted. If people have doubted your tiredness, or you&#8217;ve doubted it yourself, it helps to know that <strong class=\"eqb\">fatigue in symptomatic hypermobility can have several sources at once<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Pain is tiring. Keeping your joints stable can take physical effort. Autonomic problems can make being upright more demanding. Poor sleep cuts into recovery. Migraine can be exhausting. Distress uses up mental energy. And doing less can lead to <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-3\"><em class=\"eqi\">deconditioning<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-3\"><b>deconditioning<\/b>The loss of strength, stamina and tolerance for activity that follows a long stretch of reduced movement. It can be a consequence of symptoms and something that makes them harder to live with.<\/span><\/span>.<sup class=\"eq-cite\">[<a href=\"#ref-23\" aria-label=\"Reference 23\">23<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Fatigue keeps turning up among the common complaints in hEDS and HSD.<sup class=\"eq-cite\">[<a href=\"#ref-24\" aria-label=\"Reference 24\">24<\/a>]<\/sup> <strong class=\"eqb\">There&#8217;s rarely one neat explanation.<\/strong> If movement is part of it for you, <a href=\"\/exercise-and-mental-health\/#if-your-body-needs-a-different-plan\" style=\"color:#6e3f10;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#ecd2ae\">our article on exercise and mental health<\/a> has a section on moving with hypermobility. Pick a symptom below to see how many contributors each one can have.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-ct\" id=\"hm-ct\" data-s=\"fatigue\"><div class=\"hd\"><p class=\"ti\">One symptom, several contributors<\/p><p class=\"q\"><label for=\"hm-ct-sel\">Pick a symptom<\/label><\/p><\/div><div class=\"ctl\"><div class=\"ra-seg\" role=\"group\" aria-label=\"Which symptom\"><button type=\"button\" data-s=\"fatigue\" aria-pressed=\"true\">fatigue<\/button><button type=\"button\" data-s=\"fog\" aria-pressed=\"false\">brain fog<\/button><button type=\"button\" data-s=\"pain\" aria-pressed=\"false\">pain<\/button><button type=\"button\" data-s=\"sleep\" aria-pressed=\"false\">sleep<\/button><\/div><select class=\"hm-sel\" id=\"hm-ct-sel\"><option value=\"fatigue\" selected>fatigue<\/option><option value=\"fog\">brain fog<\/option><option value=\"pain\">pain<\/option><option value=\"sleep\">sleep<\/option><\/select><\/div><div class=\"map\"><svg class=\"ln\" viewBox=\"0 0 100 100\" preserveAspectRatio=\"none\" aria-hidden=\"true\" focusable=\"false\" id=\"hm-ct-ln\"><path d=\"M50,50 C60,50 59,12 69,12\"\/><path d=\"M50,50 C60,50 59,31 69,31\"\/><path d=\"M50,50 C60,50 59,50 69,50\"\/><path d=\"M50,50 C60,50 59,69 69,69\"\/><path d=\"M50,50 C60,50 59,88 69,88\"\/><path d=\"M50,50 C40,50 41,12 31,12\"\/><path d=\"M50,50 C40,50 41,37.33 31,37.33\"\/><path d=\"M50,50 C40,50 41,62.67 31,62.67\"\/><path d=\"M50,50 C40,50 41,88 31,88\"\/><\/svg><div class=\"core\"><p class=\"cn\" id=\"hm-ct-c\">fatigue<\/p><p class=\"cc\" id=\"hm-ct-n\">9 contributors<\/p><\/div><ul class=\"nodes\" id=\"hm-ct-g\"><li class=\"r\" style=\"left:69%;top:12%\">pain<\/li><li class=\"r\" style=\"left:69%;top:31%\"><span class=\"hmw-nrm\">the effort of keeping joints stable<\/span><span class=\"hmw-pln\">the work of keeping joints steady<\/span><\/li><li class=\"r\" style=\"left:69%;top:50%\"><span class=\"hmw-nrm\">autonomic problems when upright<\/span><span class=\"hmw-pln\">trouble with being upright<\/span><\/li><li class=\"r\" style=\"left:69%;top:69%\">poor sleep<\/li><li class=\"r\" style=\"left:69%;top:88%\">migraine<\/li><li class=\"l\" style=\"left:31%;top:12%\">anxiety<\/li><li class=\"l\" style=\"left:31%;top:37.33%\">depression or distress<\/li><li class=\"l\" style=\"left:31%;top:62.67%\"><span class=\"hmw-nrm\">doing less, and deconditioning<\/span><span class=\"hmw-pln\">doing less, and losing fitness<\/span><\/li><li class=\"l\" style=\"left:31%;top:88%\"><span class=\"hmw-nrm\">medication<\/span><span class=\"hmw-pln\">medicines<\/span><\/li><\/ul><\/div><p class=\"res\" id=\"hm-ct-r\" role=\"status\" aria-live=\"polite\"><span class=\"hmw-nrm\">This article names <b>nine<\/b> possible contributors to <b>fatigue<\/b>, and several can be at work at once.<\/span><span class=\"hmw-pln\">This article names <b>nine<\/b> things that can add to <b>fatigue<\/b>, and several can happen at once.<\/span><\/p><figcaption><span class=\"hmw-nrm\"><b>Fatigue, brain fog, pain and poor sleep can each have several contributors running at the same time.<\/b><sup class=\"eq-cite\">[<a href=\"#ref-9\" aria-label=\"Reference 9\">9<\/a>,<a href=\"#ref-23\" aria-label=\"Reference 23\">23<\/a>,<a href=\"#ref-46\" aria-label=\"Reference 46\">46<\/a>]<\/sup> That&#8217;s why looking for one cause so often fails, and why the honest answer to &ldquo;is it anxiety?&rdquo; is so often &ldquo;anxiety may be one part of it.&rdquo;<\/span><span class=\"hmw-pln\"><b>Fatigue, brain fog, pain and poor sleep can each have several things feeding them at the same time.<\/b> That&#8217;s why looking for one cause so often fails, and why the honest answer to &ldquo;is it anxiety?&rdquo; is so often &ldquo;anxiety may be one part of it.&rdquo;<\/span><\/figcaption><\/figure><script>(function(){var f=document.getElementById(\"hm-ct\");if(!f){return;}var r=document.getElementById(\"hm-ct-r\");var g=document.getElementById(\"hm-ct-g\"),ln=document.getElementById(\"hm-ct-ln\"),cn=document.getElementById(\"hm-ct-c\"),cc=document.getElementById(\"hm-ct-n\");var CT=[\"pain\",\"the effort of keeping joints stable\",\"autonomic problems when upright\",\"poor sleep\",\"migraine\",\"anxiety\",\"depression or distress\",\"doing less, and deconditioning\",\"medication\",\"fatigue\",\"constantly monitoring your body\",\"joint instability and injuries\",\"muscle overuse and altered movement\",\"nerve involvement\",\"changes in pain processing\",\"mood\",\"tissue irritation\"];var M={\"fatigue\":[0,1,2,3,4,5,6,7,8],\"fog\":[0,9,3,5,2,10],\"pain\":[11,12,16,13,14,3,15],\"sleep\":[0,5,7]};var N={fatigue:\"fatigue\",fog:\"brain fog\",pain:\"pain\",sleep:\"poor sleep\"};var CTP=[\"pain\",\"the work of keeping joints steady\",\"trouble with being upright\",\"poor sleep\",\"migraine\",\"anxiety\",\"depression or distress\",\"doing less, and losing fitness\",\"medicines\",\"fatigue\",\"watching your body all the time\",\"unstable joints and injuries\",\"muscle overuse and changed movement\",\"nerve involvement\",\"changes in pain processing\",\"mood\",\"tissue irritation\"],RP=[\"This article names <b>\",\"<\/b> things that can add to <b>\",\"<\/b>\",\", and several can happen at once.\",\", and sleep affects pain, fatigue and mood in turn.\"];var P_ON=function(){var r=document.querySelector(\".hmw-post\");if(r){return r.classList.contains(\"hmw-plain\");}return false;};var W=[\"\",\"one\",\"two\",\"three\",\"four\",\"five\",\"six\",\"seven\",\"eight\",\"nine\",\"ten\"];var bs=f.querySelectorAll(\".ra-seg button\");function place(){var L=g.children,n=L.length,left=Math.floor(n\/2),right=n-left,paths=\"\";for(var k=0;k<n;k++){var side=k<right?1:0,idx=side?k:k-right,cnt=side?right:left;var y=cnt>1?12+idx*(76\/(cnt-1)):50;var x=side?69:31;L[k].style.left=x+\"%\";L[k].style.top=y+\"%\";L[k].className=side?\"r\":\"l\";paths+=\"<path d=\\\"M50,50 C\"+(side?60:40)+\",50 \"+(side?59:41)+\",\"+y+\" \"+x+\",\"+y+\"\\\"\/>\";}ln.innerHTML=paths;}function show(s){var ids=M[s],h=\"\";for(var k=0;k<ids.length;k++){h+=\"<li>\"+(P_ON()?CTP[ids[k]]:CT[ids[k]])+\"<\/li>\";}g.innerHTML=h;place();cn.textContent=N[s];cc.textContent=ids.length+\" contributors\";var n=ids.length;var tail=s===\"sleep\"?\", and sleep in turn feeds pain, fatigue and mood.\":\", and several can be at work at once.\";if(P_ON()){r.innerHTML=RP[0]+W[n]+RP[1]+N[s]+RP[2]+(s===\"sleep\"?RP[4]:RP[3]);}else{r.innerHTML=\"This article names <b>\"+W[n]+\"<\/b> possible contributors to <b>\"+N[s]+\"<\/b>\"+tail;}}for(var i=0;i<bs.length;i++){bs[i].addEventListener(\"click\",function(){var s=this.getAttribute(\"data-s\");for(var j=0;j<bs.length;j++){bs[j].setAttribute(\"aria-pressed\",bs[j]===this?\"true\":\"false\");}f.setAttribute(\"data-s\",s);show(s);});}place();document.addEventListener(\"hmw-plain-change\",function(){show(f.getAttribute(\"data-s\"));});})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sleep sits in the middle of it all. Pain can make it harder to sleep, and poor sleep can make you more sensitive to pain. Anxiety can make it harder to fall asleep, and poor sleep can make emotions harder to manage. So it&#8217;s often more useful to ask how your sleep, pain, fatigue and mood affect one another. <strong class=\"eqb\">Complex symptoms often work in loops rather than straight lines.<\/strong> If nights are a big part of it for you, it&#8217;s worth reading about <a href=\"\/surprisingly-busy-business-of-sleeping\/\" style=\"color:#6e3f10;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#ecd2ae\">how busy your brain is while you sleep<\/a>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Brain fog isn&#8217;t a diagnosis. People use the phrase for trouble concentrating, forgetfulness, losing words or slowed thinking. Pain, tiredness, poor sleep, anxiety, feeling unwell when you&#8217;re upright and watching your body all the time can all add to it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Imagine trying to follow a conversation while also wondering whether your heart is beating too fast, whether you&#8217;re getting dizzy, whether your knee feels unstable and how much energy you have left. <strong class=\"eqb\">That&#8217;s a lot competing for your attention!<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Headaches and migraine are often reported by people with hypermobility-related conditions, though estimates vary a lot between studies. Different headaches can have different causes. <strong class=\"eqb\">That doesn&#8217;t mean hypermobility causes migraine.<\/strong> Migraine is a complex nervous system condition that&#8217;s also very common in people without hypermobility. <strong class=\"eqb\">When several symptoms turn up together, they deserve to be understood as part of your whole picture rather than treated as unrelated problems.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your gut is heavily regulated by your nervous system, and digestive symptoms are increasingly recognized in hEDS and HSD. When one recent review pooled the earlier research, more than six in ten people with hEDS or HSD reported long-term gut symptoms. The authors were careful to say that the studies varied widely, that the quality of the evidence is low, and that the findings should be read with caution.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The figure below shows the numbers, and what each problem means.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"sleep-sits-in-the-middle\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Sleep sits in the middle<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sleep can affect almost everything else. Pain can make it harder to sleep, and poor sleep can make you more sensitive to pain.<sup class=\"eq-cite\">[<a href=\"#ref-46\" aria-label=\"Reference 46\">46<\/a>]<\/sup> Fatigue can mean you do less, and doing less can change your sleep. Anxiety can make it harder to fall asleep, and poor sleep can make emotions harder to manage.<sup class=\"eq-cite\">[<a href=\"#ref-47\" aria-label=\"Reference 47\">47<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So asking &#8220;is my sleep causing my pain?&#8221; may be less useful than asking how your sleep, pain, fatigue and mood are affecting one another. <strong class=\"eqb\">Complex symptoms often work in loops rather than straight lines.<\/strong> If nights are a big part of it for you, it&#8217;s worth reading about <a href=\"\/surprisingly-busy-business-of-sleeping\/\" style=\"color:#6e3f10;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#ecd2ae\">how busy your brain is while you sleep<\/a>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"brain-fog\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Brain fog<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:16px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">&#8220;Brain fog&#8221; isn&#8217;t a diagnosis. It&#8217;s a description people use for things like:<\/p>\n\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><ul class=\"hm-chips\"><li>difficulty concentrating<\/li><li>forgetfulness<\/li><li>word-finding problems<\/li><li>slowed thinking<\/li><li>mental fatigue<\/li><li>difficulty multitasking<\/li><\/ul><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">People with symptomatic hypermobility often describe these, and again there may be several contributors.<sup class=\"eq-cite\">[<a href=\"#ref-25\" aria-label=\"Reference 25\">25<\/a>]<\/sup> Pain demands attention. Fatigue drains your mental resources. Poor sleep affects concentration and memory. Anxiety can narrow your attention toward possible threats.<sup class=\"eq-cite\">[<a href=\"#ref-48\" aria-label=\"Reference 48\">48<\/a>]<\/sup> Autonomic symptoms can make thinking harder, especially when you&#8217;re upright.<sup class=\"eq-cite\">[<a href=\"#ref-49\" aria-label=\"Reference 49\">49<\/a>]<\/sup> And constantly monitoring your body takes mental energy.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Imagine trying to follow a conversation while also wondering whether your heart is beating too fast, whether you&#8217;re getting dizzy, whether your knee feels unstable and how much energy you have left. <strong class=\"eqb\">That&#8217;s a lot competing for your attention!<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"headaches-and-migraine\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Headaches and migraine<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Headaches and migraine are often reported by people with hypermobility-related conditions. One review found that migraine is common in symptomatic hypermobility, although estimates vary a lot between studies. Its authors also stressed looking at the different possible causes of a headache, rather than assuming every headache in a hypermobile person works the same way.<sup class=\"eq-cite\">[<a href=\"#ref-15\" aria-label=\"Reference 15\">15<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So the right conclusion isn&#8217;t &#8220;hypermobility causes migraine.&#8221; Migraine is a complex neurological condition that&#8217;s also very common in people without hypermobility.<sup class=\"eq-cite\">[<a href=\"#ref-50\" aria-label=\"Reference 50\">50<\/a>]<\/sup> The more useful conclusion is that <strong class=\"eqb\">when several symptoms turn up together, they deserve to be understood as part of your whole picture rather than treated as unrelated problems<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-gut\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The gut<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At first, digestion might seem to have nothing to do with joints. But your gut is heavily regulated by the nervous system,<sup class=\"eq-cite\">[<a href=\"#ref-51\" aria-label=\"Reference 51\">51<\/a>]<\/sup> and digestive symptoms are increasingly recognized in hEDS and HSD.<sup class=\"eq-cite\">[<a href=\"#ref-17\" aria-label=\"Reference 17\">17<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">When one recent review pooled the earlier research, more than six in ten people with hEDS or HSD reported long-term gut symptoms. Disorders of gut-brain interaction, where the gut and brain don&#8217;t communicate as smoothly as they should,<sup class=\"eq-cite\">[<a href=\"#ref-52\" aria-label=\"Reference 52\">52<\/a>]<\/sup> were among the problems commonly reported alongside them, together with reflux, chronic fatigue, migraine and orthostatic intolerance. The authors were careful to say the studies varied widely, that the quality of the evidence is low, and that the findings should be read with caution.<sup class=\"eq-cite\">[<a href=\"#ref-24\" aria-label=\"Reference 24\">24<\/a>]<\/sup><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-gut\" id=\"hm-gut\"><div class=\"hd\"><p class=\"ti\">The gut, and what comes with it<\/p><p class=\"q\">Out of every 100 people with hEDS or HSD in the studies<\/p><\/div><div class=\"ctl\"><label class=\"hm-sel-l\" for=\"hm-gut-sel\">Pick a finding<\/label><div class=\"ra-seg\" role=\"group\" aria-label=\"Which finding\"><button type=\"button\" data-k=\"any\" aria-pressed=\"true\">any long-term gut symptom<\/button><button type=\"button\" data-k=\"dgbi\" aria-pressed=\"false\">disorders of gut-brain interaction<\/button><button type=\"button\" data-k=\"gerd\" aria-pressed=\"false\">reflux disease<\/button><button type=\"button\" data-k=\"fat\" aria-pressed=\"false\">chronic fatigue<\/button><button type=\"button\" data-k=\"mig\" aria-pressed=\"false\">migraine<\/button><button type=\"button\" data-k=\"oi\" aria-pressed=\"false\"><span class=\"hmw-nrm\">orthostatic intolerance<\/span><span class=\"hmw-pln\">trouble being upright<\/span><\/button><\/div><select class=\"hm-sel\" id=\"hm-gut-sel\"><option value=\"any\" selected>any long-term gut symptom<\/option><option value=\"dgbi\">disorders of gut-brain interaction<\/option><option value=\"gerd\">reflux disease<\/option><option value=\"fat\">chronic fatigue<\/option><option value=\"mig\">migraine<\/option><option value=\"oi\">orthostatic intolerance<\/option><\/select><\/div><div class=\"lay\"><div class=\"dots\" aria-hidden=\"true\"><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i class=\"on\"><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><i><\/i><\/div><div class=\"rd\" role=\"status\" aria-live=\"polite\"><p class=\"v\"><b id=\"hm-gut-v\">65<\/b><span>in 100<\/span><\/p><p class=\"t\" id=\"hm-gut-t\"><span class=\"hmw-nrm\">reported <b>any long-term gut symptom<\/b>. The true figure is probably somewhere between 51 and 77 in 100.<\/span><span class=\"hmw-pln\">reported <b>a long-term gut symptom<\/b> of some kind. The real figure is probably between 51 and 77 in 100.<\/span><\/p><\/div><\/div><figcaption><b>These are rough figures<\/b>, and they can&#8217;t show what causes what.<sup class=\"eq-cite\">[<a href=\"#ref-24\" aria-label=\"Reference 24\">24<\/a>]<\/sup><\/figcaption><\/figure><script>(function(){var f=document.getElementById(\"hm-gut\");if(!f){return;}var G=[[\"any\",\"any long-term gut symptom\",65,51,77],[\"dgbi\",\"disorders of gut-brain interaction\",44,24,67],[\"gerd\",\"reflux disease\",41,27,57],[\"fat\",\"chronic fatigue\",49,35,64],[\"mig\",\"migraine\",38,20,61],[\"oi\",\"orthostatic intolerance\",36,27,46]];var PR={\"any\":[\"a long-term gut symptom\",\" of some kind\"],\"dgbi\":[\"a disorder of gut-brain interaction\",\", where the gut and brain don't work together as smoothly as they should\"],\"gerd\":[\"reflux disease\",\", where stomach acid keeps coming back up\"],\"fat\":[\"chronic fatigue\",\", meaning long-term tiredness\"],\"mig\":[\"migraine\",\"\"],\"oi\":[\"orthostatic intolerance\",\", meaning their bodies struggled with being upright\"]},PT=[\". The real figure is probably between \",\" and \",\" in 100.\"];var P_ON=function(){var r=document.querySelector(\".hmw-post\");if(r){return r.classList.contains(\"hmw-plain\");}return false;};var d=f.querySelectorAll(\".dots i\"),v=document.getElementById(\"hm-gut-v\"),t=document.getElementById(\"hm-gut-t\");var bs=f.querySelectorAll(\".ra-seg button\");function show(k){var g=G[0];for(var i=0;i<G.length;i++){if(G[i][0]===k){g=G[i];}}for(var j=0;j<d.length;j++){d[j].className=j<g[2]?\"on\":\"\";}v.textContent=String(g[2]);if(P_ON()){t.innerHTML=\"reported <b>\"+PR[g[0]][0]+\"<\/b>\"+PR[g[0]][1]+PT[0]+g[3]+PT[1]+g[4]+PT[2];}else{t.innerHTML=\"reported <b>\"+g[1]+\"<\/b>. The true figure is probably somewhere between \"+g[3]+\" and \"+g[4]+\" in 100.\";}}for(var b=0;b<bs.length;b++){bs[b].addEventListener(\"click\",function(){for(var j=0;j<bs.length;j++){bs[j].setAttribute(\"aria-pressed\",bs[j]===this?\"true\":\"false\");}show(this.getAttribute(\"data-k\"));});}function sync(){var o=document.querySelector(\"#hm-gut-sel option[value=oi]\");if(o){o.textContent=P_ON()?\"trouble being upright\":\"orthostatic intolerance\";}}document.addEventListener(\"hmw-plain-change\",function(){var cur=f.querySelector(\".ra-seg button[aria-pressed=true]\");show(cur?cur.getAttribute(\"data-k\"):\"any\");sync();});sync();})();\/*>*\/<\/script><script>(function(){function link(fid,sid,attr){var f=document.getElementById(fid);var sel=document.getElementById(sid);if(!f){return;}if(!sel){return;}var bs=f.querySelectorAll(\".ra-seg button\");sel.addEventListener(\"change\",function(){for(var i=0;i<bs.length;i++){if(bs[i].getAttribute(attr)===sel.value){bs[i].click();}}});for(var j=0;j<bs.length;j++){bs[j].addEventListener(\"click\",function(){sel.value=this.getAttribute(attr);});}}link(\"hm-ct\",\"hm-ct-sel\",\"data-s\");link(\"hm-gut\",\"hm-gut-sel\",\"data-k\");})();\/*>*\/<\/script><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">It&#8217;s another reminder that the nervous system isn&#8217;t only in charge of thoughts, emotions and movement.<\/strong> It&#8217;s involved throughout the body.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"37\" cy=\"62\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"dn\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"nw\" cx=\"37\" cy=\"62\" r=\"4.4\"\/><circle class=\"up\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 7 of 9<\/p><h2 id=\"part-7\">Body and mind, without &#8220;it&#8217;s all in your head&#8221;<\/h2><p class=\"sb\">Trauma, &#8220;dysregulation&#8221;, the vagus nerve and what regulation really means<\/p><\/div><div class=\"no\" aria-hidden=\"true\">07<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may have sat across from a doctor and felt you had to pick a box: is this physical, or is it mental? This may be the central idea of the whole article: in your body, the line between the two is much less clear than those boxes suggest. Pain changes mood, mood changes how pain feels, and sleep and pain affect each other too. <strong class=\"eqb\">These aren&#8217;t abstract ideas. They&#8217;re real processes in your body.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may hear about a biopsychosocial approach. It doesn&#8217;t mean &#8220;everything is partly psychological, so your physical illness is really psychological.&#8221; It means biological, psychological and social things can all affect your health. <strong class=\"eqb\">The model isn&#8217;t saying &#8220;it&#8217;s all in your head.&#8221; It&#8217;s saying &#8220;let&#8217;s understand the whole person.&#8221;<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Psychological trauma doesn&#8217;t cause hEDS.<\/strong> It can still affect pain, sleep, how on edge you feel and how you manage emotions, and living with long-term symptoms is hard in itself, so physical illness and psychological experience can influence each other. There&#8217;s also no single psychological profile of a hypermobile person. Some people with hypermobility have anxiety or trauma histories and some don&#8217;t. <strong class=\"eqb\">It doesn&#8217;t justify turning those links into a personality type.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You&#8217;ll find the phrase &#8220;nervous-system dysregulation&#8221; everywhere online. It&#8217;s often so broad that it&#8217;s hard to know what&#8217;s being described. It might mean POTS, a drop in blood pressure when you stand (orthostatic hypotension), anxiety, chronic pain or something else. These are different things. <strong class=\"eqb\">There&#8217;s no single medical diagnosis called nervous-system dysregulation<\/strong>, and there&#8217;s no single exercise that &#8220;regulates your nervous system&#8221; in a way that resolves all of these. That matters with hypermobility, because genuine autonomic disorders can need medical assessment and treatment.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The vagus nerve has become a bit of a celebrity in wellness circles, and it really is important. It carries messages between your brain and organs like your heart and gut, and it&#8217;s a major part of the parasympathetic nervous system, the branch that helps your body rest and recover. But online it&#8217;s often made to sound like a simple switch between &#8220;safe&#8221; and &#8220;unsafe&#8221;. The real science is far more complicated. Polyvagal theory, a popular idea about the vagus nerve, has been influential in therapy, but <strong class=\"eqb\">several of its central claims remain scientifically disputed.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">None of this means slow breathing, relaxation, time with people you trust or mindfulness are useless. Quite the opposite: they can help! <strong class=\"eqb\">We just don&#8217;t need claims that go beyond the evidence to explain why.<\/strong> If you&#8217;d like a place to start, <a href=\"\/slow-breathing\/\" style=\"color:#6e3f10;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#ecd2ae\">slow breathing<\/a> is easy to try in two minutes.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A nervous system that switches on hasn&#8217;t necessarily gone wrong. Your heart should beat faster when you exercise, and fear and pain can protect you. <strong class=\"eqb\">The goal isn&#8217;t to be calm all the time.<\/strong> What matters is flexibility: your system can respond when something is asked of it, adapt when things change and settle back down when that&#8217;s appropriate.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A sensation isn&#8217;t the same as the meaning you give it. If you read a faster heartbeat as &#8220;I&#8217;m exercising,&#8221; you respond one way, and if you read it as &#8220;I&#8217;m having a heart attack,&#8221; you respond another. That doesn&#8217;t mean how you read a sensation creates all symptoms. It means it can shape what happens next.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Lots of habits start as sensible protection: you sit down because standing made you dizzy, or cancel plans because you can&#8217;t tell how much energy you&#8217;ll have. At first, that can be exactly the right thing to do. <strong class=\"eqb\">But sometimes protection slowly turns into restriction.<\/strong> A more useful question than &#8220;are you avoiding things?&#8221; is &#8220;is this avoidance still serving you?&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"body-and-mind-arent-separate-systems\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Body and mind aren&#8217;t separate systems<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You may have sat across from a doctor and felt you had to pick a box: is this physical, or is it mental? This may be the central idea of the whole article: biologically, the line between the two is much less clear than those boxes suggest.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Pain changes mood, and mood changes how pain feels. Stress changes autonomic activity, which creates sensations in the body, which affect emotion. Sleep affects pain and pain affects sleep. Fear changes how you move, how you move changes your physical conditioning, your conditioning affects fatigue, and fatigue affects mood. <strong class=\"eqb\">These aren&#8217;t abstract ideas. They&#8217;re real processes in your body.<\/strong><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-c0682441 wp-block-group-is-layout-constrained\" style=\"background-color:#fbf4e6;border-color:#eedcb9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:30px;margin-bottom:40px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT BIOPSYCHOSOCIAL MEANS<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That&#8217;s easy to misunderstand, so it&#8217;s worth being precise. You may hear about a <em class=\"eqi\">biopsychosocial<\/em> approach, and it doesn&#8217;t mean &#8220;everything is partly psychological, so your physical illness is really psychological.&#8221; It means biological, psychological and social processes can all affect your health.<sup class=\"eq-cite\">[<a href=\"#ref-53\" aria-label=\"Reference 53\">53<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you have joint instability, that&#8217;s a biological reality. If the instability makes you afraid of moving, that&#8217;s a psychological response. If the fear leads you to avoid things, that&#8217;s a behavioral consequence. If avoiding things affects your work and social life, that&#8217;s a social consequence, and it can then affect your psychological well-being. <strong class=\"eqb\">The model isn&#8217;t saying &#8220;it&#8217;s all in your head.&#8221; It&#8217;s saying &#8220;let&#8217;s understand the whole person.&#8221;<\/strong><\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"trauma-and-the-myth-of-a-hypermobile-personality\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Trauma, and the myth of a hypermobile personality<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Trauma is another area where online discussions get oversimplified. <strong class=\"eqb\">Psychological trauma doesn&#8217;t cause hEDS.<\/strong> It doesn&#8217;t create the connective-tissue differences behind an inherited connective-tissue disorder.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At the same time, trauma can affect pain, sleep, autonomic arousal, how you perceive threat, attention and how you manage emotions.<sup class=\"eq-cite\">[<a href=\"#ref-32\" aria-label=\"Reference 32\">32<\/a>,<a href=\"#ref-54\" aria-label=\"Reference 54\">54<\/a>]<\/sup> And living with chronic physical symptoms can be hard in itself. Repeated injuries, medical procedures, pain, uncertainty, losing things you could once do, not being believed, changes in relationships and work, and fear about the future can all add to distress.<sup class=\"eq-cite\">[<a href=\"#ref-12\" aria-label=\"Reference 12\">12<\/a>,<a href=\"#ref-42\" aria-label=\"Reference 42\">42<\/a>]<\/sup> So the better description is that physical illness and psychological experience can influence each other, not that trauma caused the illness.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It also needs saying that there&#8217;s no single psychological profile of a hypermobile person. Some people with hypermobility have anxiety and some don&#8217;t. Some have trauma histories and some don&#8217;t. Some have significant autonomic problems and some don&#8217;t. Some have severe chronic pain and some have little or none. The research shows links, and higher rates of certain difficulties in some groups.<sup class=\"eq-cite\">[<a href=\"#ref-12\" aria-label=\"Reference 12\">12<\/a>,<a href=\"#ref-16\" aria-label=\"Reference 16\">16<\/a>]<\/sup> <strong class=\"eqb\">It doesn&#8217;t justify turning those links into a personality type.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-nervous-system-dysregulation-actually-means\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What &#8220;nervous-system dysregulation&#8221; actually means<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:16px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You&#8217;ll find this phrase everywhere: &#8220;your nervous system is dysregulated,&#8221; &#8220;your body doesn&#8217;t feel safe,&#8221; &#8220;you&#8217;re stuck in fight-or-flight,&#8221; &#8220;regulate your nervous system.&#8221; Some of the ideas underneath this language can be useful. But it&#8217;s often so broad that it&#8217;s hard to know what&#8217;s actually being described. Is it:<\/p>\n\n\n\n<div style=\"margin-top:0;margin-bottom:0\"><ul class=\"hm-chips open\"><li>POTS?<\/li><li>orthostatic hypotension?<\/li><li>sympathetic activation?<\/li><li>anxiety?<\/li><li>hypervigilance?<\/li><li>chronic pain?<\/li><li>central sensitization?<\/li><li>sleep disturbance?<\/li><li>emotional overwhelm?<\/li><li>something else?<\/li><\/ul><\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">These aren&#8217;t interchangeable. Orthostatic hypotension, for example, is a drop in blood pressure when you stand,<sup class=\"eq-cite\">[<a href=\"#ref-30\" aria-label=\"Reference 30\">30<\/a>]<\/sup> which is a different thing from anxiety or chronic pain. <strong class=\"eqb\">There&#8217;s no single medical diagnosis called nervous-system dysregulation<\/strong>, and there&#8217;s no single exercise that &#8220;regulates your nervous system&#8221; in a way that resolves all of these. That matters with hypermobility, because genuine autonomic disorders can need medical assessment and treatment.<sup class=\"eq-cite\">[<a href=\"#ref-3\" aria-label=\"Reference 3\">3<\/a>,<a href=\"#ref-31\" aria-label=\"Reference 31\">31<\/a>]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"the-vagus-nerve-and-what-the-evidence-supports\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">The vagus nerve, and what the evidence supports<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">The vagus nerve has become a bit of a celebrity in wellness circles, and it really is important. It&#8217;s a major part of the <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-4\"><em class=\"eqi\">parasympathetic nervous system<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-4\"><b>parasympathetic nervous system<\/b>The branch of the autonomic nervous system associated with rest, digestion and recovery. It works alongside the sympathetic branch, which prepares the body for effort, rather than taking turns with it.<\/span><\/span>, and it carries messages between the brain and organs including the heart and the gut.<sup class=\"eq-cite\">[<a href=\"#ref-28\" aria-label=\"Reference 28\">28<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">But online explanations often make it sound much simpler than it is. You may have heard that it works like a switch between &#8220;safe&#8221; and &#8220;unsafe&#8221;, or that almost any symptom comes from a vagus nerve that isn&#8217;t &#8220;activated&#8221; enough. The real neurobiology is far more complicated.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is also why it&#8217;s worth being careful about treating <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-5\"><em class=\"eqi\">polyvagal theory<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-5\"><b>polyvagal theory<\/b>A theory developed by the neuroscientist Stephen Porges that links feelings of safety and threat to different branches of the vagus nerve. It&#8217;s widely used in therapy, and several of its central claims are disputed.<\/span><\/span> as established fact. It has been influential in psychotherapy and trauma-informed practice, but <strong class=\"eqb\">several of its central claims remain scientifically disputed<\/strong>. Recent peer-reviewed papers have strongly criticized its claims about anatomy and evolution, and others have been published defending it.<sup class=\"eq-cite\">[<a href=\"#ref-20\" aria-label=\"Reference 20\">20<\/a>,<a href=\"#ref-21\" aria-label=\"Reference 21\">21<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">None of this means slow breathing, relaxation, time with people you trust or mindfulness are useless. Quite the opposite: they can help!<sup class=\"eq-cite\">[<a href=\"#ref-55\" aria-label=\"Reference 55\">55<\/a>,<a href=\"#ref-56\" aria-label=\"Reference 56\">56<\/a>]<\/sup> <strong class=\"eqb\">We just don&#8217;t need claims that go beyond the evidence to explain why.<\/strong> If you&#8217;d like a place to start, <a href=\"\/slow-breathing\/\" style=\"color:#6e3f10;text-decoration:underline;text-underline-offset:3px;text-decoration-thickness:1.5px;text-decoration-color:#ecd2ae\">slow breathing<\/a> is easy to try in two minutes.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"you-dont-need-to-calm-your-nervous-system-every-time-you-f\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">You don&#8217;t need to calm your nervous system every time you feel something<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A nervous system that switches on hasn&#8217;t necessarily gone wrong. Your heart should beat faster when you exercise. You should get more alert when something needs your attention; that&#8217;s your stress response doing its job. Fear is sometimes the right response. Pain protects you. <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-6\"><em class=\"eqi\">Sympathetic activation<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-6\"><b>Sympathetic activation<\/b>Activity in the branch of the autonomic nervous system that prepares the body for effort or for something that needs attention: heart rate rises, breathing quickens, muscles ready themselves.<\/span><\/span> is normal.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The goal isn&#8217;t to be calm all the time.<\/strong> A system that never switched on would be just as much of a problem as one that never settled. What matters is flexibility.<sup class=\"eq-cite\">[<a href=\"#ref-57\" aria-label=\"Reference 57\">57<\/a>]<\/sup> Can your system respond when something is asked of it, adapt when things change and settle back down when that&#8217;s appropriate? Can you notice a sensation without jumping to catastrophe, and respond to your body without being completely run by it? That&#8217;s a far more useful way to think about regulation.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"same-heartbeat-different-meaning\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Same heartbeat, different meaning<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A sensation isn&#8217;t the same as the meaning you give it. Your heart beats faster; that&#8217;s the sensation. If you read it as &#8220;I&#8217;m exercising,&#8221; you respond one way. If you read it as &#8220;I&#8217;m having a heart attack,&#8221; you respond another. The sensation may be identical. The meaning changes the emotional experience.<sup class=\"eq-cite\">[<a href=\"#ref-33\" aria-label=\"Reference 33\">33<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">That doesn&#8217;t mean interpretation creates all symptoms. It means interpretation can shape what happens next. It matters most when you&#8217;ve had unpredictable symptoms, because your brain has a history. <strong class=\"eqb\">It remembers what happened last time, and that history shapes what it predicts this time.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"when-protection-turns-into-restriction\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">When protection turns into restriction<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Many habits that become a problem in long-term illness start as sensible protection. You avoid a movement because it once hurt. You sit down because standing made you dizzy. You check your heart because it has raced before. You cancel plans because you don&#8217;t know how much energy you&#8217;ll have. At first, these can be exactly the right thing to do.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">But sometimes protection slowly turns into restriction.<\/strong> So a more useful question than &#8220;are you avoiding things?&#8221; is &#8220;is this avoidance still serving you?&#8221;<sup class=\"eq-cite\">[<a href=\"#ref-36\" aria-label=\"Reference 36\">36<\/a>]<\/sup><\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"23\" cy=\"62\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"dn\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"dn\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"nw\" cx=\"23\" cy=\"62\" r=\"4.4\"\/><circle class=\"up\" cx=\"30\" cy=\"81\" r=\"3.3\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 8 of 9<\/p><h2 id=\"part-8\">Where therapy fits<\/h2><p class=\"sb\">What it can and can&#8217;t do, what the evidence says, and what it works on<\/p><\/div><div class=\"no\" aria-hidden=\"true\">08<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve spent years being told it&#8217;s anxiety, the word &#8220;therapy&#8221; might make you wary, and that&#8217;s understandable. So it&#8217;s worth starting with the limits. Psychotherapy can&#8217;t stabilize an unstable joint. It can&#8217;t replace treatment for POTS, repair connective tissue, or make a migraine disappear through positive thinking. <strong class=\"eqb\">It should never be offered as a substitute for proper medical care.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So what can it do? Quite a lot! It can help with the psychological side that grows around a physical condition: fear, avoiding things, worst-case thinking, grief, and a relationship with your body that feels like a fight. It can help you live with not knowing, and get back to what matters to you. And <strong class=\"eqb\">it can be a place where you don&#8217;t have to prove your symptoms are real before you&#8217;re allowed to talk about how hard they are<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">There isn&#8217;t much research yet on therapy for hypermobility. Most of the few studies tested therapy as part of a bigger program with other professionals, mostly for pain and fear of pain. The results look promising, but bigger and better studies are still needed. So it&#8217;s important not to oversell this. <strong class=\"eqb\">There&#8217;s reason to think psychological treatment can help, but there isn&#8217;t yet enough high-quality research to call any one therapy the treatment for hypermobility.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve been injured again and again, movement can become frightening. Therapy can help you explore the difference between &#8220;this movement is medically unsafe&#8221; and &#8220;this movement has become associated with danger.&#8221; That&#8217;s a distinction to make carefully and, where needed, together with a physical therapist or doctor.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Thoughts can run ahead too. A symptom can quickly turn into a prediction about the future, one small step at a time. The figure below shows the chain.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-therapy-can-and-cant-do\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What therapy can and can&#8217;t do<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve spent years being told it&#8217;s anxiety, the word &#8220;therapy&#8221; might make you wary, and that&#8217;s understandable. So it&#8217;s worth starting with the limits. Psychotherapy can&#8217;t stabilize an unstable joint. It can&#8217;t replace treatment for POTS, repair connective tissue, or make a migraine disappear through positive thinking. <strong class=\"eqb\">It should never be offered as a substitute for proper medical care.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So what can it do? Quite a lot! Therapy can work with the psychological processes that grow around a physical condition. It can help you understand fear, recognize avoidance, question worst-case thoughts, work through grief, build a relationship with your body that feels less like a fight, adapt to uncertainty, and reconnect with activities and values that illness has pushed aside. And sometimes, perhaps most importantly, <strong class=\"eqb\">it can be a place where you don&#8217;t have to prove your symptoms are real before you&#8217;re allowed to talk about how hard they are<\/strong>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"what-the-research-says-about-therapy\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">What the research says about therapy<\/h3>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-c0682441 wp-block-group-is-layout-constrained\" style=\"background-color:#f1f6f6;border-color:#d9e7e6;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:30px;margin-bottom:40px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WHAT THE STUDIES FOUND<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Research on therapy specifically for HSD and hEDS is still thin. One review found relatively few studies of psychological approaches for this group, covering cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), education about the condition, and pain programs run by several professions working together.<sup class=\"eq-cite\">[<a href=\"#ref-13\" aria-label=\"Reference 13\">13<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Another review found only a handful of studies that met its standards. Most built psychological treatment into a wider program alongside other professionals, rather than testing therapy on its own. They mostly focused on pain, fear related to pain, and <em class=\"eqi\">catastrophizing<\/em>, meaning expecting the worst, and some also looked at anxiety, depression, fatigue and quality of life. The authors concluded that programs including psychological treatment looked promising, but that larger and better-designed trials are still needed.<sup class=\"eq-cite\">[<a href=\"#ref-14\" aria-label=\"Reference 14\">14<\/a>]<\/sup><\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">So it&#8217;s important not to oversell this. <strong class=\"eqb\">There&#8217;s reason to think psychological treatment can help, but there isn&#8217;t yet enough high-quality research to call any one therapy the treatment for hypermobility.<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"fear-of-movement-and-thoughts-that-run-ahead\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Fear of movement, and thoughts that run ahead<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you&#8217;ve been injured again and again, movement can become frightening. Therapy can help you explore the difference between &#8220;this movement is medically unsafe&#8221; and &#8220;this movement has become associated with danger.&#8221; That&#8217;s a distinction to make carefully and, where needed, together with a physical therapist or doctor.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Thoughts can run ahead too. A symptom can quickly turn into a prediction about the future, one small step at a time.<\/p>\n\n\n\n<style>.eqp .hm-ch{margin:30px 0 34px;padding:26px 28px 22px;background:#faf8f3;border:1.5px solid #e8e1d5;border-radius:20px}.eqp .hm-ch .ey{margin:0 0 4px;font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66}.eqp .hm-ch .q{margin:0 0 18px;font-family:\"Playfair Display\",Georgia,serif!important;font-size:clamp(20px,2.2vw,23px);font-weight:700;line-height:1.3;color:#00373e}.eqp .hm-ch ol{list-style:none;margin:0;padding:0}.eqp .hm-ch li{position:relative;margin:0 0 0 calc(var(--i) * 9%);padding:0 0 30px;transition:margin .5s ease}.eqp .hm-ch li:last-child{padding-bottom:0}.eqp .hm-ch .cd{display:inline-block;max-width:100%;box-sizing:border-box;background:#fff;border:1.5px solid #d9d0c3;border-radius:14px 18px 12px 16px;padding:10px 16px 11px}.eqp .hm-ch .th{margin:0;font-family:\"Patrick Hand\",\"Work Sans\",sans-serif;font-size:calc(19px + var(--i) * 2.4px);line-height:1.25;color:#2a2622;transition:font-size .5s ease}.eqp .hm-ch .tg{display:inline-block;margin:0 0 6px;padding:2px 9px;border-radius:999px;font-size:12px;font-weight:700;letter-spacing:.08em;text-transform:uppercase;line-height:1.5}.eqp .hm-ch .tg.now{background:#e9f3f3;color:#1d5f66}.eqp .hm-ch .tg.pr{background:#fff;color:#5d554d;border:1.5px dashed #b3a99c}.eqp .hm-ch .ar{position:absolute;left:18px;bottom:4px;height:22px;display:flex;align-items:center;gap:6px;font-size:13px;color:#6b6259}.eqp .hm-ch .ar svg{width:16px;height:22px;fill:none;stroke:#8fb6b9;stroke-width:1.8;stroke-linecap:round;stroke-linejoin:round}.eqp .hm-ch.js .tg{display:none}.eqp .hm-ch.js.slow .tg{display:inline-block}.eqp .hm-ch.slow li{margin-left:0}.eqp .hm-ch.slow .th{font-size:19px}.eqp .hm-ch.slow li.pr .cd{border-style:dashed;background:#fdfcf9}.eqp .hm-ch .ctl{margin:20px 0 0}.eqp .hm-ch:not(.js) .ctl{display:none}.eqp .hm-ch button{font:inherit;font-size:15px;font-weight:600;color:#1d5f66;background:#fff;border:1.5px solid #1d5f66;border-radius:999px;padding:9px 18px;min-height:44px;cursor:pointer}.eqp .hm-ch button:hover{background:#e9f3f3}.eqp .hm-ch button:focus-visible{outline:3px solid #1d5f66;outline-offset:2px}.eqp .hm-ch .out{margin:12px 0 0;font-size:16px;line-height:1.55;color:#2a2622;min-height:1px}.eqp .hm-ch figcaption{margin:18px 0 0;padding-top:14px;border-top:1px solid #e8e1d5;font-size:15px;line-height:1.55;color:#4a433c}.eqp .hm-ch figcaption b{color:#2a2622}@media(max-width:560px){.eqp .hm-ch{padding:20px 18px 18px}.eqp .hm-ch li{margin-left:calc(var(--i) * 5%)}.eqp .hm-ch .th{font-size:calc(18px + var(--i) * 1.6px)}}@media(prefers-reduced-motion:reduce){.eqp .hm-ch li,.eqp .hm-ch .th{transition:none}}<\/style><figure class=\"hm-ch hmw-keep\" id=\"hm-chain\"><p class=\"ey\">Thoughts that run ahead<\/p><p class=\"q\"><span class=\"hmw-nrm\">How one hard day turns into a forecast<\/span><span class=\"hmw-pln\">How one hard day turns into a prediction<\/span><\/p><ol><li class=\"now\" style=\"--i:0\"><div class=\"cd\"><span class=\"tg now\">Happening today<\/span><p class=\"th\">&#8220;My pain is worse today.&#8221;<\/p><\/div><span class=\"ar\" aria-hidden=\"true\"><svg viewBox=\"0 0 16 22\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M5 2c-2 6 0 11 6 16M11 18l-5-.6M11 18l.4-5\"\/><\/svg>becomes<\/span><\/li><li class=\"pr\" style=\"--i:1\"><div class=\"cd\"><span class=\"tg pr\">A prediction<\/span><p class=\"th\">&#8220;I&#8217;m getting worse.&#8221;<\/p><\/div><span class=\"ar\" aria-hidden=\"true\"><svg viewBox=\"0 0 16 22\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M5 2c-2 6 0 11 6 16M11 18l-5-.6M11 18l.4-5\"\/><\/svg>which becomes<\/span><\/li><li class=\"pr\" style=\"--i:2\"><div class=\"cd\"><span class=\"tg pr\">A prediction<\/span><p class=\"th\">&#8220;This is never going to improve.&#8221;<\/p><\/div><span class=\"ar\" aria-hidden=\"true\"><svg viewBox=\"0 0 16 22\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M5 2c-2 6 0 11 6 16M11 18l-5-.6M11 18l.4-5\"\/><\/svg>which becomes<\/span><\/li><li class=\"pr\" style=\"--i:3\"><div class=\"cd\"><span class=\"tg pr\">A prediction<\/span><p class=\"th\">&#8220;My life is going to become increasingly limited.&#8221;<\/p><\/div><\/li><\/ol><div class=\"ctl\"><button type=\"button\" aria-pressed=\"false\">Slow the chain down<\/button><\/div><p class=\"out\" aria-live=\"polite\"><\/p><figcaption><span class=\"hmw-nrm\"><b>One hard day can grow into a forecast about the rest of your life.<\/b> Each step feels like it follows from the last, but only the first one describes what&#8217;s happening right now.<sup class=\"eq-cite\">[<a href=\"#ref-58\" aria-label=\"Reference 58\">58<\/a>]<\/sup><\/span><span class=\"hmw-pln\"><b>One hard day can grow into a prediction about the rest of your life.<\/b> Each step seems to follow from the last. Only the first one is about what&#8217;s happening now.<\/span><\/figcaption><\/figure><script>(function(){var f=document.getElementById(\"hm-chain\");if(!f)return;f.classList.add(\"js\");var bt=f.querySelector(\"button\"),out=f.querySelector(\".out\");var P_ON=function(){var r=document.querySelector(\".hmw-post\");if(r){return r.classList.contains(\"hmw-plain\");}return false;};var OF=\"Only the first line is about today. The other three are your mind predicting what comes next, and seeing that difference is what slowing the chain down means.\",OP=\"Only the first line is about today. The other three are guesses about what comes next. Slowing the chain down means seeing that difference.\";bt.addEventListener(\"click\",function(){var on=!f.classList.contains(\"slow\");f.classList.toggle(\"slow\",on);bt.setAttribute(\"aria-pressed\",on?\"true\":\"false\");bt.textContent=on?\"Let it run ahead again\":\"Slow the chain down\";out.textContent=on?(P_ON()?OP:OF):\"\";});document.addEventListener(\"hmw-plain-change\",function(){if(f.classList.contains(\"slow\")){out.textContent=P_ON()?OP:OF;}});})();<\/script>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Therapy can help slow that chain down.<\/strong> It doesn&#8217;t do that by pretending the future is guaranteed to be good. It does it by separating what&#8217;s happening now from what your mind predicts will happen next.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Watching your body all the time is exhausting. Therapy can help your attention become more flexible, so <strong class=\"eqb\">you can notice your body without having to monitor it every second<\/strong>. If fear has slowly made your world smaller, it can help you see what you&#8217;ve stopped doing. Sometimes the goal is to return to an activity, sometimes to find a changed version of it, and sometimes the activity genuinely needs to go. Nobody is trying to make you do everything.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Acceptance is often misunderstood as &#8220;this is your life now, just accept it.&#8221; It isn&#8217;t approval or resignation, it isn&#8217;t giving up on treatment, and it isn&#8217;t deciding that your symptoms don&#8217;t matter. <strong class=\"eqb\">It&#8217;s being willing to acknowledge things as they are right now, without needing them to be different before you can start living.<\/strong> Sometimes that sounds like &#8220;my body hurts today,&#8221; without immediately adding &#8220;so today is ruined.&#8221; The question becomes: given the body I have today, what still matters to me?<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Living with chronic physical symptoms can mean making more adjustments than other people do. Plans change, energy goes up and down, and some days are better than others. <strong class=\"eqb\">Psychological flexibility means being able to respond to those changes without being completely defined by them.<\/strong> That&#8217;s very different from pretending your symptoms don&#8217;t exist.<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">Therapy can help slow that chain down.<\/strong> Not by pretending the future is guaranteed to be good, but by separating what&#8217;s happening now from what your mind predicts will happen next.<sup class=\"eq-cite\">[<a href=\"#ref-58\" aria-label=\"Reference 58\">58<\/a>]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"checking-and-avoiding\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Checking and avoiding<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Constantly monitoring your body is exhausting. Therapy can help you notice when your attention has locked onto threat. You don&#8217;t have to stop noticing your body. The aim is to make your attention more flexible, so <strong class=\"eqb\">you can notice your body without having to monitor it every second<\/strong>.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If fear has slowly made your world smaller, therapy can help you see what you&#8217;ve stopped doing. Sometimes the goal is to return to an activity. Sometimes it&#8217;s to find a changed version of it. Sometimes the activity genuinely needs to go. Nobody is trying to make you do everything. The question is how to make sure fear and symptoms don&#8217;t decide the size of your life more than they need to.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"acceptance-isnt-giving-up\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Acceptance isn&#8217;t giving up<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Acceptance is often misunderstood as &#8220;this is your life now, just accept it.&#8221; That isn&#8217;t psychological acceptance. It isn&#8217;t approval or resignation, it isn&#8217;t giving up on treatment, and it isn&#8217;t deciding that your symptoms don&#8217;t matter. <strong class=\"eqb\">It&#8217;s being willing to acknowledge things as they are right now, without needing them to be different before you can start living.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-59\" aria-label=\"Reference 59\">59<\/a>,<a href=\"#ref-60\" aria-label=\"Reference 60\">60<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Sometimes that sounds like &#8220;my body hurts today,&#8221; without immediately adding &#8220;so today is ruined.&#8221; Or &#8220;I don&#8217;t have enough energy for everything I wanted to do,&#8221; without concluding &#8220;so I can&#8217;t have a meaningful life.&#8221; The question becomes: given the body I have today, what still matters to me?<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"flexibility-on-the-hard-days\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Flexibility on the hard days<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Living with chronic physical symptoms can mean making more adjustments than other people do. Plans change, energy goes up and down, activities need adapting, rest becomes part of the schedule, and some days are better than others. <strong class=\"eqb\">Psychological flexibility means being able to respond to those changes without being completely defined by them.<\/strong><sup class=\"eq-cite\">[<a href=\"#ref-57\" aria-label=\"Reference 57\">57<\/a>,<a href=\"#ref-60\" aria-label=\"Reference 60\">60<\/a>]<\/sup> That&#8217;s very different from pretending your symptoms don&#8217;t exist.<\/p>\n\n\n\n<div class=\"wp-block-group has-background hmw-keep hmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-61bc63ed wp-block-group-is-layout-constrained\" style=\"background-color:#fcf2e6;border-radius:18px;margin-top:4px;margin-bottom:34px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hm-lead wp-block-paragraph\" style=\"color:#6e3f10;margin-top:0;margin-bottom:12px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.341), 17px);font-weight:700;line-height:1.4\">What helps on a hard day<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>Instead of &#8220;I can&#8217;t do this today, so everything is pointless,&#8221; try &#8220;I can&#8217;t do this today, so what can I do instead?&#8221;<\/li>\n\n\n\n<li>Instead of &#8220;I&#8217;m frightened, so fear gets to make every decision,&#8221; try &#8220;I&#8217;m frightened, but I can decide what to do next.&#8221;<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<style>.eqp .eq-kp{display:grid;grid-template-columns:auto minmax(0,1fr);gap:4px 16px;align-items:start;background:#e9f3f3;border:0;border-left:4px solid #1d5f66;border-radius:4px 18px 18px 4px;padding:20px 26px;margin:6px 0 34px}.eqp .eq-kp .mk{grid-row:1\/3;width:40px;height:40px;border-radius:50%;background:#fff;color:#1d5f66;display:flex;align-items:center;justify-content:center}.eqp .eq-kp .mk svg{width:21px;height:21px}.eqp .eq-kp .k{font-family:\"Work Sans\",sans-serif;font-size:12px;font-weight:700;letter-spacing:.16em;text-transform:uppercase;color:#1d5f66;margin:2px 0 4px}.eqp .eq-kp .t{font-family:\"Work Sans\",sans-serif;font-size:clamp(15px,calc(10.6px + .72vw),19px);font-weight:500;line-height:1.55;color:#2a2622;margin:0}@media(max-width:560px){.eqp .eq-kp{grid-template-columns:minmax(0,1fr);padding:18px 20px}.eqp .eq-kp .mk{grid-row:auto;width:34px;height:34px}}<\/style><aside class=\"eq-kp\"><span class=\"mk\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.7\" stroke-linecap=\"round\" stroke-linejoin=\"round\"><path d=\"M6.5 3.5h11a1 1 0 0 1 1 1v15.6a.5.5 0 0 1-.78.42L12 16.4l-5.72 4.12a.5.5 0 0 1-.78-.42V4.5a1 1 0 0 1 1-1z\"\/><\/svg><\/span><p class=\"k\">Worth remembering<\/p><p class=\"t\">Therapy can help you separate what&#8217;s happening today from what your mind predicts will happen next, so fear doesn&#8217;t get to decide the size of your life. It can also help you keep asking what still matters to you, given the body you have today.<\/p><\/aside>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:92px;margin-bottom:34px\"><div class=\"hm-ph\"><div class=\"fg\"><svg viewBox=\"0 0 60 88\" aria-hidden=\"true\"><g class=\"bd\"><circle cx=\"30\" cy=\"9\" r=\"5.5\"\/><path d=\"M30 15v31M30 20l-13 10-8 13M30 20l13 10 8 13M30 46l-7 16-3 16M30 46l7 16 3 16\"\/><path class=\"fl\" d=\"M12 81h36\"\/><\/g><circle class=\"hl\" cx=\"30\" cy=\"81\" r=\"8\"\/><circle class=\"dn\" cx=\"53\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"7\" cy=\"44\" r=\"3.3\"\/><circle class=\"dn\" cx=\"48\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"12\" cy=\"38\" r=\"3.3\"\/><circle class=\"dn\" cx=\"43\" cy=\"30\" r=\"3.3\"\/><circle class=\"dn\" cx=\"17\" cy=\"30\" r=\"3.3\"\/><circle class=\"dn\" cx=\"37\" cy=\"62\" r=\"3.3\"\/><circle class=\"dn\" cx=\"23\" cy=\"62\" r=\"3.3\"\/><circle class=\"nw\" cx=\"30\" cy=\"81\" r=\"4.4\"\/><\/svg><\/div><div class=\"tx\"><p class=\"lb\">Point 9 of 9<\/p><h2 id=\"part-9\">Putting it together<\/h2><p class=\"sb\">One picture of how it all connects, and a way of listening to your body without fear<\/p><\/div><div class=\"no\" aria-hidden=\"true\">09<\/div><\/div><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-plk wp-block-paragraph\" style=\"color:#1d5f66;margin-top:38px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">In plain words<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It helps to step back now. Rather than one straight line from cause to effect, it&#8217;s more accurate to picture several parts of you influencing one another all the time: your connective tissue, how you move, the signals from your body, how pain is handled, your brain and spinal cord, your autonomic nervous system, what you live through day to day, how you respond, and what you end up doing. The drawing below sorts out the pieces.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-n has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"one-picture-many-directions\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">One picture, many directions<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">At this point it can help to step back. Rather than one straight line from cause to effect, it&#8217;s more accurate to picture several systems influencing one another all the time: your connective tissue, the mechanics of how you move, the signals from your body, pain processing, your brain and spinal cord, your autonomic nervous system, what you live through day to day, how you respond psychologically, and what you end up doing.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:40px;margin-bottom:48px\"><figure class=\"ra-fig hm-md\" id=\"hm-md\"><div class=\"hd\"><p class=\"ti\">A more complete picture<\/p><p class=\"q\"><span class=\"hmw-nrm\">Not one pathway, but several systems influencing one another<\/span><span class=\"hmw-pln\">Several parts of you, all affecting one another<\/span><\/p><\/div><ol class=\"tiers\"><li class=\"tier t1\"><p class=\"tn\">Your body<\/p><ol class=\"lv\"><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M3 8c3 0 3-3 6-3s3 3 6 3 3-3 6-3\"\/><path d=\"M3 13c3 0 3-3 6-3s3 3 6 3 3-3 6-3\"\/><path d=\"M3 18c3 0 3-3 6-3s3 3 6 3 3-3 6-3\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">1<\/span>Connective tissue<\/p><p class=\"tx\"><span class=\"hmw-nrm\">Differences in the tissue itself, changing how far joints move and how tissues behave.<\/span><span class=\"hmw-pln\">Differences in the tissue that gives your body its structure. They change how far joints move and how tissues behave.<\/span><\/p><\/div><\/li><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"12\" cy=\"12\" r=\"2.6\"\/><path d=\"M10.2 13.8L5 19M13.8 10.2L19 5\"\/><path d=\"M3.2 17.4l3.4 3.4M17.4 3.2l3.4 3.4\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">2<\/span><span class=\"hmw-nrm\">Biomechanics<\/span><span class=\"hmw-pln\">How you move<\/span><\/p><p class=\"tx\"><span class=\"hmw-nrm\">Joint stability, altered loading and muscles compensating.<\/span><span class=\"hmw-pln\">How stable your joints are, how weight and force fall on them, and how hard your muscles work to make up for it.<\/span><\/p><\/div><\/li><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4.5 12a7.5 7.5 0 0 1 15 0\"\/><path d=\"M7.8 12a4.2 4.2 0 0 1 8.4 0\"\/><circle cx=\"12\" cy=\"12.5\" r=\"1.2\"\/><path d=\"M12 13.7V20\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">3<\/span><span class=\"hmw-nrm\">Sensory information<\/span><span class=\"hmw-pln\">Body signals<\/span><\/p><p class=\"tx\"><span class=\"hmw-nrm\">Proprioception and the other signals that tell your nervous system where your body is.<\/span><span class=\"hmw-pln\">Your sense of where your body is (proprioception) and the other signals that tell your nervous system about it.<\/span><\/p><\/div><\/li><\/ol><\/li><li class=\"link\" aria-hidden=\"true\"><span class=\"bi\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path d=\"M4 12h16\"\/><path d=\"M8 8l-4 4 4 4\"\/><path d=\"M16 8l4 4-4 4\"\/><\/svg><\/span><\/li><li class=\"tier t2\"><p class=\"tn\">Your nervous system<\/p><ol class=\"lv\"><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M13 3L5.5 13.5h5.5L10 21l8-11h-5.6z\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">4<\/span><span class=\"hmw-nrm\">Pain processing<\/span><span class=\"hmw-pln\">How pain is handled<\/span><\/p><p class=\"tx\"><span class=\"hmw-nrm\">Pain signals, repeated pain, and possibly changes in central pain processing.<\/span><span class=\"hmw-pln\">Pain signals, pain that keeps coming back, and possibly changes in how your brain and spinal cord handle pain.<\/span><\/p><\/div><\/li><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M9 4.5a3 3 0 0 0-3 3 3 3 0 0 0-2 5.2A3 3 0 0 0 6.5 18 3 3 0 0 0 12 19V5.8A2.8 2.8 0 0 0 9 4.5z\"\/><path d=\"M15 4.5a3 3 0 0 1 3 3 3 3 0 0 1 2 5.2 3 3 0 0 1-2.5 5.3A3 3 0 0 1 12 19\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">5<\/span>Brain and spinal cord<\/p><p class=\"tx\"><span class=\"hmw-nrm\">Attention, prediction, pain sensitivity and how threat is processed.<\/span><span class=\"hmw-pln\">What you notice, what you expect, how sensitive you are to pain and how you sense danger.<\/span><\/p><\/div><\/li><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M2.5 12.5h4l2-5.5 3.6 11 2.3-5.5h7.1\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">6<\/span>Autonomic nervous system<\/p><p class=\"tx\"><span class=\"hmw-nrm\">Heart rate, blood pressure, blood vessels, digestion and temperature.<\/span><span class=\"hmw-pln\">Looks after heart rate, blood pressure, blood vessels, digestion and temperature without you thinking about it.<\/span><\/p><\/div><\/li><\/ol><\/li><li class=\"link\" aria-hidden=\"true\"><span class=\"bi\" aria-hidden=\"true\"><svg viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" focusable=\"false\"><path d=\"M4 12h16\"\/><path d=\"M8 8l-4 4 4 4\"\/><path d=\"M16 8l4 4-4 4\"\/><\/svg><\/span><\/li><li class=\"tier t3\"><p class=\"tn\">Your life<\/p><ol class=\"lv\"><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M4 20V10l8-6 8 6v10z\"\/><path d=\"M9.5 20v-5.5h5V20\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">7<\/span>What you live through<\/p><p class=\"tx\">Pain, dizziness, fatigue, uncertainty and physical limits.<\/p><\/div><\/li><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M5 5.5h14a1.5 1.5 0 0 1 1.5 1.5v8a1.5 1.5 0 0 1-1.5 1.5h-7l-4.5 3.5v-3.5H5A1.5 1.5 0 0 1 3.5 15V7A1.5 1.5 0 0 1 5 5.5z\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">8<\/span>How you respond<\/p><p class=\"tx\"><span class=\"hmw-nrm\">Fear, anxiety, frustration, hypervigilance, avoidance and grief.<\/span><span class=\"hmw-pln\">Fear, anxiety, frustration, constant body-checking, avoiding things and grief.<\/span><\/p><\/div><\/li><li><span class=\"dot\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><circle cx=\"13\" cy=\"4.4\" r=\"1.9\"\/><path d=\"M12 8l-2 5 3 2.5 1 5.5M10 13l-3.5 7.5M12 8l3.5 3.5 3 .5M12 8L8.5 10l-1 3\"\/><\/svg><\/span><div><p class=\"nm\"><span class=\"no\">9<\/span>What you do<\/p><p class=\"tx\">Changes in movement, activity, sleep and time with other people.<\/p><\/div><\/li><\/ol><\/li><\/ol><div class=\"back\" aria-hidden=\"true\"><span class=\"u\"><\/span><\/div><div class=\"fb\"><svg class=\"ic\" viewBox=\"0 0 24 24\" fill=\"none\" stroke=\"currentColor\" stroke-width=\"1.75\" stroke-linecap=\"round\" stroke-linejoin=\"round\" aria-hidden=\"true\" focusable=\"false\"><path d=\"M20 12a8 8 0 1 1-2.6-5.9\"\/><path d=\"M20 4v5h-5\"\/><\/svg><div><p class=\"nm\">And it feeds back<\/p><p class=\"tx\"><span class=\"hmw-nrm\">What you do and how you respond can feed back into pain, fatigue, autonomic symptoms and distress, which changes the picture further up.<\/span><span class=\"hmw-pln\">What you do and how you react can feed back into pain, tiredness, symptoms like dizziness when you stand, and distress. That changes everything above it.<\/span><\/p><\/div><\/div><figcaption><span class=\"hmw-nrm\"><b>It isn&#8217;t a diagnosis of anybody.<\/b> It&#8217;s a way of picturing how connected these systems can become. The arrows can point in both directions, which is why the same symptom can have several contributors.<\/span><span class=\"hmw-pln\"><b>It isn&#8217;t a diagnosis of anybody.<\/b> It&#8217;s a way of picturing how linked these parts can become. The arrows can point both ways, which is why one symptom can have several things feeding it.<\/span><\/figcaption><\/figure><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">This isn&#8217;t one proven chain of cause and effect.<\/strong> When all of this feeds into itself, that isn&#8217;t a failure of your body. It&#8217;s how interconnected systems in the body work.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Take fatigue again. It might come from pain, poor sleep, autonomic problems, muscle effort, migraine, medicines, depression, anxiety, or several of these at once. That&#8217;s one reason people with multisystem conditions get frustrated with simple explanations, and why two people with the same diagnosis can have completely different symptoms. <strong class=\"eqb\">There&#8217;s no single &#8220;hypermobility protocol&#8221; that makes sense for everyone.<\/strong> Medical assessment, physical rehabilitation, psychological support and symptom management may each play a different role, depending on you.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you live with hypermobility, you may have come across language telling you that your nervous system is &#8220;broken,&#8221; &#8220;dysregulated,&#8221; or stuck in fight-or-flight. I think there&#8217;s a more compassionate and scientifically grounded way to look at it. Your nervous system is trying to make sense of what&#8217;s happening. Sometimes it responds to a genuine physical threat. Sometimes it becomes protective because something painful or frightening has happened again and again.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">So the aim is to understand your nervous system, not to fight it.<\/strong> That means learning to recognize when something genuinely needs medical attention and to tell discomfort apart from danger where that&#8217;s appropriate. It also means noticing when fear is making decisions for you, and knowing when rest is necessary and when avoidance has taken over.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Acknowledging the psychological effects of a physical condition doesn&#8217;t invalidate the physical condition. You can have genuine dysautonomia, which means your autonomic nervous system doesn&#8217;t control your body as reliably as it should, and anxiety as well. You can have a genuine connective-tissue disorder and still benefit from therapy. <strong class=\"eqb\">These things don&#8217;t cancel each other out.<\/strong><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A life completely free of uncomfortable sensations isn&#8217;t realistic. <strong class=\"eqb\">The goal isn&#8217;t to become someone who never notices their body.<\/strong> It&#8217;s to understand your body well enough, and respond flexibly enough, that sensations don&#8217;t automatically decide what you think, feel or do. The box below has four answers your body might need, depending on the moment.<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">This isn&#8217;t one proven chain of cause and effect.<\/strong> When all of this feeds into itself, that isn&#8217;t a failure of your body. It&#8217;s how interconnected biological systems work.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"why-your-symptoms-need-an-individual-look\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Why your symptoms need an individual look<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Take fatigue again. It might come from pain, poor sleep, autonomic problems, muscular effort, migraine, medication, depression, anxiety, or several of these at once.<sup class=\"eq-cite\">[<a href=\"#ref-23\" aria-label=\"Reference 23\">23<\/a>]<\/sup> The same goes for concentration, dizziness, digestive symptoms, sleep and pain. It&#8217;s one reason people with multisystem conditions get frustrated with simple explanations.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">It&#8217;s also why two people with the same diagnosis can have completely different symptoms.<sup class=\"eq-cite\">[<a href=\"#ref-25\" aria-label=\"Reference 25\">25<\/a>]<\/sup> One struggles mainly with unstable joints, another with severe chronic pain, another with orthostatic intolerance, another with migraine and fatigue, and another with all of these. Their priorities will be different. <strong class=\"eqb\">There&#8217;s no single &#8220;hypermobility protocol&#8221; that makes sense for everyone.<\/strong> Medical assessment, physical rehabilitation, psychological support and symptom management may each play a different role, depending on you.<sup class=\"eq-cite\">[<a href=\"#ref-39\" aria-label=\"Reference 39\">39<\/a>,<a href=\"#ref-45\" aria-label=\"Reference 45\">45<\/a>]<\/sup><\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"your-nervous-system-is-not-your-enemy\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Your nervous system is not your enemy<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">If you live with hypermobility, you may have come across a lot of language telling you that your nervous system is &#8220;broken,&#8221; &#8220;dysregulated,&#8221; or stuck in fight-or-flight. I think there&#8217;s a more compassionate and scientifically grounded way to look at it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your nervous system is trying to make sense of what&#8217;s happening. Sometimes it responds to a genuine physical threat. Sometimes it becomes protective because something painful or frightening has happened again and again. Sometimes it learns to pay very close attention to sensations because those sensations have mattered before. And sometimes those protective responses end up restricting you.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\"><strong class=\"eqb\">The goal isn&#8217;t to fight your nervous system. It&#8217;s to understand it<\/strong>: to understand what your body is telling you, to tell discomfort apart from danger where that&#8217;s appropriate, to recognize when something genuinely needs medical attention, to notice when fear has started making decisions for you, to learn when rest is necessary and when avoidance has taken over, and to build a relationship with your body that&#8217;s informed rather than fearful.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"you-can-believe-your-body-and-still-work-psychologically\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">You can believe your body and still work psychologically<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Acknowledging the psychological effects of a physical condition doesn&#8217;t invalidate the physical condition.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You can have genuine <span class=\"gl\" tabindex=\"0\" aria-describedby=\"gd-7\"><em class=\"eqi\">dysautonomia<\/em><span class=\"gd\" role=\"tooltip\" id=\"gd-7\"><b>dysautonomia<\/b>A general term for the autonomic nervous system not regulating the body as reliably as it should. It describes a pattern rather than a single condition, and POTS is one form of it.<\/span><\/span> and anxiety. You can have genuine chronic pain and fear related to that pain. You can have genuine joint instability and avoid movement because of it. You can have genuine fatigue and depression. You can have a genuine connective-tissue disorder and still benefit from psychotherapy. <strong class=\"eqb\">These things don&#8217;t cancel each other out.<\/strong> Making room for both can feel far more respectful of what you&#8217;re living with than insisting only one explanation is allowed.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"listening-without-being-afraid\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">Listening without being afraid<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">A life completely free of uncomfortable sensations isn&#8217;t realistic. Even healthy bodies produce pain, fatigue, dizziness, tension, changes in heart rate, gut sensations and countless other signals. <strong class=\"eqb\">The goal isn&#8217;t to become someone who never notices their body.<\/strong> It&#8217;s to understand your body well enough, and respond flexibly enough, that sensations don&#8217;t automatically decide what you think, feel or do.<\/p>\n\n\n\n<div class=\"wp-block-group has-background hmw-keep hmw-nopill has-global-padding is-layout-constrained wp-container-core-group-is-layout-61bc63ed wp-block-group-is-layout-constrained\" style=\"background-color:#fcf2e6;border-radius:18px;margin-top:4px;margin-bottom:34px;padding:24px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hm-lead wp-block-paragraph\" style=\"color:#6e3f10;margin-top:0;margin-bottom:12px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.341), 17px);font-weight:700;line-height:1.4\">Four answers your body might need, depending on the moment<\/p>\n\n\n\n<ul class=\"wp-block-list has-text-color has-work-sans-regular-font-family\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.568), 19px);line-height:1.7\">\n<li>&#8220;I need to stop and take care of my body.&#8221;<\/li>\n\n\n\n<li>&#8220;This is uncomfortable, but I&#8217;m safe.&#8221;<\/li>\n\n\n\n<li>&#8220;I don&#8217;t know what this symptom means yet, so I should get it checked.&#8221;<\/li>\n\n\n\n<li>&#8220;I&#8217;ve experienced this before. I know what it is, and I don&#8217;t need to panic.&#8221;<\/li>\n<\/ul>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-pl has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Those are very different responses, and learning to tell which one fits is part of building a healthier relationship with your body.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Perhaps the most useful way to see hypermobility and the nervous system isn&#8217;t as a battle between body and mind, but as a conversation. Your body keeps sending information, and your nervous system keeps interpreting it. Sometimes it becomes more protective than it needs to be, and sometimes your body genuinely needs protecting. It isn&#8217;t always easy to know which is which, and that uncertainty can be frightening. It can also be approached with curiosity rather than blame.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You don&#8217;t have to convince yourself that your symptoms aren&#8217;t real. And you don&#8217;t have to choose between medical care and psychological care. <strong class=\"eqb\">You can take your body seriously and still work on your relationship with it.<\/strong> You can acknowledge your limits without letting them decide the whole shape of your life.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your nervous system isn&#8217;t something you need to hack, reset or permanently calm down. Understanding it a little better is how the question can slowly shift, from &#8220;why is my body doing this to me?&#8221; toward a more useful one: &#8220;what is my body telling me, what does it need, and how can I respond without letting fear take over the conversation?&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Those are very different responses, and learning to tell which one fits is part of building a healthier relationship with your body.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family hmw-n\" id=\"a-conversation-not-a-battle\" style=\"color:#1d5f66;margin-top:72px;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">A conversation, not a battle<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Perhaps the most useful way to see hypermobility and the nervous system isn&#8217;t as a battle between body and mind, but as a conversation. Your body keeps sending information. Your nervous system keeps interpreting it. Your brain keeps making predictions, your experiences shape those predictions, and your responses shape what happens next. Sometimes that system works beautifully. Sometimes illness, pain, autonomic problems or repeated injury change the conversation. Sometimes your nervous system becomes more protective than it needs to be, and sometimes your body genuinely needs protecting. It isn&#8217;t always easy to know which is which, and that uncertainty can be frightening. It can also be approached with curiosity rather than blame.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">You don&#8217;t have to convince yourself that your symptoms aren&#8217;t real. You don&#8217;t have to blame yourself for having anxiety, or blame your body for being difficult. And you don&#8217;t have to choose between medical care and psychological care. <strong class=\"eqb\">You can take your body seriously and still work on your relationship with it.<\/strong> You can look into what&#8217;s happening physically while also exploring fear, uncertainty, avoidance, grief and identity. You can acknowledge your limits without letting them decide the whole shape of your life, and you can learn that listening to your body doesn&#8217;t have to mean being afraid of it.<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family hmw-n wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Your nervous system isn&#8217;t something you need to hack, reset or permanently calm down. It&#8217;s part of the system through which you experience being alive, and understanding it a little better is how the question can slowly shift, from &#8220;why is my body doing this to me?&#8221; toward a more useful one: &#8220;what is my body telling me, what does it need, and how can I respond without letting fear take over the conversation?&#8221;<\/p>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group has-global-padding is-layout-constrained wp-container-core-group-is-layout-d12c95ff wp-block-group-is-layout-constrained\">\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-f86ed65e wp-block-group-is-layout-constrained\" style=\"background-color:#fbf4e6;border-color:#eedcb9;border-width:1.5px;border-style:solid;border-radius:20px;margin-top:46px;margin-bottom:46px;padding:34px 38px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#00373e;margin-top:0;margin-bottom:12px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORTH BEING CLEAR ABOUT<\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:26px;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">This is a young field, and there are major open questions. Nobody yet fully understands the biological basis of hEDS, why some hypermobile people never have symptoms while others develop problems across several systems, why dysautonomia develops in some people, whether POTS works the same way in everyone with hypermobility, how connective tissue relates to how the body senses itself, or exactly how central sensitization develops in a particular person. There isn&#8217;t yet a strong enough evidence base to say which psychological treatments work best for which people with HSD or hEDS.<sup class=\"eq-cite\">[<a href=\"#ref-1\" aria-label=\"Reference 1\">1<\/a>,<a href=\"#ref-13\" aria-label=\"Reference 13\">13<\/a>,<a href=\"#ref-14\" aria-label=\"Reference 14\">14<\/a>,<a href=\"#ref-31\" aria-label=\"Reference 31\">31<\/a>]<\/sup><\/p>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#2a2622;margin-top:0;margin-bottom:0;font-size:clamp(14.082px, 0.88rem + ((1vw - 3.2px) * 0.786), 21px);line-height:1.68\">Studies don&#8217;t always use the same definitions, people seen in clinics can differ a lot from people in the wider community, many studies are small, and some findings come from spotting links at one moment rather than following people over time.<sup class=\"eq-cite\">[<a href=\"#ref-6\" aria-label=\"Reference 6\">6<\/a>,<a href=\"#ref-11\" aria-label=\"Reference 11\">11<\/a>,<a href=\"#ref-24\" aria-label=\"Reference 24\">24<\/a>]<\/sup> So it&#8217;s worth keeping apart what has been shown, what is strongly linked, what is biologically plausible and what is still a hypothesis. The evidence doesn&#8217;t support reducing hypermobility to a vague idea of &#8220;nervous-system dysregulation.&#8221; It doesn&#8217;t support the idea that trauma causes hEDS, or that a particular vagus nerve exercise can correct the underlying connective-tissue condition. The science is more complicated than that.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div class=\"wp-block-group has-background has-global-padding is-layout-constrained wp-container-core-group-is-layout-50ae14a5 wp-block-group-is-layout-constrained\" style=\"background-color:#faf8f3;border-color:#e8e1d5;border-width:1.5px;border-style:solid;border-radius:18px;margin-top:34px;margin-bottom:44px;padding:30px 34px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">REFERENCES AND FURTHER READING<\/p>\n\n\n\n<ol class=\"eq-refs\" style=\"color:#524a42;margin:0;padding-left:30px;font-size:15.5px;line-height:1.7;font-family:&quot;Work Sans&quot;,sans-serif\"><li id=\"ref-1\"><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31552\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Malfait F, Francomano C, Byers P, et al. The 2017 international classification of the Ehlers-Danlos syndromes. American Journal of Medical Genetics Part C: Seminars in Medical Genetics. 2017.<\/a><\/li><li id=\"ref-2\"><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31539\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Castori M, Tinkle B, Levy H, Grahame R, Malfait F, Hakim A. A framework for the classification of joint hypermobility and related conditions. American Journal of Medical Genetics Part C. 2017.<\/a><\/li><li id=\"ref-3\"><a href=\"https:\/\/doi.org\/10.1002\/ajmg.c.31543\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Hakim A, O\u2019Callaghan C, De Wandele I, Stiles L, Pocinki A, Rowe P. Cardiovascular autonomic dysfunction in Ehlers-Danlos syndrome-hypermobile type. American Journal of Medical Genetics Part C. 2017.<\/a><\/li><li id=\"ref-4\"><a href=\"https:\/\/doi.org\/10.1016\/j.autneu.2018.02.006\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Roma M, Marden CL, De Wandele I, Francomano CA, Rowe PC. Postural tachycardia syndrome and other forms of orthostatic intolerance in Ehlers-Danlos syndrome. Autonomic Neuroscience. 2018.<\/a><\/li><li id=\"ref-5\"><a href=\"https:\/\/doi.org\/10.1016\/j.autneu.2020.102637\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Miller AJ, Stiles LE, Sheehan T, et al. Prevalence of hypermobile Ehlers-Danlos syndrome in postural orthostatic tachycardia syndrome. 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Behaviour Research and Therapy. 2006.<\/a><\/li><li id=\"ref-60\"><a href=\"https:\/\/doi.org\/10.1037\/a0035623\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. American Psychologist. 2014.<\/a><\/li><\/ol>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:30px;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">BOOKS FROM OUR SHELF<\/p>\n\n\n\n<ol class=\"eq-refs\" style=\"color:#524a42;margin:0;padding-left:0;list-style:none;font-size:15.5px;line-height:1.7;font-family:&quot;Work Sans&quot;,sans-serif\"><li><a href=\"https:\/\/www.noigroup.com\/product\/explain-pain-second-edition\/\" target=\"_blank\" rel=\"noopener\" style=\"color:inherit;text-decoration:underline;text-decoration-thickness:1px;text-underline-offset:3px;text-decoration-color:#c2d5d3\">Butler, D. S., &amp; Moseley, G. L. (2013). <em>Explain pain<\/em> (2nd ed.). Noigroup Publications.<\/a><\/li><\/ol>\n\n\n\n<p class=\"eq-lastrev\" style=\"margin:34px 0 0;font-family:&quot;Work Sans&quot;,sans-serif;font-size:12px;font-weight:700;letter-spacing:.15em;text-transform:uppercase;line-height:1.5;color:#6b6259\">Last reviewed October 2026<\/p>\n\n\n<\/div>\n\n\n\n<style>.eqp{--rc-accent:#925c0c;--rc-band:#f9f2e9;--rc-hover:#f4e9d9;--rc-bg:#faf8f3}.eqp .eq-rc-btn{display:none}.eqp .eq-rc{position:relative}.eqp .eq-rc li[hidden]{display:block;margin:0;padding:0;height:0;line-height:0;font-size:0}.eqp .eq-rc li.rc-off{display:none}.eqp .eq-rc.is-collapsed::after{content:\"\";position:absolute;left:0;right:0;bottom:0;height:76px;background:linear-gradient(to bottom,transparent,var(--rc-bg) 94%);pointer-events:none}.eqp .eq-rc ~ .eq-rc-btn{display:inline-flex;align-items:center;justify-content:center;gap:8px;box-sizing:border-box;min-width:260px;min-height:48px;margin:22px 0 0;padding:12px 26px;background:var(--rc-band);color:var(--rc-accent);border:1.5px solid var(--rc-accent);border-radius:9px;font-family:\"Work Sans\",system-ui,sans-serif;font-size:15px;font-weight:600;line-height:1.3;letter-spacing:normal;text-transform:none;text-decoration:none;text-align:center;box-shadow:none;cursor:pointer;-webkit-appearance:none;appearance:none;-webkit-tap-highlight-color:transparent}.eqp .eq-rc ~ .eq-rc-btn:hover{background:var(--rc-hover);color:var(--rc-accent)}.eqp .eq-rc ~ .eq-rc-btn:focus-visible{outline:3px solid var(--rc-accent);outline-offset:3px}.eqp .eq-rc-chev{flex:0 0 auto;width:8px;height:8px;margin-top:-4px;border-right:2px solid currentColor;border-bottom:2px solid currentColor;transform:rotate(45deg);transition:transform .2s ease}.eqp .eq-rc-btn[aria-expanded=\"true\"] .eq-rc-chev{margin-top:4px;transform:rotate(-135deg)}@media (max-width:640px){.eqp .eq-rc ~ .eq-rc-btn{display:flex;width:100%;min-width:0;margin:18px 0 0;padding:12px 10px}}@media (prefers-reduced-motion:reduce){.eqp .eq-rc-chev{transition:none}}@media print{.eqp .eq-rc-btn{display:none!important}.eqp .eq-rc::after{display:none!important}.eqp .eq-rc li[hidden]{display:list-item!important;content-visibility:visible!important;height:auto!important;font-size:inherit!important;line-height:inherit!important}.eqp .eq-rc li.rc-off{display:list-item!important}}<\/style><style>\n\/* 21 Oct sweep (2318), design items D1, D2, D3, D4, D7, D8, D9. 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wp-container-core-group-is-layout-32086477 wp-block-group-is-layout-constrained\" style=\"border-left-color:#b8740f;border-left-width:4px;border-left-style:solid;border-radius:0px;margin-top:8px;margin-bottom:56px;padding:4px 0px 4px 28px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#6b6259;margin-top:0;margin-bottom:0;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.227), 16px);line-height:1.7\"><strong style=\"color:#95560b\">This article is general information, not medical advice.<\/strong> It can&#8217;t diagnose or rule out any condition. Hypermobility-related symptoms, particularly pain, dizziness, palpitations and fatigue, deserve proper medical assessment. If any of this sounds like your experience, please speak to your doctor. Psychological support is intended to work alongside appropriate medical care, never to replace it.<\/p>\n\n\n<\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:0px;margin-bottom:44px\"><a class=\"ra-next\" href=\"\/slow-breathing\/\"><span class=\"eyb\">Read next<\/span><span class=\"ti\">Slow Breathing<\/span><span class=\"wy\">A simple way to work with your nervous system directly: why a longer out-breath settles the body, and a pattern you can try in two minutes.<\/span><\/a><\/div>\n\n\n<\/div>\n\n\n\n<div class=\"wp-block-group hmw-keep hmw-end has-global-padding is-layout-constrained wp-container-core-group-is-layout-d2a766d4 wp-block-group-is-layout-constrained\">\n\n\n<div style=\"margin-top:0px;margin-bottom:0px\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"1708\" src=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg\" alt=\"A therapist taking notes on a clipboard during a session\" class=\"wp-image-230\" style=\"width:100%;height:340px;object-fit:cover;object-position:center 40%;border-radius:22px 22px 0 0;display:block\" srcset=\"https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-scaled.jpg 2560w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-300x200.jpg 300w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1024x683.jpg 1024w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-768x512.jpg 768w, https:\/\/equilibriumpsychotherapy.net\/wp-content\/uploads\/2024\/06\/mid-shot-woman-therapist-taking-notes-clipboard-1536x1025.jpg 1536w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/div>\n<div hidden data-eq-related=\"2873,2661,2503\"><\/div>\n\n\n\n<div class=\"wp-block-group has-background eq-ondark has-global-padding is-layout-constrained wp-container-core-group-is-layout-f761ea3b wp-block-group-is-layout-constrained\" style=\"background-color:#00373e;border-radius:0px 0px 22px 22px;margin-top:0;margin-bottom:80px;padding:52px\">\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#bcd7d8;margin-top:0;margin-bottom:14px;font-size:12px;font-weight:700;letter-spacing:0.16em;line-height:1.4\">WORKING WITH THIS<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-color has-work-sans-regular-font-family\" id=\"it-is-hard-to-live-in-a-body-that-nobody-has-been-able-to-\" style=\"color:#ffffff;margin-top:0;margin-bottom:18px;font-size:clamp(16.293px, 1.018rem + ((1vw - 3.2px) * 0.989), 25px);font-style:normal;font-weight:700;line-height:1.28\">It&#8217;s hard to live in a body that nobody has been able to fully explain to you<\/h3>\n\n\n\n<p class=\"has-text-color has-work-sans-regular-font-family wp-block-paragraph\" style=\"color:#ffffff;margin-top:0;margin-bottom:30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.455), 18px);line-height:1.7\">When hypermobility comes with uncertainty, exhaustion, fear, or the constant question of what&#8217;s happening and why, it can become difficult to know what to do with all of that. Therapy can offer a place to make sense of that experience with someone. Not instead of medical care, and not as an explanation for everything medicine hasn&#8217;t yet been able to explain, but alongside it. A place where you don&#8217;t have to choose between understanding your body and taking care of your mind, and where the difficulty itself can be talked about.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-text-color has-background has-work-sans-regular-font-family wp-element-button\" href=\"\/book-now\/\" style=\"border-radius:9px;color:#2a2622;background-color:#faf8f3;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:700\">Book a discovery session<\/a><\/div>\n\n\n\n<div class=\"wp-block-button footer_b\"><a class=\"wp-block-button__link has-text-color has-work-sans-regular-font-family wp-element-button\" href=\"\/our-approach\/\" style=\"border-color:#bcd7d8;border-width:1.5px;border-style:solid;border-radius:9px;color:#ffffff;padding:15px 30px;font-size:clamp(14px, 0.875rem + ((1vw - 3.2px) * 0.284), 16.5px);font-weight:600\">How we work<\/a><\/div>\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>What hypermobility is and what it isn&#8217;t, how your body keeps track of where it is, why pain can outlast an injury, why standing up can set your heart racing, how a real symptom can teach your brain to be afraid, the fatigue, fog, headaches and gut trouble nobody can see, why body and mind aren&#8217;t separate, where therapy fits, and how it all fits together<\/p>","protected":false},"author":2,"featured_media":4709,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"iawp_total_views":742,"footnotes":""},"categories":[15,16],"tags":[],"class_list":["post-2318","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-body-and-mind","category-deep-dive"],"_links":{"self":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/comments?post=2318"}],"version-history":[{"count":20,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2318\/revisions"}],"predecessor-version":[{"id":4759,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/posts\/2318\/revisions\/4759"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media\/4709"}],"wp:attachment":[{"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/media?parent=2318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/categories?post=2318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/equilibriumpsychotherapy.net\/hr\/wp-json\/wp\/v2\/tags?post=2318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}