The October Slide Is Real

6 days ago

3 min read

The leaves are changing, the pumpkin spice is back, and somehow you feel like you got hit by a truck. Again.

If you live with an autoimmune disorder, Ehlers-Danlos Syndrome (EDS), POTS, MCAS, or you carry an MTHFR gene mutation, you may already know this feeling. In the chronic illness community, it even has a name: the October Slide.

It isn’t an official medical diagnosis. But every fall I hear the same things from my clients, big and small. “I’m exhausted all the time.” “My joints are screaming.” “I can’t think straight.” And the one that breaks my heart: “I thought I was finally doing better.”

So, what is going on?

Why Fall Knocks Us Down

There isn’t one single cause. It’s a pile-up.

Barometric pressure drops. Lower pressure can let tissues swell, which shows up as joint pain, headaches and migraines. For my EDS folks with already loose, achy joints, this can be brutal.
Colder temperatures. Cold makes muscles and joints stiffer, and stiff bodies hurt more.
Shorter days. Less sunlight means less vitamin D, and low vitamin D is linked to fatigue, muscle pain, low mood and brain fog.
Cold and flu season. A “simple” cold isn’t simple when your immune system is already working overtime. Infections are a common trigger for autoimmune flares and can set off POTS and MCAS symptoms too.
Fall triggers for mast cells. Ragweed hangs on, wet leaves grow mold, and the heat kicks on and blows dust through the house. For MCAS, every one of those is a possible trigger.
Back-to-school (and back-to-everything) stress. New schedules, less rest, less pacing. And stress is fuel for every single condition on this list.
Moving less. It gets dark and cold, so we hibernate. For POTS especially, less movement means deconditioning, and deconditioning makes symptoms worse.

And what about the MTHFR gene? A mutation doesn’t cause the October Slide. But it does affect how your body uses folate and B vitamins, so if you know you carry one, this is a great season to make sure your levels are where they need to be. Ask your provider about checking your homocysteine and whether a methylfolate supplement makes sense for you.

No, It’s Not in Your Head

So, I’ll say it again for the people in the back: this is not laziness. This is not “just anxiety.” Your body is responding to real changes around it.

But I won’t pretend it’s only physical. When you’ve worked so hard to feel better and then the season knocks you back down, it can feel like you’re losing ground. That is grief. Grief for the good days, for the plans you have to cancel, for the version of you that had more energy in July. Add in the people who don’t understand an invisible illness, and it gets lonely fast.

Your frustration is valid. Your exhaustion is valid. And a hard season doesn’t erase your progress.

How to Get Ahead of the Slide

But not all hope is lost. You can’t stop October from coming, but you can plan for it.

Track the weather. A barometric pressure app lets you see drops coming, so you can schedule rest before you crash instead of after.
Hydrate. Heated indoor air is dry. POTS bodies especially need extra fluids, and extra salt if your doctor approves.
Get your levels checked. Ask your provider about vitamin D, and B vitamins and homocysteine if you have MTHFR.
Keep moving, gently. A recumbent bike, stretching, your PT exercises or a walk around the house all count.
Clean up your air. Run a humidifier, change your air filters before the heat kicks on, and keep wet leaves outside. Your mast cells will thank you.
Protect your immune system. Wash those hands and talk with your doctor about how to stay healthy through cold and flu season.
Lighten the calendar. Pace yourself, say no to the extras and build in recovery days.

My personal suggestion, the easiest one to start with: pick one thing from this list this week. Just one. Small changes add up, and you don’t have to do it all at once.

Fall doesn’t have to mean falling apart.

If the October Slide is weighing on your mood as much as your body, our individual therapy sessions offer a space to process the weight of living with chronic illness.