Long COVID: Your Autonomic Nervous System Is Collapsing

My Body Has Changed After COVID-19

"Many of you experienced strange shortness of breath, heart palpitations, and persistent brain fog after recovering from COVID-19, didn't you? Tests all came back normal, they said. But your body clearly isn't what it used to be, is it? You can't concentrate, you get easily exhausted by small tasks, and you might suddenly experience cold sweats and trembling hands and feet. This isn't just about being in poor condition; it could be a sign that your body's 'autonomic nervous system' is out of balance."

But are these symptoms... new with COVID-19? No. Today, we'll explore the history and progression of autonomic nervous system dysfunction, which has become more evident since COVID-19. In fact, it encompasses symptoms and underlying mechanisms that we either didn't fully understand or chose to ignore.

1. Autonomic Symptoms That Existed Before – Why Didn't We Know?

Symptoms like dizziness upon standing, rapid heart rate, nausea, and brain fog. These clearly existed even before COVID-19. Some people experienced similar symptoms after infections like the flu, EB virus, or gastroenteritis viruses. However, the problem was that these symptoms often went undiagnosed.

In the clinic, the symptoms patients described were always similar: 'My body feels strange, but all tests are normal.' Doctors were perplexed, and patients felt wronged. Consequently, these symptoms were often dismissed as 'anxiety,' 'stress,' 'hysteria,' or 'panic disorder.'

However, in 1993, the narrative began to change when the term Postural Orthostatic Tachycardia Syndrome was first defined at Vanderbilt University in the United States. This was the first conceptualization of autonomic nervous system dysfunction repeating in a specific pattern.

2. Postural Orthostatic Tachycardia Syndrome – Symptoms That Got a Name

POTS, Postural Orthostatic Tachycardia Syndrome. The name is complex, but the core concept is simple. It's a condition where, within 10 minutes of standing up from a lying position, your heart rate increases by more than 30 beats per minute, accompanied by dizziness and brain fog. Strange symptoms where blood pressure is normal, but the body doesn't feel right.

With the naming of this syndrome, the concept that the autonomic nervous system's 'balance regulation function' could break down began to take root in the medical community. Yet, it remained largely undiagnosed. A name had emerged, but the system wasn't ready.

Especially since it appeared more frequently in women and younger age groups, it was long stigmatized as a 'psychological problem,' even though it was, in reality, a physiological system breakdown.

3. COVID-19 Shines a Spotlight on the Autonomic Nervous System

Then, in 2020, COVID-19, which infected hundreds of millions worldwide, flipped the script. Symptoms that previously had no name began to be reported all at once, globally. People whose respiratory infection had cleared still experienced shortness of breath, brain fog, persistent heart palpitations, a sense of anxiety, and unremitting fatigue. Tests showed nothing abnormal, and they were all told, 'It's probably stress.'

However, when similar individuals were gathered, a striking pattern emerged. This wasn't a coincidence; it was an underlying mechanism.

From then on, autonomic nervous system dysfunction began to be studied under the name 'Long COVID' after the pandemic, and cases diagnosed as autonomic nervous system disorders surged. Symptoms that had finally gained a name could now be explained within an underlying framework.

4. Is This Unique to COVID-19?

Here's an important question: Are these symptoms unique to COVID-19? No. To be precise, they existed before, but COVID-19 brought them to light.

In the past, even if recovery after an infection was prolonged or vague cognitive impairments like brain fog occurred, it was difficult to get understanding from others. However, after COVID-19, these cases surged by the tens of thousands. The medical community and society could no longer ignore this problem.

Ultimately, COVID-19 was an event that put a 'collective breakdown' under a magnifying glass for the quiet system of the autonomic nervous system. It was the catalyst that made visible problems we hadn't seen before.

5. Which Autonomic Disorders Have Been Reported?

To date, a variety of autonomic nervous system disorders have been reported following COVID-19. These notably include Postural Orthostatic Tachycardia Syndrome (POTS), Inappropriate Sinus Tachycardia (IST), Orthostatic Hypotension, Neurally Mediated Syncope (NCS), Chronic Fatigue Syndrome (ME/CFS), and the most common, brain fog.

The autonomic nervous system is a system that regulates the heart, digestive tract, blood vessels, and brain. When this balance is disrupted, we experience disturbances in breathing rate, body temperature, digestion, and even speed of thought. This is the true nature of 'feeling listless but unable to explain why,' or 'feeling strange despite being normal at the hospital.' Brain fog is a prime example of this: a dull mind, difficulty recalling words, inability to concentrate, and an endless feeling of fatigue. This isn't a problem of cognitive ability; it's a signal that recovery capacity, circulation, and brain function itself are unstable.

6. Why Does This Happen? – The Perspective of Disinhibition

The causes of autonomic dysfunction are not singular. There are broadly two categories. One is when a virus directly attacks the nervous system, or when the immune system mistakenly attacks the autonomic nerves. The other is when individuals with a pre-existing weakness in their autonomic nervous system experience a breakdown triggered by an infection.

We can describe this as 'disinhibition.'

It's a state where the normally well-regulated balance of the autonomic nervous system collapses as its last support crumbles under the stress of an infection. This concept is particularly observed in individuals with chronic stress or a history of latent anxiety disorders.

The problem here isn't the infection itself, but rather what traces it left on certain neural pathways and how much resilience the recovery system has lost. That's why reactions differ from person to person.

What we are seeing now is a very old story. Thus, the symptoms of autonomic dysfunction we are witnessing now were not newly created by COVID-19. They have existed for a very long time but remained undiagnosed. COVID-19 was the 'catalyst that made them visible,' and now it's time to truly confront them.

If you are experiencing these symptoms, it's not simply a matter of fatigue or mental weakness. It could be a sign that the balance within your body has been disrupted. And it is a clear physiological condition that deserves understanding and treatment.

From now on, we enter a new era of understanding this quiet system – the autonomic nervous system. This is also a journey to relearn how our bodies achieve recovery and balance.

#LongCOVID #IncheonLongCOVID