FAQs: POTs and Psychology

Wait…why psychology for a health issue?

At Northground, we know all to well that “wait, why am I here?" feeling that many POTS patients experience when referred to a psychologist.

No, your very intense symptoms are not in your head. They are real, physical and significant.

To help explain the neurological benefit of therapy for physical health issues such as POTs and other dysautonomia, we have addressed some of the frequently asked questions that come up.

Frequently Asked Questions

  • No. In fact, it’s the opposite. Acknowledging the role of the nervous system is a sign that your care team understands the complexity of POTS. Because POTS is a disorder of the Autonomic Nervous System, it affects the very parts of the brain that regulate stress, fear, and physical arousal. We aren't treating a "mental illness"; we are treating a "system dysregulation.

  • We actually focus on "Bottom-Up" therapy, which is less about talking and more about the body. While traditional therapy works on thoughts (top-down), somatic therapies like EFT (Tapping) or EMDR work on the brainstem and the insular cortex (bottom-up). These methods help "reset" the physical signals your heart and brain are sending to each other, which can help stabilise your heart rate variability (HRV).

  • Many POTS patients (64% according to 2025 data) are misdiagnosed with anxiety because the physical symptoms—racing heart, shortness of breath, tremors—look the same on the outside.

    • Anxiety usually starts with a worried thought that triggers a physical response.

    • POTS starts with a physical trigger (like standing up) that the brain then interprets as an emergency. Our goal is to help your brain recognise that these physical "glitches" aren't true emergencies, reducing the chronic state of "fight or flight" your body is stuck in.

  • Somatic means "of the body." These are evidence-based tools designed to calm the nervous system directly. Examples include:

    • EFT (Tapping): Stimulating specific pressure points to lower cortisol.

    • Somatic Experiencing: Learning to release the physical tension and "stored energy" from the trauma of chronic illness.

    • Vagus Nerve Exercises: Simple physical movements to trigger the body's "rest and digest" system.

  • In a word - no. Nor is talking therapy - somatic or otherwise - a replacement for the medical advice and interventions suggested by your medical care team.

    To be clear - while these therapies are not a "cure" for the underlying medical causes of POTS (like low blood volume or autoimmunity), they are a vital part of the
    Gold Standard of care.

    By lowering your body’s baseline level of "high alert," you may find that your medications work better, your physical therapy is easier to complete, and your "flares" become less frequent or intense.