Navigating Thanksgiving with Long Covid, POTS, Dysautonomia, and Invisible Illness
Holidays have a way of magnifying what is already hard ~ but also what our hearts most deeply long for.
Living with Long Covid, POTS, Dysautonomia, MCAS, or any invisible illness means that everyday life is already layered with limitations, uncertainty, and grief. But when Thanksgiving arrives and family gathers around tables, laughter, and meals… the contrast between our inner reality and the outer world can feel even sharper.
We want to be part of it.
We ache for connection, familiar voices, warmth, belonging…
Yet we also brace ourselves …. because gatherings bring their own kind of pain. The unintentional dismissive comments. The relatives who don’t understand why we can’t sit at the table long. The exhaustion of trying to talk while your body is screaming for stillness. The pressure to appear “better” than you are. The fear of crashing for days or weeks afterward.
Some of us may choose not to go at all, not because we don’t love our family, but because the physical and emotional cost can feel too high. And yet, in the quiet of our hearts, the longing remains.
So how do we honor ourselves this Thanksgiving?
How do we seek connection at a pace that loves us back, rather than depletes us?
Below is a simple framework (a compassionate plan) to help you navigate the holiday gently, intentionally, and with self-honoring at its center.
1. Know and Write Down Your Limits
Before the day arrives, take 10 minutes to be honest with yourself:
How much talking can I realistically do?
How much sitting before I need to recline?
How long can I be around noise before symptoms rise?
What physical positions help me the most?
Where can I rest quietly during the gathering?
This isn’t pessimistic ~ it’s protective.
It’s an act of self-love.
Write these limits down somewhere accessible.
Your body’s wisdom deserves to be heard.
2. Identify Your Wishes for Connection
Invisible illness creates deep grief around relationships.
So instead of leaving the day to chance, ask yourself:
Who do I genuinely want to connect with?
Who brings out my softest, safest self?
Who drains me, overwhelms me, or triggers guilt/shame?
What is one meaningful moment I’d love to have?
It’s okay ~ even healthy ~ to acknowledge:
Some people are not safe for my nervous system.
Some people are nourishment.
This gives clarity and empowers choice.
3. Ask a Loved One or Friend to Be Your Protection Team
You don’t have to navigate the gathering alone.
Choose one person (your partner, a child, a trusted sibling, or a close friend) and share your list with them:
your limits
your wishes
who to avoid
what to look for in your symptoms
Ask them to support you by:
redirecting conversations
helping you lie down when you start to push yourself
guiding you away from draining people
checking in quietly
reminding you that your needs matter
If no family member fits this role, ask a friend to stop by, or stay on standby by phone, or come sit with you afterward.
Human connection doesn’t have to come through the holiday table.
4. Visualize Being Seen, Valued, and Honored
Invisible illness can trick the mind into believing we are a burden.
So the night before … or the morning of … gently imagine:
✨ People speaking kindly to you
✨ A quiet moment of connection
✨ Someone asking how they can support you
✨ Feeling safe in your body
✨ Feeling worthy of love and care
Visualization isn’t fantasy.
It’s nervous system preparation.
It sets the tone for self-honoring.
5. Create an Exit Plan (and Share It)
This is essential.
Your exit plan can include:
a planned time to leave
a signal to your support person
a quiet room where you can lie down
stepping outside to breathe
leaving early without guilt
Your health is not negotiable.
Your energy is not infinite.
Your worth is not measured by how long you can “hold on.”
🌿 A Gentle Closing Thought
Thanksgiving will look different for each of us.
But different does not mean lesser.
And your presence, in whatever form it takes, matters.
Connection doesn’t only happen across crowded tables.
It happens in small glances…
in quiet conversations…
in the ways we allow ourselves to be soft with our limitations…
and in the ways we honor our own truth.
However you spend this holiday, may you feel:
✨ seen
✨ safe
✨ valued
✨ held
And may you remember:
~ Your worth is not defined by your energy.
~ Your belonging is not diminished by your limitations.
~ Your heart is still deserving of connection, tenderness, and love.
From my heart to yours,
~ Dr. Rachael