05/08/2026
Here is a really good breakdown (of a piece) of why my mental health is so fu***ng challenging, if you ever wondered.
🗣️ "You look fine. You're just being lazy."
It is the sentence that lands like a verdict. You spend your day on the couch not because you want to—but because your body has been working since the moment you stood up.
You aren't lazy. Your body is doing something measurably, scientifically different from what other bodies do just to exist upright.
(📌 Note: While I personally navigate Classical EDS, this post specifically breaks down the latest research on hEDS and Hypermobility Spectrum Disorder [HSD], the most common hypermobility-related diagnoses. Experiences vary, and this is not medical advice!)
Here are three evidence-based reasons why standing completely drains you:
1️⃣ The Stability Tax: Your Muscles Pay What Your Connective Tissue Can't
In a standard body, ligaments provide passive stability. Standing is metabolically cheap. In hEDS and HSD, connective tissue does not function as expected — though the exact molecular reason remains one of medicine's open questions. What research does confirm is that passive joint stability is measurably compromised, forcing muscles to compensate. Because your passive joint support is compromised, your muscles must actively compensate to stabilize joints that would otherwise sublux or strain.
This isn't just a feeling; it's measurable. Research confirms that people with hEDS/HSD have reduced muscle endurance, and a 2025 gait study proved that this altered muscle strategy literally burns more energy. You are not resting while standing. You are working.
2️⃣ The Circulation Loop (For those with POTS)
POTS (Postural Orthostatic Tachycardia Syndrome) is one of the most significant and well-documented comorbidities in the hEDS community. When POTS is present, standing triggers a huge heart rate spike. When POTS is present, standing triggers a sharp heart rate increase. The leading explanation is that connective tissue laxity in the veins allows blood to pool excessively in the lower limbs, reducing the amount returning to the heart. The heart compensates by beating faster, reacting to a structural inefficiency it cannot fully solve. Your heart is not training; it is reacting to a structural problem it cannot fully solve.
3️⃣ The Processing Overhead: Your Brain on Overdrive
Your nervous system usually manages posture automatically using proprioception (your sense of where your body is in space). In hEDS, this sense is impaired. Your brain has to recruit conscious processing to perform tasks that other bodies handle on autopilot.
Combine this cognitive drain with chronic pain, poor sleep, and a racing heart, and you get a compounding effect: fatigue worsens your coordination, poor coordination demands more brain power, and that brain power accelerates your fatigue.
💬 From the Community:
"People see me cancel plans and assume I'm flaky. What they don't see is that I spent 45 minutes getting ready—blow-drying my hair standing up, negotiating with my ankles to stay straight, trying to ignore my heart rate creeping past 110 before I'd even left the bathroom. I have learned to do math most people never have to do: will the shower cost me the dinner? Will the dinner cost me tomorrow? I'm not lazy. I'm load-bearing."
🛑 The Bottom Line
Laziness is a choice to avoid effort. Fatigue in hypermobility is the documented metabolic and physiological cost of effort your body cannot make efficient. You aren't avoiding life. You are navigating it with a fundamentally different energy budget.
👇 Let’s validate each other in the comments: Do you feel exhausted after "just" standing in line or cooking a simple meal? What does invisible effort look like in your day?
(Be sure to save and share this to help educate those who don't understand our energy budget! 🦓💙)
📚 The Science :
Malfait F, et al. (2017) - EDS diagnostic framework.
Ti**le B, et al. (2017) - Fatigue & muscle coordination in hEDS.
Hakim A, et al. (2017) - Multifactorial fatigue & autonomic dysfunction.
Coussens M, et al. (2021) - Persistent muscle strength deficits in hEDS/HSD.
Miller AJ, et al. (2020) - 31% hEDS prevalence in POTS cohorts.
Ladell C, et al. (2025) - Measurably higher energy cost of movement.
Bell AL, et al. (2024) - Gait mechanics & neuromuscular strategy.
