Disclaimer: These posts are speaking from my personal experience and I am merely relaying what has been beneficial for me. I know everyone’s situation is different, and I truly respect that and want to say up front that I know my methods may not work for others. By no means am I looking to push my experience as the only way that works, nor am I trying to say that anyone is wrong or weak for not exploring the methods I propose, or for having a varying opinion or experience. I have tremendous respect for everyone fighting through POTS, and I am only looking to extend empathy, offer support, encourage resilience, all while attempting to be as positive as possible! I’m also just looking to share my story and connect with others!
“Routine, in an intelligent man, is a sign of ambition.”
– W. H. Auden
For many people with POTS, mornings are the toughest part of the day, and that’s been 100% true in my experience. Whether it’s brain fog, dizziness, muscle soreness, or overwhelming fatigue after waking up, mornings can be a sizable challenge, and we all know a rough morning can lead to a rough day. However, the opposite is also true — a great morning can lead to a great day.
In three years of self-experimentation, I’ve learned that a morning routine has a significant positive impact on my day. Meaning, if I miss a component or two, there’s a noticeable difference in my energy levels and disposition, and skipping all 5 of my post-wake habits makes my day much, much, tougher.
I use 5 steps every morning to ensure I’ll be in a peak state when tackling the mental and physical challenges of the day. Each component of my routine has concrete scientific benefits, and every step I complete also leads to the feeling of a mental “win” that helps to build my self-esteem and willpower. I’m constantly changing the order and adding and subtracting things, but these 5 have consistently served me well across different times, places, and situations.
The habits of my morning routine have transformed my mornings into a time of day when I feel lively and motivated for the tasks ahead. My habits set me up to perform at my best physically, mentally, and psychologically, and checking things off in the morning makes checking off the day’s more difficult tasks later on much, much, easier.
(For reference, I currently go to bed at 11-11:30 PM on weeknights and wake up with an alarm at 7-7:30 AM on weekdays. Weekend bedtimes range from 11:30 PM-1 AM and wake times are 7:30-9 AM. I’m currently trying to exercise some discipline and align my weekday and weekend bedtime schedules for greater consistency across the board.)
Pop Out of Bed
Quick disclaimer here: If you are at a high risk for fainting, it’s probably best to take your time getting out of bed because rapid movement could bring on dizziness. Having a glass of water near your bed can be a good idea, and sitting up and monitoring how you feel before you get up can help as well. I’m just sharing what’s worked for me, and this is an approach I’ve learned from the Mayo Clinic that’s worked for my siblings as well. It could help some people, and may not be a good fit for others. I’m talking in this section more about not hitting the snooze button on an alarm, and waking up only once during the morning, rather than physically jumping out of bed.
Ever since I’ve set my alarm to wake myself up in the morning, I’ve jumped right out of bed, the second I hear the alarm. I despise the sound of my alarm in the morning, and I want to turn that thing off as soon as I can. Sometimes I wake up in a daze or am confused coming right out of a dream, but I always get up immediately when I come to my senses.
The fact that I jump right out of bed may not seem interesting or important, but I believe popping up is crucial for my morning. When I get up right away, I am starting my day in complete control, and I’m not wasting one second lying comfortably. letting time tick away. Once my day starts, I want to get right into attack mode.
This habit wasn’t an easy one to begin. When I started setting a consistent alarm, it was an attempt to get myself on a schedule, and, at the time, my mornings were rough and I was highly symptomatic. Because of this, I needed an extra boost mentally to help me power through and believe in myself. For about 18 months, I followed the advice of Dr. Norman Vincent Peale and his incredible book The Power of Positive Thinking by repeating an affirmation from the Bible verse Philippians 4:13 when I got out of bed in the morning:
“I believe, I believe, I believe, that I can do all things through He who strengthens me, and that if God is on my side, then no one and nothing can oppose me.”
Usually, after waking, I would feel lightheaded or dizzy, and self-doubt would creep into my mind. I remember thinking, “maybe I can’t do this today, maybe I need to go back to bed.” However, repeating my affirmation strengthened my belief that I could push through the start of the day. It wasn’t just a “mental toughness” aspect, it was the thought that I had God on my side, and I knew He is more powerful than any worldly impediment. I applied the same logic to win the rest of the day, as I convinced myself I had God’s support to carry me through any challenges I would face.
Today, having built up my habit, I find it much easier to get right out of bed. One new addition that also helps is thinking about something that excites me for that day immediately after waking. Keeping a person I love or a dream I’m passionate about in mind can be a fantastic morning motivator.
Funny enough, the first step in my morning routine doesn’t take much more than a second. An important distinction is that I go right into the next part of my routine after getting out of bed.
Once I wake up, no matter how I feel or how tired I am, I follow my routine. I focus on the step-by-step process, and each progressive action gets easier over time. An added bonus? The Silicon Valley-esque notion that I am eliminating decision fatigue, which is the mental exhaustion that accumulates and saps brain energy with every new decision in the morning.
Make my bed
“If all else fails, at least I made my bed.” That’s the thinking behind the habit I picked up after reading the highly inspiring and informational book Make Your Bed by Admiral William H McRaven. Much like my other habits, the utility of making my bed is twofold. As I mentioned earlier, making my bed gives me a sense of control over my morning, my day, and my life. It’s the one thing life cannot take away from me and something I can complete every morning, no matter what.
Making my bed also improves my ability to form habits. Every day, when I’m making my bed, I am reinforcing a positive habit. I find it easier to start and take control of new habits and routines when I’m in the process of practicing already-existing ones, and making my bed is a good reinforcement of habit practice.
By making my bed, I don’t mean doing it flawlessly. I don’t think any home improvement magazines are featuring my sleeping quarters anytime soon, so I don’t feel a need to make it look prim and perfect. Instead, I make sure my sheets are tucked in at the bottom, my covers are evenly pulled to the top of my bed, and any major wrinkles are smoothed out. I place my pillow at the head of the bed, and voilà. I’m finished. On to the next one.
Cold Shower
(Disclaimer: I know some people are highly sensitive to extreme temperature, and even a warm bath or regular shower can make them feel worse. Additionally, some people may react negatively to overwhelming physical stimuli. I understand that and a cold shower is probably a good idea for only a certain subset of people. I encourage you to try one, or even just turn down the temperature on your shower or bath a bit, but I know it is out of the question for certain people, and I completely acknowledge and respect that.)
“Cold shower? Cold shower?! Cold Shower?!?! That sounds like the worst idea ever!!”
That’s usually the reaction I get when I tell people that I take a cold shower every morning. And you might be reading this thinking, why the heck would he take a cold shower in the morning?
First of all, let me preface this by letting you in on a little secret: my morning shower is hot 90% of the time, only it’s topped off with 30-60 seconds of cold at the end. I enjoy basking in a hot shower and I often want to stay in there forever, leading to me occasionally spending a bit too long under the hot water. However, I balance out my pleasure with some discipline. I make sure I always muster up the courage to end my shower with cold.
The first thing you’ll notice when you take a cold shower is the shock value. A cold shower jolts the Central Nervous System and stimulates blood flow quickly throughout the body to all extremities. This can be a fantastic way to enhance circulation – especially to the legs – in the morning for people with POTS. There’s an added benefit to cold showers for helping with POTS because of the way they stimulate the autonomic nervous system and strengthen the sympathetic nervous system. I talk more about the balance between the sympathetic and parasympathetic systems and POTS in my post on meditation, and to sum it up, cold showers can be an essential tool in helping to control your fight-or-flight response and rapid onset breathing. Moreover, according to published studies, cold showers are a common and useful treatment for depression, they can help to burn fat, and they help the body recover to homeostasis quickly.
The science behind cold shower benefits is still small and emerging, so you may elect to dismiss the findings I presented. That’s fine — the biggest benefits I get from cold showers aren’t even scientific, rather they are practical and immediately noticeable.
A cold shower wakes me up like a cup of coffee and sends an adrenaline rush through my entire body. On a psychological level, cold showers are my first big “win” of the day. It’s a challenge to step into the cold water, and it’s something my body doesn’t exactly want to do. Despite that, standing under the cold water helps me to build my willpower and solidify my hold on a more difficult habit. Once I go in, any fear and anxiety I have is replaced by a mini-mental celebration and, sometimes, a desire to get out as quick as I can. When I turn the water off, though, I come out feeling alert and, quite frankly, that “I AM A BEAST!”
Mark Twain said, “Eat a live frog first thing in the morning, and nothing worse will happen to you the rest of the day.” Taking a cold shower helps me to “eat a frog” in the morning. I know if I can stand in that cold, I can face any symptoms or challenges that come my way that day.
If you want to try taking a cold shower, start small. My first few were 3-5 seconds, and I gradually built up my tolerance. Your body will have an initial negative reaction from the CNS shock, but I’ve learned and confirmed that it only takes about 4 days to build up a tolerance. Now, I’m used to the cold, and it actually feels refreshing and calming when I’m under the freezing water.
I use water that’s about 55 degrees Fahrenheit, and I recommend you find a sweet spot that is stimulating but also relatively bearable. Additionally, go easy on your first few, as some people, especially with autonomic dysfunction, could have an unpredictable experience with all of the stress a cold shower can put on the body. I encourage you to look up the benefits and try it out. It can change your morning and your life!
Meditate
Meditation is an integral part of priming myself to be calm, non-reactive, and focused for my day, which is why I’ve covered the benefits of meditation for POTS, as well as techniques and easy ways to get started, in my meditation post I linked to earlier. With regards to how meditation fits into my morning, I have been experimenting with the timing of my practice. It’s usually the second thing I’ll do when I’m out of the shower — the first being drinking a glass of water to rehydrate myself and get fluids into my body.
If the sun is out and it’s not super cold, I’ll go outside shirtless and sit down on a chair or bench to start my practice. There are many benefits to getting morning sunlight, with the most impactful being increased Vitamin D production and a more natural circadian rhythm, which helps to promote sleepiness and wakefulness at the right times of day. Additionally, getting sun in the morning has been proven to be healthier for the skin than getting sun in other parts of the day, because the infrared light present in the AM helps the body to absorb UV rays more efficiently.
In an article on his blog, famous neurosurgeon Dr. Jack Kruse said “The fact that UV and infrared light in AM sunlight work in unison to create this circumstance says something very deep about sunlight importance… mood will be altered by a chronic lack of AM life.”
The sunlight is important, but the meditation is where the real magic happens. I’ll sit down, load up Soundcloud or Headspace, and focus on diaphragmatic breathing while listening to and acting on the prompts given by my guide. This will go on for about ten minutes. If I’m distracted at all, I do my best to keep my eyes closed and focus on my breathing, getting up only for absolute emergencies.
Once the ten or so minutes are over, I’ll open my eyes, take a few deep breaths, and get myself set for the next part of my morning, which is movement.
If you want to learn more about meditation or hear more about my experience with a practice, the post I did here is an awesome resource — you can also find it in the sidebar and under the “Posts” header.
Morning Movement
The purpose of my morning movement routine is to get my blood flowing while lengthening my muscles and setting my joints in the right place, which helps me to move well throughout the day. Additionally, moving helps to mitigate the negative effects of sitting.
I start my morning movement practice by going to a room in my house where I have a rug, open floor space, and a foam roller/lacrosse balls. I tend to do everything in my routine in the same rooms and at the same times every day (on weekdays), because I find it’s easier to build my habits by compartmentalizing them and linking them to specific times and places. For example, when I sit down on the bench outside my house in the morning, my mind and body know it is time for meditation, which allows me an easier time getting into a relaxed mental state.
Another act that precedes my morning movement practice is turning on a podcast, an audiobook, or an affirmational/motivational speech. I learn most of what I know from podcasts and audiobooks, and motivational videos can help to quickly get me in a prime state, ready to attack the day. I’ll use Audible for audiobooks, Apple Podcasts for podcasts, and Soundcloud or YouTube for motivational videos. If you’re interested in any of those and want my recommendations on shows and titles, please reach out to me in the comments!
Not only do I enjoy starting my day off with learning and entertainment, but I also find I am more mindful when I am paying attention to auditory content rather than if I am just doing my exercises, letting my thoughts wander. Especially after my meditation practice, where there’s an emphasis on mindfulness – but also not trying too hard or focusing too much – it’s good to get my brain and body into a state of focus and concentration.
As for my specific morning movement routine, I outline my favorite drills and resources about midway through my guide to exercise with POTS. My outline in this post will be a bit lighter on detail, but if you are interested and want more in-depth content, check out the post I linked to previously.
I use a combination of yoga poses, YouTube mobility drills, quick exercise, and self-massage in a 5-10 minute span for my movement practice. What I do depends on how I’m feeling and what my plans are for the day. For example, if I wake up with a sore upper back or hip, I’ll use a lacrosse ball to massage the aching area for about a minute. On the other hand, if I plan on doing a leg workout in the following couple hours, I’ll do some air squats or active mobility drills to get my hips and ankles moving. My morning movement routine is the time of day where I listen to my body the most, and I use the short timespan I have to address any nagging pains and nip them in the bud.
Let’s jump into the movement possibilities. For my poses, I like downward and upward dog along with cat/camel pose the most because they involve core and back activation. I find mobilizing those areas allows me to get the biggest bang for my buck with regards to how my entire body feels during the day. Luka Hocevar and Kelly Starrett have awesome YouTube channels and almost all of my mobility drills come from their resources.
Attempting to describe their routines would not do them justice, so click on those links and you’ll find an abundance of drills and exercises for people of all fitness and skill levels. Even watching just one of their videos can help you eliminate tightness or soreness in an area that might have been bothering you for months, and I only know that because their videos have helped me eliminate nagging pain from all over my body in minutes.
“Quick exercises” means standard bodyweight movements that most people are familiar with, like push-ups or sit-ups. 5-10 reps of those movements along with others such as air squats, lunges, and any assisted/modified versions of those movements have done wonders for me in clearing brain fog, and they always make my body feel much better. On a biological level, they stimulate the neuromuscular connection to promote easier movement throughout the day. On a psychological level, they can give you a real boost in self-esteem and a feeling of accomplishment. I know people have differing levels of physical fitness and ability, and I want to say even one or two reps of these movements can make a big difference! It’s not about where you are right now, rather, it’s all about how you can get better for tomorrow.
I mentioned self-massage earlier with the lacrosse ball example, and the benefits of a massage practice include decreased muscle soreness, increased flexibility, and greater range of bodily motion. All of these things are important for our body, especially if we are dealing with issues like Ehlers-Danlos syndrome, Thoracic Outlet Syndrome, or any other body-related maladies that may tag along with POTS. Just like the mobility drills, trying to describe how to perform self-massage in this blog would be doing it a disservice, so here’s a video (https://youtu.be/u86d5zV2jKc) that does a fantastic job explaining.
Once I’m finished with my mobility drills, I’ve concluded the “structured” portion of my morning. This is when I’ll check my phone for the first time, and I find my anxiety is reduced in the morning if I am not flooded with messages or social media stress immediately after waking up. From here, I almost always go right into breakfast, but that can change, and this is the point at which I allow myself leeway for the rest of the day!
Breakfast
I needed to throw breakfast in at the end because I’m a big believer in the first meal of the day. I’m usually a fan of eggs and vegetables with the occasional side of avocado or bacon, and a smoothie with fruits, veggies, and a non-whey based protein powder are options that have also suited me well in the past. Overall, my belief is to eat something and feed your body with some good, real, food in the morning! Of course, different people react in different ways so breakfast may not be the best option for everyone. I just wanted to throw in my two cents as a proponent of healthy breakfast and add in that it’s definitely a part of my morning routine, just not a “habit” that some people might think fits in with the others!
Other Thoughts
I’ve recently started journaling in the morning. I primarily focus on gratitude, getting rid of negative mental chatter, and reviewing my goals for the day. I can’t judge yet whether or not it will make a profound impact in my life, but my journaling habit at night has been good for me, so I’m hoping for the best. I think journaling and self-reflection, along with goal setting in a written form, are highly rewarding habits, so I’m looking to put them into practice as much as I can.
The only problem with adding journaling to my morning is that it can lead to my routine getting a bit too long, and I often only have a limited amount of time before I have an outside commitment in the morning! Although, as Abe Lincoln said, “Give me six hours to chop down a tree and I will spend the first four sharpening my axe.” Judging from that quote, and my experience, I’m not sure if there’s such a thing as being too overprepared for the day!
I’ve also recently tried the Lion’s Mane and Cordyceps mushroom coffee from Four Sigmatic. It tastes good, is low in caffeine (leading to no afternoon crash), and the mushrooms in it have been scientifically proven to provide benefits in cognitive function and performance. I feel pretty good and can churn out longer periods of work than usual after sipping it in the morning. I know caffeine can be bad for POTS and can lead to symptoms such as anxiety and rapid heartbeat, so I’m careful to monitor how my body is doing before I pour myself a coup. With that being said, on days when I’m feeling good, the coffee makes me feel even better. I’ve been throwing grass-fed ghee butter, MCT oil, and coconut oil in there, and along with my eggs, I’m intaking a ton of healthy fats in the morning, which helps me to feel sated until lunch.
My morning routine is ever expanding, as I’m a fanatic for learning more about morning and evening routines along with habits in general. As a result, I’m sure I’ll make some additions and possibly some subtractions in the near future. If you like this stuff as much as I do, check out Tim Ferriss and Hal Elrod; they’re pioneers in the morning routine game. There’s also content all over the internet about the morning routines of celebrities and top performers that are pretty cool, and that can be another great way to learn about new habits if you so desire.
What I’ve learned from my research and personal practice is there’s no magic morning routine that’ll give you superpowers. Everyone is different, and one person might like to have his first two hours planned out while another can thrive by laying in bed for 30 minutes on her phone and then rolling out of bed, throwing on some clothes, and getting out the door. I encourage you to try some different habits and techniques and see what works for you. Mornings can be tough, but adding some structure and daily habits can really help you start the day strong.
Let me know in the comments: Do you have any specific morning habits or routines that work well for you? I would love to hear from you, and I’m sure I or someone else could benefit from learning about a new strategy that works well for POTS or in general!
Thank you as always for reading and, if you want to be a superhero, please be sure to spread this post and the word of POTS positivity with your family, friends, and social media. I appreciate the feedback and support immensely, and responses can go a long way in improving the content on this blog. You can also reach out to me through the “Contact” section at the top — I am always looking to answer questions or provide support in any way I can. Thank you again for reading.
Let’s keep making POTS a positive!