Autism, ADHD, POTS & Connective Tissue Disorders: Why These Conditions Can Overlap
Some people are diagnosed with autism or ADHD and later discover that their body has been trying to get their attention too.
Maybe it’s dizziness when they stand up. A racing heart. Unusual exhaustion. Joint pain, frequent injuries, stomach problems, or feeling overheated when everyone else is comfortable. These symptoms can seem unrelated, especially when different specialists are looking at different parts of the body.
Research and clinical experience are drawing more attention to the overlap between neurodevelopmental conditions, autonomic disorders such as POTS, and connective tissue conditions such as hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorder (HSD).
That doesn’t mean everyone with autism or ADHD has POTS or a connective tissue disorder. It means these conditions may occur together often enough that the whole picture deserves attention—and that care may need to account for the whole person.
What do these conditions have in common?
Autism and ADHD are neurodevelopmental conditions. POTS is a form of dysautonomia, which involves problems regulating automatic functions such as heart rate and blood pressure. hEDS and HSD affect connective tissue, which supports structures throughout the body, including joints, skin, and blood vessels.
They are different diagnoses, but symptoms can overlap and some people live with more than one.
Fatigue, brain fog, difficulty concentrating, sleep problems, and digestive symptoms can show up in more than one condition. When a symptom is attributed to only one diagnosis, another piece of the picture may be missed.
POTS and the autonomic nervous system
POTS stands for postural orthostatic tachycardia syndrome. It involves symptoms that occur when the body has trouble adjusting to being upright. Someone may experience a racing heart, dizziness, weakness, nausea, blurred vision, or feeling faint after standing.
POTS is not the only form of dysautonomia, and symptoms alone can’t confirm a diagnosis. A clinician evaluates a person’s history and symptoms and may measure heart rate and blood pressure while they are lying down and standing, or use other testing.
A small study at two specialist autonomic clinics found autonomic conditions in 20 of 28 autistic patients referred for assessment. Nine had POTS, and others had different autonomic diagnoses. That finding is worth paying attention to, but it is not a rate that can be applied to all autistic people: the study was small and included people already referred to specialist clinics. (pmc.ncbi.nlm.nih.gov)
Where hypermobility and connective tissue fit
Hypermobility means a joint moves beyond the usual range. For some people, it causes no problems. For others, it comes with joint instability, recurring injuries, pain, muscle fatigue, or difficulty sensing where the body is in space. When symptoms and other criteria are present, a clinician may assess for HSD, hEDS, or another connective tissue condition.
POTS and hypermobility are commonly associated. In a worldwide survey of people with POTS cited by PoTS UK, 31% of participants were classified as having hEDS, and 55% met the survey’s criteria for hypermobility. Those numbers describe a group of people who already had POTS; they do not mean everyone who is hypermobile has POTS. (potsuk.org)
One possible connection is that connective tissue differences may affect how blood vessels support circulation, which could contribute to blood pooling and difficulty tolerating an upright position for some people. Researchers are still studying how these conditions relate and why they cluster in some people.
A review of research on autism and EDS/HSD discusses reported overlap and shared family patterns, while also emphasizing that the evidence and explanations are still developing. Association does not prove that one condition causes another. (pmc.ncbi.nlm.nih.gov)
And what about ADHD and autism?
Autism and ADHD often co-occur with one another. Research is also exploring their relationships with hypermobility and autonomic symptoms, but the strength of evidence varies across each pairing. The growing conversation is a reason to notice symptoms and ask informed questions—not a reason to assume every neurodivergent person has POTS, EDS, or HSD.
The Autism Research Institute webinar you shared discusses nutritional support for autistic people with co-occurring PANS and POTS. It may be a useful resource for that specific topic, but it does not establish that autism, ADHD, POTS, and connective tissue disorders are all present together or caused by one another. Nutrition and treatment decisions should be individualized with qualified clinicians. (autism.org)
Where massage may fit
Massage can be one way to support comfort, relaxation, and muscle tension for some people living with chronic pain or complex health conditions. It does not treat or cure autism, ADHD, POTS, EDS, or HSD, and there is limited research showing that massage itself is an effective treatment for these conditions.
A session should be adapted to the person in front of the therapist. For someone with hypermobility or joint instability, that may mean avoiding forceful pressure, aggressive stretching, or pushing a joint toward the end of its range. Gentle, well-supported positioning and frequent check-ins can help the client communicate what feels comfortable.
For someone with POTS or orthostatic intolerance, lying still, heat, or getting up quickly may affect symptoms. It can help to discuss positioning and temperature before the session, take transitions slowly, and allow extra time before standing. The client should be able to pause, change position, or stop at any point.
Massage is not a substitute for medical care or physical therapy. For hEDS and HSD, The Ehlers-Danlos Society notes that some clinicians use manual therapy, but research has not established its effectiveness for these conditions. A physical therapist familiar with hypermobility can help determine what hands-on care or movement support is appropriate. (ehlers-danlos.com, abmp.com, ehlers-danlos.com)
If you’re considering massage, let the therapist know about relevant diagnoses, symptoms, medications, pain sensitivities, and any positions or techniques that have caused problems before. A thoughtful therapist will work collaboratively, check in throughout the session, and adapt the approach to your needs.
Why the overlap can be missed
When symptoms affect several body systems, care can become fragmented. A person may talk about dizziness with one provider, joint pain with another, and brain fog or attention difficulties with someone else. Each symptom can have several possible explanations, and some can be mistaken for anxiety or stress without a thorough evaluation.
There can also be communication barriers. Someone may have trouble noticing or describing internal body sensations, or may have spent years being told that their symptoms are “just how their body is.” A symptom diary can help make patterns easier to describe: what happens, when it happens, what makes it better or worse, and how it affects daily life.
What to do if this sounds familiar
You don’t need to arrive at an appointment with a diagnosis. You can bring specific observations and ask whether they warrant evaluation.
It may help to note:
Whether dizziness, palpitations, weakness, or nausea are worse after standing
Whether you faint or feel close to fainting
Joint pain, repeated sprains, dislocations, or unusually flexible joints
Fatigue, brain fog, heat intolerance, or digestive symptoms
How often symptoms happen and how they affect daily activities
A primary care clinician can help decide what evaluations or referrals make sense. Depending on the symptoms, care may involve clinicians familiar with autonomic disorders, cardiology, neurology, rheumatology, genetics, physical therapy, or other relevant specialties.
Please don’t try to diagnose POTS or a connective tissue disorder from a checklist or online post. And don’t start treatments such as increasing salt or fluids, supplements, or restrictive diets without checking whether they are appropriate for your health.
The takeaway
Autism, ADHD, POTS, and connective tissue disorders are distinct conditions, but they can overlap in the same person. The evidence is still growing, and some connections are better established than others. When symptoms cross between the brain, joints, circulation, and other body systems, the full picture matters.
Massage may be a supportive part of someone’s comfort and self-care when it is appropriate for them and carefully adapted. It belongs alongside informed medical care—not in place of it.
People deserve to have their symptoms taken seriously, investigated thoughtfully, and understood as more than a collection of unrelated complaints.
Sources & further reading
The Relationship between Autism and Ehlers-Danlos Syndromes/Hypermobility Spectrum Disorders
Dysautonomia and Neurodivergence: ADHD, Autism, POTS, and Hypermobility
Autism Research Institute webinar: Addressing Symptoms of PANS and POTS Nutritionally
The Ehlers-Danlos Society: Evidence-based rationale for physical therapy treatment
This article is for general education and is not a substitute for medical advice, diagnosis, or treatment.