I'm currently in a difficult stage of my illness - I was improving very slowly over the past couple of years (sick since 2006) and starting to feel I was not 'sick', just very deconditioned, so I was very slowly trying to increase my stamina without overdoing it. However so far this year, I've just kept going down and down. I believe I have POTS as my heart rate is approx 70-75 lying down, 90 sitting and 110-125 standing. I'm pretty sure the majority of my current symptoms revolve around circulation issues. I'm getting a tilt table test next week, but my doctor is also wanting to investigate anxiety/depression as a potential cause of some of my issues. I'm not totally excited about this idea, as I am pretty aware of what both are like from how I felt when I was younger and this is different. I feel physically bad THEN I feel anxious or a bit down about my circumstances (wouldn't call it actually depression). I've also read that POTS tends to cause biological changes that increase anxiety too. One of the major things I'm struggling with (and always have with CFS) is how to tell what's a symptom of CFS or POTS and what's feeling physically bad due to feeling emotionally bad. When does one rest and recuperate, and when does one push through to do activity that makes you feel good? I'm really trying to work on clarifying this a bit more so I can explain to my doctor why I feel this is not caused by emotional/mental issues and that the issues present are caused by my symptoms instead. It can be such a fine line between the two, so I would love to hear if anyone has any ideas, methods or feelings about how to tell the difference.