You get home and they are on the couch. The breakfast dishes are where they were at eight this morning. The washing you asked about is still in the machine.
Nobody has done anything wrong. But a word turns up in your head before you can stop it, and the word is lazy.
You don't say it. You might hate that you thought it. You put the kettle on and ask how their day was, and they say "fine", and you both know that isn't the whole answer.
What you can't see from the doorway is that they may well have got to that word hours before you did. If they did, they were harder about it than you would ever be.
They got there first
Many people with POTS have fatigue and trouble concentrating. In EDS, long-term fatigue can be a major problem, the kind that rest does not do much to shift.
Tired like that doesn't look like anything. A broken arm comes with a plaster cast. This comes with nothing to look at.
From the doorway, it looks exactly like someone who couldn't be bothered. It can look that way from the inside too.
Someone who is worn out every day still has plans, pride and a list of things they meant to do. When the list doesn't get done, they reach for the nearest explanation. It is the same one you reached for.
Being doubted by other people doesn't help. People with POTS are often misdiagnosed with anxiety, even though their symptoms are real.
The doubt can move inside. In one study, 43 people with EDS were surveyed about doubting themselves. About three in four had questioned how bad their own pain was, or whether it was real.
They put much of that down to health professionals dismissing their symptoms again and again. That study asked about pain, not tiredness. But a person who has learned to doubt their pain may doubt their tiredness too.
Medicine can't settle it for them either. Researchers have not found one single cause of POTS, though several have been proposed.
For fatigue in EDS, specialists list a number of things that can feed it, poor sleep and long-term pain among them. They also say large, good-quality trials are still missing.
MCAS is less clear again. In one study of 413 people diagnosed with it, fatigue was the most common symptom. Yet a 2019 report by allergy specialists says fatigue is too imprecise a sign to diagnose MCAS by.
So "lazy or limited?" is a question nobody in the room can answer, and the research can't answer it yet either.
What stings, and what some people find helps
Since you can't rule on it, you are free to stop trying. That changes what comes out of your mouth.
Some lines land as a verdict, however lightly they are meant:
- "Have you done anything today?" They may have been asking themselves that since breakfast. From you, it sounds like the answer.
- "You were fine on Saturday." One good day becomes evidence against every other day.
Other lines ask for information and leave the judging out. These are things some people find help. They will not suit everyone, and on a bad day some people would rather not be asked anything.
- "How much is in the tank today?" It asks about today only, and it accepts any answer.
- "What's the one thing you'd most like off your list?" It treats the list as theirs, and offers a hand with it.
- "I'm doing the dishes. That's not a comment." It says out loud that you are not keeping score.
Your own tiredness counts too. You may be carrying more of the house than you expected to, and some days you will resent it.
Anyone who walks in tired and sees dishes can have the thought you had in the doorway. Having it does not make you a bad person.
What you do next is the part that is yours. You can't know whether it was lazy or limited, and you don't need to. You can ask how today went, and believe the answer.