School Tips for Teens with POTS: Managing Symptoms During the School Day

For most teenagers, a long school day can be tiring. But for teens living with Postural Orthostatic Tachycardia Syndrome (POTS), simply making it from first period to the final bell can require tremendous physical and mental effort.

Standing in crowded hallways, climbing multiple flights of stairs, carrying a heavy backpack, sitting through long classes, and trying to stay focused while managing dizziness or fatigue can make school feel overwhelming.

The good news is that with the right supports, accommodations, and daily strategies, many teens with POTS are able to successfully navigate high school while protecting their health.

Here are practical tips that can help make the school day a little easier.

What Is POTS?

POTS is a disorder of the autonomic nervous system that affects how the body regulates heart rate and blood flow when moving from sitting or lying down to standing.

While symptoms vary from person to person, many teens experience:

Dizziness
Lightheadedness
Rapid heart rate
Fatigue
Brain fog
Headaches
Nausea
Difficulty concentrating
Exercise intolerance
Fainting or near-fainting episodes

Because many symptoms are invisible, classmates and even school staff may not realize how difficult a typical school day can be.

Prioritize Hydration Throughout the Day

One of the most important parts of managing POTS is staying hydrated.

Many healthcare providers recommend increased fluid intake, although the exact amount should follow your teen’s medical team’s recommendations.

Helpful strategies include:

Carrying a refillable water bottle.
Refilling water between classes.
Keeping water at their desk when permitted.
Setting reminders to drink throughout the day.

Consistent hydration often helps reduce symptoms before they become severe.

Don’t Forget Electrolytes

Many teens with POTS are also encouraged by their healthcare providers to increase electrolytes or sodium intake as part of their treatment plan.

Depending on your provider’s recommendations, this may include:

Electrolyte drink mixes
Electrolyte tablets
Salty snacks
Sports drinks
Sodium supplements

Always follow your healthcare provider’s guidance before making changes to sodium intake.

Request Flexible Seating

Standing for long periods can worsen symptoms.

Ask whether your teen can:

Sit immediately upon entering class.
Have access to seating while waiting.
Leave class a few minutes early to avoid crowded hallways.
Sit during presentations when appropriate.

Small changes can significantly reduce physical strain.

Consider Locker Location

A locker that requires climbing several flights of stairs may not be ideal for a student with POTS.

Possible accommodations include:

Locker near classrooms
Locker on the main floor
Extra set of textbooks at home
Permission to carry fewer materials between classes

Reducing unnecessary walking and carrying heavy loads conserves energy.

Ask About Elevator Access

If your teen’s school has multiple levels, elevator access may be appropriate.

Using the elevator can help reduce:

Fatigue
Dizziness
Increased heart rate
Risk of falls

This accommodation can be especially helpful on days when symptoms are worse than usual.

Modify Physical Education

Exercise can still be important for many teens with POTS, but traditional PE classes may need adjustments.

Possible accommodations include:

Modified activities
Alternative assignments
Seated exercises
Reduced running
Extra rest breaks
Participation based on daily symptoms

Work with your teen’s healthcare provider and school to determine what is appropriate.

Build Rest Breaks Into the Day

Sometimes a short break is enough to prevent symptoms from becoming overwhelming.

Your teen may benefit from permission to:

Sit quietly for a few minutes.
Visit the nurse.
Lie down briefly if recommended.
Cool off after walking.
Recover after climbing stairs.

Preventing symptoms is often easier than recovering from them.

Plan for Brain Fog

Many teens with POTS describe periods of “brain fog,” making it difficult to focus, remember information, or process new material.

Helpful accommodations may include:

Copies of class notes
Extended testing time
Reduced distractions during tests
Recorded lessons when available
Extra time for assignments during symptom flare-ups

These supports help students demonstrate what they know without being unfairly limited by temporary symptoms.

Discuss Attendance Flexibility

Some days are simply harder than others.

Medical appointments, symptom flare-ups, or recovery days may occasionally affect attendance.

Possible accommodations include:

Excused medical absences
Flexible deadlines
Makeup work without penalty
Virtual participation when available
Teacher communication plans

Open communication helps reduce stress when absences are unavoidable.

Create an Emergency Plan

Talk with the school about what should happen if your teen becomes dizzy or feels faint.

The plan might include:

Who to notify
Where your teen should go
Emergency contacts
Medication instructions (if applicable)
Steps staff should follow

Knowing everyone understands the plan can provide peace of mind.

Encourage Self-Advocacy

As teens get older, it’s helpful for them to understand their condition and communicate their needs.

Encourage your teen to feel comfortable saying things like:

“I need to sit down for a minute.”
“I’m feeling dizzy.”
“May I refill my water bottle?”
“I have an accommodation for elevator access.”
“I need to visit the nurse.”

These conversations help build independence while ensuring their health needs are met.

Work With the School Team

If your teen’s POTS substantially affects school participation, they may qualify for accommodations through a 504 Plan or, in some situations, special education services through an IEP if additional eligibility criteria are met.

Meeting with teachers, counselors, nurses, and administrators before the school year begins can help everyone understand your teen’s needs and create a plan for supporting them throughout the year.

Living with POTS can make the school day more physically demanding than most people realize, but the right supports can make a meaningful difference. Staying hydrated, managing energy, planning for symptom flare-ups, and having appropriate accommodations in place can help teens focus more on learning and less on simply getting through the day.

Every student experiences POTS differently, so there is no one-size-fits-all approach. Work closely with your teen’s healthcare provider and school team to create a plan that reflects their individual needs and goals.

With understanding, flexibility, and the right strategies, teens with POTS can continue to participate in school, build friendships, pursue their interests, and prepare for life after graduation—one day at a time.