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The Nervous System’s Role in Recovery from Long COVID


Recovery from Long COVID often focuses on managing symptoms like fatigue, brain fog, sleep disruption, and pain.

But what if there was a way to get closer to the root cause by addressing a powerful, often-overlooked system at the heart of all of these symptoms: the autonomic nervous system (ANS).

When supported properly, this system can be a major key to healing and restoring daily function.

Why the Nervous System Matters

Your autonomic nervous system is responsible for regulating essential functions such as heart rate, digestion, energy, immune activity, and sleep. It operates through two primary branches:

Tool 1

The Sympathetic Nervous System

  • Activates the "fight, flight" response
  • Prepares the body for action and energy expenditure
  • Increases heart rate, dilates pupils, slows digestion
  • Useful in situations requiring alertness, focus, or quick reaction
Tool 2

The Parasympathetic Nervous System as Rest and Digest

  • Activates the "rest and digest" response
  • Supports relaxation, healing, digestion, and deep sleep
  • Slows heart rate, constricts pupils, stimulates digestion
  • Encourages long-term recovery, cellular repair, and hormonal balance
Tool 3

The Parasympathetic Nervous System as Freeze

  • Activates “freeze” or immobilization response in extreme stress or overwhelm
  • May cause shutdown, numbness, dissociation, or extreme fatigue
  • Characterized by low energy, slowed responses, and a sense of being "stuck"
  • Can be protective but may hinder recovery if the body remains in this state too long
All 3 Branches Together

The Sympathetic and Parasympathetic Nervous Systems are both essential parts of the autonomic nervous system. Each plays a vital role: the sympathetic system prepares the body for action ("fight or flight"), while the parasympathetic system supports both deep recovery ("rest and digest") and, in times of overwhelm, protective shutdown ("freeze"). Together, these systems help the body respond to stress, restore balance, and support healing.

After a significant viral infection or chronic stress—like with Long COVID—the autonomic nervous system can become dysregulated. Instead of moving flexibly between activation, rest, and protection, the body can get stuck in a prolonged sympathetic state (overactivation) or a parasympathetic freeze state (shutdown). Both can disrupt energy, focus, sleep, and healing.

When this happens, symptoms like fatigue, poor memory, anxiety, dizziness, or insomnia may actually be signals of a nervous system in distress—not just standalone problems. And if the body can’t access its “rest and repair” mode, healing becomes much harder.

What Does the Nervous System Do? 

Your autonomic (or involuntary) nervous system is responsible for regulating essential functions in the body that happen without our conscious control such as heart rate, digestion, energy, immune activity, metabolic function, and sleep.
It operates through two primary branches:

The Sympathetic Nervous System
  • Activates the "fight, flight" response
  • Prepares the body for action and energy expenditure
  • Increases heart rate, affects inflammation, slows digestion
  • Useful in situations requiring alertness, focus, or quick reaction
The Parasympathetic Nervous System as Rest and Digest
  • Activates the "rest and digest" response
  • Supports relaxation, healing, digestion, and deep sleep
  • Slows heart rate, constricts pupils, stimulates digestion
  • Encourages long-term recovery, cellular repair, and hormonal balance
The Parasympathetic Nervous System as Freeze
  • Activates “freeze” or immobilization response in extreme stress or overwhelm
  • May cause shutdown, numbness, dissociation, or extreme fatigue
  • Characterized by low energy, slowed responses, and a sense of being "stuck"
  • Can be protective but may hinder recovery if the body remains in this state too long
ALL 3 BRANCHES TOGETHER

The Sympathetic and Parasympathetic Nervous Systems are both essential parts of the autonomic nervous system. Each plays a vital role to help us function: the sympathetic system prepares the body for action ("fight or flight"), while the parasympathetic system supports both deep recovery ("rest and digest") and, in times when we are overwhelmed, protective shutdown ("freeze"). Together, these systems help the body respond to stress, restore balance, and support healing.

After a significant injury, chronic stress or viral infection—including Long COVID—the autonomic nervous system can become dysregulated. Instead of moving flexibly between activation, rest, and protection, the body can get stuck in a prolonged sympathetic state (overactivation) or a parasympathetic freeze state (shutdown). Both can disrupt energy, focus, sleep, and healing.

When this happens, symptoms like fatigue, poor memory, anxiety, dizziness, or insomnia may actually be signals of a nervous system in distress, not just standalone problems. And if the body can’t access its “rest and repair” mode, healing and recovery become much harder.

REGULATION OF THE NERVOUS SYSTEM

The Science of Stress, Sickness, and Survival

The body’s stress response is a natural part of how we adapt to challenges. When the nervous system detects a potential threat, like an illness, a sudden traumatic event, or ongoing external stressors, it activates a survival response, releasing hormones like adrenaline and cortisol to help us respond effectively. This response evolved to help us run away from threats or perform to get out of a challenging situation - like running from a saber toothed tiger or swimming across a river with a strong current. This response is still incredibly useful in certain situations, like when we need to have an important conversation at work or are getting ready for a sports competition, helping us stay alert and focused. 

In these moments, our body shifts to face a near term challenge, and also prepares our body to be ready to manage an injury. We temporarily:

  • Redirect energy toward muscles and systems that support alertness, while reducing activity in areas like digestion and higher-level cognitive functions responsible for long-term planning
  • Increase clotting and inflammation
  • Influence immune activity and hormone regulation, both of which demand energy from other systems to operate
  • Affect the lining of blood vessels (endothelium), which may relate to microclotting—a proposed factor in Long COVID

These changes are part of the body’s built-in strategy to handle immediate physical challenges—like escaping danger. However, if the nervous system stays in this activated state for too long, it may make it harder for the body to shift into rest, repair, and recovery.

With Long COVID, some people find themselves stuck in either a prolonged state of activation or shutdown, which can make it harder to access the calm, regulated state that supports rest, repair, and recovery. Rebuilding nervous system flexibility—the ability to shift between states as needed—is an important part of healing.

In a flexible nervous system, these shifts happen naturally. We might briefly move into fight-or-flight to get energy and near-term focus to meet a deadline, then return to a sense of safety and rest once the task is over. The freeze state is usually a last resort for our system, arising when neither fight nor flight feels possible. 

The Vagus Nerve:
A Pathway to Healing

The vagus nerve plays a central role in regulating the autonomic nervous system. It’s a long nerve that connects the brain to many areas of the body that are impacted by Long COVID symptoms—such as the lungs, heart, digestive tract, and pathways that influence immune function.

Research (G. Llados et al., 2023) has shown structural and functional changes in the vagus nerve among Long COVID patients. When this nerve is impaired, symptoms such as gastrointestinal issues, changes in heart rate, chronic inflammation, and fatigue may follow. Research also shows that children are impacted as well as adults, which highlights the need to support people of all ages (N. Granana et al., 2024). 

Clinical trials using non-invasive vagus nerve stimulation have shown promising early results in reducing chronic inflammation and improving recovery after COVID-19. While diagnostic tools are still limited, these findings point toward a strong therapeutic target. Based on research, high performance science and lived experience of people with other infection related chronic conditions, we know that specific movements can have a large and positive impact on nervous system regulation and functioning.

CONTROL THE CONTROLLABLE

What You Can Do Today

Supporting the nervous system isn’t about pushing harder—it’s about restoring balance, cultivating safety, and rebuilding flexibility. This means using specific movements and tools that help restore nervous system alignment. It also means including a blend of activity and rest in your day, so the nervous system relearns how to switch between the two states, based on the situation. This does not mean pushing yourself to do activity that is beyond your limits. It is important to make sure that the actions are gentle enough to be interpreted by your body as safe. This will lay a strong foundation and enable resilience, and greater functionality and a quicker recovery. At ThriveNinety, our approach includes:

  • Gentle pacing (activities and rest at appropriate levels) to prevent crash cycles
  • Somatic tools to help the body feel safe with movements and to align the nervous system (3 Tools)
  • Practical movement to re-engage the brain-body connection
  • Simple daily rhythms to use routines that restore regulation and continue to feel ongoing benefit as a foundation for recovery
Practical ways to regulate the Nervous System:
  • Move gently—try one of our free tools that are specifically designed to create capacity for the nervous system to shift to a regulated state.  Link to Free Tool
  • Track with curiosity—notice how your body reacts to environments or routines, embrace the signals it sends to help you calibrate your Pacing
  • Reframe former activities and do things that bring you joy and energy - even if it is done for a very short time or in a modified way, there is still benefit (and fun), even if it’s not exactly the same as it was at first.

By supporting your nervous system functioning and staying within your safe limits, it is possible to accelerate recovery. From these foundations, you can improve resilience and ability over a relatively short time period and be able to get back to feeling like yourself again. 

SCIENCE-BACKED 

What the Research is Showing

Long COVID research is ongoing, but we know enough to understand much about how bodies are impacted, and to act on that knowledge to help people feel better. Issues related to the nervous system include:  

  • Vagus nerve dysfunction contributes to autonomic dysregulation (Woo et al., 2023)
  • Autonomic imbalance impairs recovery from acute infection
  • Imaging and diagnostics show structural and functional changes consistent with vagal disruption (Davis, 2023)

These findings provide a strong direction for those looking to heal. Interventions that support vagal tone and nervous system regulation are already helping people move toward recovery. 

PERSONAL EXPERIENCE

A Personal Note from Katie

I know the impact of aligning the nervous system is first hand. After developing Long COVID, I was stuck in cycles of fatigue, dizziness, and despair. I felt unwell and didn’t have a way out. No one was talking about the nervous system—but once I learned more about it, and started to regulate it, everything changed. It wasn’t the only thing I did as part of my recovery, but it was a key element. What’s more, I still do small regulating movements multiple times a day and they continue to support further improvement, and now enhanced performance.  

Through targeted pacing, appropriate movement, an anti-inflammatory diet, and nervous system retraining, I made meaningful progress. Andrea’s guidance along this path was so valuable. Andrea and I built ThriveNinety to share what we’ve learned and create programs rooted in science, systems thinking, and hope. We also made sure everyone can have access to our guides; no waiting period, or specific appointments, needed.

TAKE CONTROL OF THE CONTROLLABLE

Recovery Is Possible—Let’s Start Together

You don’t need to push harder. You need the right support. At ThriveNinety, we help you work with your body—not against it.

The nervous system is one of five pillars in our PEDAL™ framework for Long COVID recovery. “A” stands for Align the Nervous System—because healing begins when your body feels safe enough to shift into recovery mode.

If you're ready to take your first step, check out our Long COVID Symptom Management Program or explore free resources to start today.

We’re here with you,
Katie & Andrea
Co-Founders, ThriveNinety

More about Katie and Andrea