Following our recent Red Flags Guide, we wanted to explore another important aspect of supporting people with their health: what happens when someone already lives with a chronic or complex health condition.

For someone with a long-term condition, it can be surprisingly difficult to recognise when something has genuinely changed. Fatigue may already be part of everyday life. Pain may come and go. Brain fog, poor sleep, digestive problems, dizziness or changes in mood may all be familiar experiences.

So, when a new symptom appears, it can be very easy to think, “That’s probably just part of my existing condition.” Sometimes it is. But sometimes it isn’t.

Conditions such as ME/CFS, Long COVID, fibromyalgia and life stages such as menopause can affect many different parts of the body and mind. Symptoms can fluctuate, overlap and change over time. Living with this uncertainty can be exhausting. People can become skilled at managing their symptoms and understanding their own patterns but sometimes symptoms are unpredictable and it’s a challenge to get through the days. But many will know what a good day feels like, what a flare feels like and what they can realistically manage.

That familiarity can also make a new symptom harder to spot. Someone may have lived with fatigue for years and therefore not immediately recognise that their fatigue has changed. Someone with longstanding digestive problems may assume that new bloating is simply another part of their condition. A person experiencing a flare may understandably attribute every new symptom to that flare.

This is where masking, sometimes called diagnostic overshadowing, can occur. An existing diagnosis can unintentionally become the explanation for symptoms that may actually have a separate or co-existing cause. But an existing diagnosis does not automatically explain every new symptom.

Knowing someone’s usual pattern

For yoga teachers and therapists, this is where our regular contact with students can be so valuable. We may become familiar with their usual energy, movement, breathing, concentration and their participation. That means we may notice a change or something that is unusual.

Perhaps a student who normally manages a particular practice is suddenly struggling in a way that seems different. Perhaps they have started to need significantly more rest, or mention a symptom they haven’t talked about before. These observations don’t mean that something is seriously wrong. They simply give us a reason to become curious.

A useful question is:

“Is this typical for you, or has something changed?”

That question invites a moment of self-reflection to compare what they are experiencing now with their own baseline, rather than with someone else’s idea of what their condition should look like.

Listening beneath the words

People don’t always describe their symptoms fully. Someone may minimise what they are experiencing because they have become accustomed to feeling unwell. They may be worried about being dismissed, feel embarrassed discussing certain symptoms, or simply assume that what they are experiencing is part of their existing diagnosis. Someone saying, “I’m just tired” may also realise that they are experiencing breathlessness or another symptom that is unusual for them.

This doesn’t mean that we should investigate further or try to work out what is causing it, however it can mean that we can listen carefully and give the person an opportunity to say more. Sometimes the conversation will provide reassurance that the person knows what is happening and has already sought appropriate advice. Sometimes it may prompt them to realise that something new needs to be checked.

When someone has a complex health condition, if we are teaching them yoga, it can be helpful to pause before automatically connecting a new symptom to their existing diagnosis. Has something changed in character, severity or duration? Does the person themselves feel that something has changed? If it is different, encouraging appropriate medical advice can be a sensible next step. This isn’t about creating a sense of fear. It is about making space for the possibility that there may be more than one thing going on.

Some patterns deserve extra curiosity

Our Red Flags Guide covers symptoms that should prompt medical attention. There are also some common presentations where it can be helpful to pause rather than make assumptions.

Cautionary Patterns:

• New or unusual headaches, particularly where there is no previous history or where visual symptoms are present.
• Persistent abdominal pain or bloating, particularly when it is different from the person’s usual experience.
• Fatigue accompanied by breathlessness, bleeding, weight changes or significant changes in mental or emotional wellbeing.
• A cough that persists, particularly when accompanied by weight loss or blood in sputum or mucus.

These are prompts to stay curious and consider whether medical advice may be appropriate.

Our role and responsibility as yoga teachers and therapists isn’t to work out what is wrong. It is to create a space where people feel comfortable talking about what they are experiencing, while recognising the boundaries of our role. We can listen without trying to solve the problem. We can notice changes without interpreting them. We can ask questions without turning the conversation into a medical assessment, where we feel that we know the answers.

And when something doesn’t seem right, we can encourage the person to seek appropriate medical advice using a calm and supportive approach. It doesn’t suggest that we know what is happening, and it doesn’t unnecessarily alarm the person.

Perhaps the most important message is that people are complex and health is layered.

A person can have ME/CFS and another health condition. They can experience menopause and develop an unrelated health problem. They can have Long COVID and later experience something new that needs investigating. One diagnosis does not necessarily explain everything that happens afterwards.

For people living with chronic illness, this isn’t about becoming anxious about every new symptom. It is about becoming confident in recognising what is usual for them and what isn’t.

For yoga teachers and therapists, it is about supporting that awareness without stepping outside our scope of practice.

We can help someone reconnect with their own experience and encourage them to seek professional advice when appropriate. That small conversation could make a meaningful difference. Be curious. Listen carefully. Don’t assume. And when something doesn’t feel right, encourage appropriate medical advice.