This short article has been on my radar since PhD days, when the idea that chronic stress, hypervigilance and repeated “micro‑threats” could shape immune and autonomic function was only just emerging in the literature. At that time, linking frequent rejection and criticism (as described in this ADHD opinion piece) with later presentations such as POTS, MCAS, hEDS and broader dysautonomia was still considered speculative, rather than clinically obvious.

What stands out now is how clearly this estimate of tens of thousands of additional negative messages helps explain the allostatic load many ND peeps carry into adolescence and then adulthood (and this load just gets bigger and bigger). It really helps me explain why so many present with complex, overlapping dysautonomia and autoimmune‑like symptom profiles. We are a fragile ecosystem!