> ## Content Index > Fetch the complete content index at: https://www.hello-self.fr/llms.txt > Use this file to discover other available public pages before exploring further. # Dealing with dips and setbacks - URL: https://www.hello-self.fr/setbacks-en/ - Published: 2025-10-14T14:33:41.000Z - Updated: 2026-08-13T12:58:19.000Z - Description: We all heard that recovery from Long Covid and ME/CFS is not a linear process. But ups and downs can be extremely difficult to handle. Here is what helps me dealing with setbacks. - Author: Alice - Tags: All posts, Understand & learn, #english [🇫🇷 Lire en français](https://www.hello-self.fr/setbacks-fr) Listen to this post 0:00 /464.704 1× ✋ **I am not a doctor. I am sharing my personal experience. This should not be considered medical advice. Always consult your healthcare providers for any decisions regarding your health, and listen to your body.* We all hear that recovery from chronic illnesses is **not linear**, that it is made of **up and downs**. But even if you know that, this journey can be extremely **frustrating** (believe me, I know). When you break your ankle, doctors can predict pretty accurately what is going to happen. The improvement will overall be linear on a given period of time. But recovery from chronic illness don’t follow those rules, and it **can feel chaotic, long and unpredictable**. In this post I’m going to share what helped me deal with these unavoidable setbacks. I realized that the best I deal with setbacks, the better is my progress afterwards. **Allowing ebbs and flows along the way may be the most important part of recovery**! ## What does a setback look like? ### 1- What is it? Once you start getting better, even if you are working with great [pacing techniques](https://www.hello-self.fr/pacing-en), you will inevitably encounter things like: - **Temporary symptom increases**: more fatigue, more brain fog, more of any of your habitual symptoms, or sometimes even **new symptoms** showing up. - **Difficult emotions**: low mood, more anxiety, frustration, anger, discouragement - **Negative thoughts**: rumination, catastrophic thinking, self-criticism especially if symptoms go up ("*this is all my fault, I messed up again..."*) - And often... **a mix** of all of that. ### 2- When does it happen? Setbacks may occur after: - An **expansion phase:** - you did a bit **more activity** (physical, cognitive or emotional) - you tried **something new** that you hadn’t done in a while... - A **more demanding phase**: - you had to deal with an **unexpected stressor** - you went through a **highly emotional moment** (positive or negative) - you had to do something that was **outside of your current capacity** - a trigger brought you back to **past trauma**, consciously or not - And sometimes… you can't pinpoint why it happened but it still happened 🤷‍♀️ Setbacks can last **a few hours, a few days, or more**. They result in a **temporary decrease of your overall capacity**, forcing you to pull back. ![An image of a women laying down in bed, looking sad, with a small storm above her head](https://www.hello-self.fr/content/images/2025/10/ChatGPT-Image-13-oct.-2025--13_19_17.png) **I know setbacks are extremely discouraging and feel like all progress is lost... but it's not the case**. Setbacks often signal that your system is adjusting or processing change, not that you’re going backwards. 💡 ****Note about PEM** Yes, what I call a "setback" is what's medically described as "post-exertional malaise" (PEM). Over time, I realized that how I **name* these moments deeply affects how I **experience* them. Terms like "PEM" or "crash" are heavy, scary, and it always brought a sense of guilt for me. So I chose to stop using them. Many people in recovery have found ****softer words**: **adjustment period*, **dip*, **flare-up*, or **setback*. ### 3- Why does it happen? Setbacks happen when your nervous system becomes **temporarily** **overwhelmed**: when it needs to restore balance after working a lot. It warns you the only way it knows how: by switching back to "danger" states (fight/flight/freeze), and forcing you to slow down. And these states generate difficult symptoms, emotions and thoughts (more details about [nervous system states here](https://www.hello-self.fr/polyvagal-theory-en)). **Setbacks are not your fault.** They are your nervous system naturally **adjusting and processing new information. It is your brain taking time to learn that living is safe again.** That is why ups and downs are completely expected in recovery. Cycles of expansion and contraction serve a purpose, and they are a normal way of functioning for every living organism. ## What helps me during setbacks? Setbacks are not pleasant, and let's be clear: **I still hate them**. 😅 But I found a few ways to **make them more bearable** and help my nervous system **recover quicker**: - **Don't fight it, don't push through!** It will only fuel the danger response and make the setback last longer. Acceptance is not giving up: it is a message of safety. Lean into things, give your body and mind the best care you can, and slow down (here are some ideas for [resourceful rest](https://www.hello-self.fr/pacing-en#7rest)). - **Let go of the guilt, all of this is temporary** Setbacksarenever your fault. Even if you went a little bit "too fast" in increasing activity and your symptoms are a bit more difficult to deal with this time... it's okay. Visualize it as a storm: it is scary, it is unpleasant, but it will pass. - **Setbacks are an opportunity for more progress afterwards** I see setbacks as "nervous system soreness" after activity expansion, just like the body gets sore after a great training! When you stay calm with your symptoms, you signal to your brain that the danger response is not needed anymore. Most of the work is done here! - **Remember that setbacks mess up your nervous system state** Difficult emotions and thoughts will arise because "the story follows the state". Remember that these emotions and thoughts are not *you*, they are just one more symptom. Allow them to pass through, you don't need to pay much attention to them. 😮‍💨 ****This symptom was gone, and now it's back!** ****And this other symptom was replaced by a new one!** ****Why??** Here are 2 important additional concepts about symptoms caused by nervous system dysregulation: ****Symptom imperative** Symptoms will appear, move and change along the way, because your brain wants your attention. I experienced 60 different symptoms over 2 years, which did exactly that: came and went, all over the body, changed in nature and in intensity, without any clear medical reason [(learn more](https://www.youtube.com/watch?v=DAYpZOBJOnk)). ****Extinction bursts** At some point in your recovery, old symptoms may resurface. It is your brain testing you, asking: "**Are you SURE we're safe??*". Yes you are. It’s like when you stop feeding a habit: it flares up one last time before disappearing [(learn more](https://www.youtube.com/watch?v=9uM5INmmBFY)). These shifts don’t mean something is worsening. They’re signs of the nervous system recalibrating. ## Conclusion When I started my journey, my setbacks would be very intense and last for weeks. But as I'm progressing, and as I'm cultivating more compassion for myself, **setbacks are becoming less intense and less long**. Again, don't get me wrong... I'm writing this draft while dealing with a setback. It's still a very hard moment to go through, every time. But I'm trying to find as much grace as I can in those moments. Each time you move through a setback with confidence and patience, your nervous system learns safety a bit more. **That’s how progress builds up over time.** [Back to posts list](https://www.hello-self.fr/tag/en) ## 👋 Hello Self newsletter Sign up to receive an email when a new post is online Subscribe Email sent! 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