Between us, we bring two perspectives to persistent illness: personal experience of long COVID, and clinical and research experience in chronic illness rehabilitation.

Both have taught us the same thing: when symptoms are real, disabling and difficult to explain, patients need more than reassurance that tests are normal. They need to be believed, assessed carefully and offered ways to make sense of what is happening in their bodies.

One of us, Sarahjane, knows this personally. Before developing long COVID, she was fit and healthy. As a professor of health and physical activity, her life was dedicated to helping people understand and improve their health.

For two years, she could barely function. At her worst, she could not stand for more than a few minutes. Everyday life shrank around severe and frightening symptoms. Like many people living with long COVID, myalgic encephalomyelitis/chronic fatigue syndrome, often shortened to ME/CFS, chronic pain and other persistent conditions, she searched for answers. There were scans, tests and consultations. Again and again, results came back clear. Yet the symptoms remained.

That mismatch can be devastating. When the body feels as if it is screaming for help, normal test results can feel less like reassurance and more like abandonment. The more medicine struggles to explain symptoms, the more patients may fear being disbelieved.

Nervous system education

For decades, people with poorly understood conditions have been told their symptoms are “all in their head”. That phrase has done enormous harm. It has been used to........

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