October has many positive associations: spooky season, beautiful fall foliage, delicious hot beverages, apple picking, and more. However, in the chronic illness and disabled communities, there is another association, commonly called “the October slide.” 

In these communities, the October slide refers to the common experience of the worsening of pre-existing symptoms in the fall, typically around the month of October. For many people with chronic health conditions, the October slide is a source of dread and anxiety each year. For those who are newly experiencing their chronic health condition, the October slide can also be an unpleasant surprise. 

Whether you’ve experienced it many times or this year is your first encounter, know this: you’re not alone, and there are effective strategies to help manage the October slide. 

What is the October Slide? 

While anyone can experience things like “sick season” or the “back to school stress,” the October slide is a colloquial term used within the disabled, chronically ill, and chronic pain communities. It is a community term rather than a clinical diagnosis. Common symptom changes associated with the October slide include:

• Increased chronic pain symptoms such as joint pain or migraines
  
  
• Increased vertigo, dizziness, or falling or fainting episodes
  
  
• Increased feelings of fatigue
   
• Increased cognitive symptoms, such as “brain fog” and difficulty concentrating
  
  
• Increased mood symptoms, such as feeling depressed or having low motivation
  
  
• Increased frequency of viral infections like flu, RSV, and COVID 

There is no set list of conditions who may experience the October slide, but the phenomenon is commonly discussed among people with diagnoses like fibromyalgia, Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Ehler-Danols Syndrome, Lupus, chronic migraine, chronic pain, Long Covid (which we’ve written about in our article Can Therapy Help with Long COVID?), and multiple sclerosis. 

Causes of the October Slide 

The October slide, while commonly experienced and discussed within the chronic health conditions community, isn’t a well-researched phenomenon in medical science. Therefore, we don’t have definitive answers about the cause (or other variables, like prevalence) from medical or psychological research. However, there are several possible causes that have been identified:

• Weather Changes: in the northern hemisphere, autumn weather involves frequent, abrupt changes in barometric pressure as well as abrupt, unpredictable temperature rises and falls. Both of these changes can impact chronic pain, such as by triggering migraines or joint pain flares. 
  
  
• Darker, Shorter Days: As autumn progresses, the northern hemisphere experiences progressively shorter days. Reduced sunlight can result in lower vitamin D levels, disrupted circadian rhythms, and seasonal mood impacts.
  
  
• Immune System Stress: October includes seasonal allergies and the start of “sick season,” when colds, flus, RSV, and COVID often increase in the population. Every infection is a stressor on the immune system. Infections can cause flares of existing conditions or the development of new conditions, such as Long COVID.
  
  
• Increased Busy Schedules: The start of the school year and upcoming holidays can result in an especially busy calendar, with markedly less time for rest, especially in comparison to the summer months. This increase in obligations can be taxing on the body, especially for those with chronic health conditions.
  
  
• Reduced Physical Activity: Colder weather in autumn often means people reduce their outdoors time, which in turn reduces physical activity. With less movement, our bodies can experienced decreased strength and increased pain.

Tips for Managing the October Slide

While we can’t control the calendar, there are many steps we can take to reduce the impact of the October slide. Most of the strategies useful for managing the specific experience of the October slide are also proven to be useful for multiple other concerns, such as chronic pain, anxiety, or burnout. Therefore, for those with chronic health conditions, these strategies can have utility at any time of the year. Here are a few ways you can manage the October slide:

1. Mindfulness Practice: This involves cultivating the ability to be fully engaged in the present moment without judgement and without attempting to control our experience. Mindfulness allows us to step out of the “what if?” thoughts about the future and the “would’ve, could’ve, should’ve” thoughts about the past. When focused on just one, present moment, the intensity of our experience can feel smaller and more manageable.
   
   
2. Pacing: Balancing rest and activity, including resisting the temptation to be overly active on a “good day” is an important skill for reducing the frequency and intensity of symptom flares. Pacing involves learning to base activity on time, rather than waiting for pain to force limits. It also requires learning to listen to your body and detect subtle cues—a skill that requires mindfulness, which is discussed above. Pacing is an evidence-based technique commonly taught in Cognitive Behavioral Therapy for Chronic pain, which you can read about here.
   
   
3. Getting Good Sleep: Health symptoms can worsen our sleep, and poor sleep can worsen health symptoms like chronic pain and brain fog. Practicing healthy sleep hygiene (also called sleep habits) is an important step in protecting our sleep so that our bodies can get time to heal and recuperate at night. Sleep hygiene involves habits like reducing screen time before bed, only using our beds for sleep and sex (and not other activities, like TV or scrolling), and having a regular wake time. You can read more about how therapy can support healthy sleep in our article about Cognitive Behavioral Therapy for Insomnia, which is the single most evidence-based treatment available for insomnia. It even outperforms medications!
   
   
4. Getting Good Rest: Rest is different from sleep! There are many types of rest, and rest doesn’t always involve being sedentary or quiet. Physical, mental, emotional, sensory, creative, and spiritual rest are all important for maintaining consistent wellbeing, including during the October slide. You can read more about the seven types of rest in our blog post Burnout and the Psychology of Rest. By getting fuller, better rest, you can improve your body’s resiliency during the October slide.
    
5. Therapy: Managing stress is hard to do on our own. For that reason, therapy is an excellent choice for anyone experiencing intense or prolonged stress. Therapy can address stress directly by teaching skills like mindfulness, relaxation techniques, and emotion regulation skills. It can also help by treating and reducing the effects of stress, such as insomnia. 

How Therapy Can Help with the October Slide 

The October slide is most commonly associated with a change in physical symptoms, such as an increase in chronic pain flares. For many people, this means they think of the impacts as distinct from mental health. However, our physical health impacts our mental health and vice versa, and chronic pain is no exception. 

Chronic pain has profound impacts on our mental health by impacting our physical, psychological, social, professional, and even spiritual experiences. People living with chronic pain are at higher risk of psychological conditions like depression and anxiety, frequently lack financial resources to support a sense of stability in society, and are often subjected to social isolation as a result of their limitations and needs. All of these experiences impact our emotional wellbeing, even if the root cause is physical pain.

You can learn more about the relationship between chronic pain and mental health by reading our blog posts about Living Well with Chronic Pain and about How Therapy Can Help With Chronic Pain. Because of the impact of chronic pain on mental health, Aviva Psychology Services offers a Chronic Pain Specialty Clinic staffed by specialist psychologists. 

Therapy can also offer evidence-based interventions for conditions that develop because of the October slide or pain flares. For example, chronic pain commonly interferes with our ability to get good, restful sleep. When sleep problems are frequent and persistent, they may be a sign of Insomnia. Fortunately, insomnia is highly treatable via a gold standard therapy called Cognitive Behavioral Therapy for Insomnia (CBT-i). Psychologists at Aviva have completed extensive training in CBT-i, which you can read about in detail via the Aviva blog post about insomnia or by visiting the Insomnia Speciality Clinic webpage. 

However, the October slide also impacts mental health directly. As noted above, many people with chronic health conditions notice that during the October slide, they experience increased cognitive symptoms, such as “brain fog” and difficulty concentrating, as well as increased mood symptoms, such as feeling depressed or having low motivation. Therapy can directly address these psychological symptoms through a lens of health psychology or by treating secondary conditions like depression or anxiety, 

The October slide can also be a source of complicated feelings about having chronic health conditions or about being disabled. For example, sometimes a decrease in our abilities can lead to feelings of grief and loss. Grief is a complex, painful human experience discussed further in this Aviva blog post and treated via our Grief Specialty Clinic. 

For others, the October slide may challenge their identity, beliefs about health and self-worth, or uncover internalized, ableist beliefs that increase suffering. In these cases, it can be helpful to learn to increase self-compassion and to embrace disability pride as described in our Disability Pride Month blog post. Aviva Psychology Services offers a specialty Disability & Chronic Illness Clinic with expert psychologists who can provide disability-affirmative therapy. 

Getting Started in Therapy

At Aviva Psychology Services, your psychologist can help you develop strategies to manage the impacts of chronic health conditions, including during the October slide. Whether the October slide has you dealing with increased pain, trouble sleeping, depressed mood, or questions of identity and self-worth, we are here to help. 

Psychologists at Aviva are trained to help you develop a customized treatment plan that will honor your unique experiences, including your unique health conditions and your specific goals and values. All therapy at Aviva is evidence-based, trauma-informed, and tailored to each unique client’s needs, preferences, goals, abilities, and readiness. 

You can get connected with a psychologist who has expertise and experience in working with clients who are experiencing stress by filling out the Request an Appointment form.

Selected References and Additional Reading

1. Bogart, K. R., Lund, E. M., & Rottenstein, A. (2018). Disability pride protects self-esteem through the rejection-identification model. Rehabilitation Psychology, 63(1), 155–159. https://doi.org/10.1037/rep0000166
   
   
2. Jeter, A. (2025, October 16). I’m disappointed that the ‘October slide’ seems to be a thing. Pulmonary Hypertension News. https://pulmonaryhypertensionnews.com/columns/im-disappointed-october-slide-seems-be-thing/
   
   
3. McCracken, L. M., Yu, L., & Vowles, K. E. (2022). New generation psychological treatments in chronic pain. The BMJ, 376, Article e057212. https://doi.org/10.1136/bmj-2021-057212
   
   
4. Robert Kovach Ph.D. (2025, October 21). The coziest time of year is also when energy is depleted and burnout is common. Psychology Today. https://www.psychologytoday.com/us/blog/the-psychology-of-work/202510/the-fall-of-the-fall-why-autumn-is-burnout-season
   
   
5. The Sick Times - Chronicling the Long Covid crisis. (2025, April 15). The Sick Times - Chronicling the Long Covid Crisis. https://thesicktimes.org/