Understanding the 'October Slide': Essential Insights for Individuals with Chronic Illness

For many people, fall marks the start of apple picking, cozy sweaters, and warm drinks. But some people with chronic illnesses like asthma and depression say this time of year also comes with a major downside: a worsening of symptoms. The phenomenon is often referred to as the “October Slide,” including by some members of TikTok's chronic illness community.

In one video that references the October Slide, TikTok user Laura Gouge explains that people with chronic conditions experience a significant decline in how they feel during this time of year.

In another video, a user with hypermobility—when joints have an unusually large range of motion—shares how the changing seasons worsen her symptoms. “All year, I will experience kind of the same symptoms, but depending on the time of year, some symptoms are worse than others,” she said. “I am hypermobile, and that has caused some early arthritis for me, and I experience so much pain when it gets cold out.”

But why might seasonal changes trigger flare-ups in people with chronic illness? Which conditions are affected? And what are some tips for managing symptoms? Here’s what experts have to say.

In the context of chronic illnesses, the term “slide” stands for school stress, low pressure, illness increase, days darkening, and exercise ebbs, Sarah Buday, PhD, a clinical psychologist specializing in pain psychology and an associate professor of Anesthesiology at the Washington University School of Medicine University in St. Louis, told Health.

This acronym highlights various factors that can contribute to a decline in well-being during certain seasons—and there's some accuracy to it, Buday said.

“There are weather and activity changes that are typically more prominent in the fall, including changes in barometric pressure, temperature, and humidity shifts,” she said, adding that these factors could exacerbate symptoms.

For example, colder air can cause the synovial fluid lubricating the joints to thicken, leading to increased chronic joint pain, Joaquin Villegas Inurrigarro, MD, MPH, family medicine physician at UTHealth Houston, told Health. This can make osteoarthritis feel much worse in the fall.

Temperature and pressure changes may also exacerbate migraines and connective tissue disorders like hypermobile Ehlers-Danlos Syndrome, Villegas said. Long COVID symptoms may flare up, as could those associated with postural orthostatic tachycardia syndrome, or POTS, a blood circulation disorder.

The fall environment can also produce more allergic reactions, Villegas said, particularly as ragweed pollen levels increase.

Other issues, such as a decrease in daylight hours, “can worsen depressive and behavioral conditions,” Villegas added. And holiday stresses, as well as the circulation of more germs as children return to school, could also heighten symptoms.

Villegas said the length of the October Slide can vary significantly from person to person and depends on the specific chronic condition.

For some people, more severe symptoms may last just a few weeks, especially if you know your trigger. “Being able to identify and control the specific aggravating factor can help reduce the duration of this phenomenon,” Villegas said.

Meanwhile, others may experience heightened symptoms throughout the entire fall season. This reality, Villegas said, has even prompted the “snowbird phenomenon,” in which older adults with arthritis and musculoskeletal conditions move to warmer, sunnier climates for the winter. Milder temperatures, increased daylight, and more stable weather can alleviate pain and discomfort, Buday added.

While the exact steps necessary to prevent an October Slide or reduce its effects depend on your specific condition, experts have some general tips for managing symptoms if you notice an increase during the fall.

Strategies include:

If you notice worsening symptoms, Villegas recommends talking to your healthcare provider to assess whether it’s a flare-up of a chronic condition or something new. “The provider might be able to adjust your treatment plan to better treat the symptoms,” he said.