You wake up exhausted. You glance at the clock and realize the meeting you were supposed to be at started 15 minutes ago. Instantly, shame floods in. You imagine what your coworkers will think when you arrive late yet again, having missed something important.

For many people living with narcolepsy, this is not an occasional inconvenience. It is daily life.

Narcolepsy is a chronic neurological disorder that disrupts the brain’s regulation of sleep and wakefulness. While popular culture often portrays narcolepsy as someone suddenly collapsing asleep mid-sentence, the reality is usually far more subtle—and significantly misunderstood. People with narcolepsy may experience overwhelming daytime sleepiness, fragmented nighttime sleep, sleep paralysis, hallucinations, cognitive fog, and in some cases cataplexy, a sudden loss of muscle tone often triggered by emotion.

But one of the most psychologically painful aspects of narcolepsy is not the symptoms themselves. It is what those symptoms can come to mean about a person’s character.

I saw this firsthand through my friend Meredith, who lives with narcolepsy and now works for a biotechnology company in the sleep medicine space. Before receiving a diagnosis, she spent years blaming herself for symptoms she could not control.

“Years I had blamed myself, been told I was lazy, and struggled with my self-worth,” she told me.

We live in a culture that often moralizes exhaustion. Chronic fatigue, low energy, lateness, forgetfulness, or difficulty waking up are frequently interpreted not as possible signs of illness, but as evidence of laziness, irresponsibility, or lack of discipline. Over time, these assumptions can become internalized.

Invisible conditions are particularly vulnerable to this dynamic. When symptoms are not outwardly obvious, people often feel pressured to continually prove that their struggles are legitimate. The result can be a profound sense of shame.

Meredith described spending years creating elaborate systems to compensate for her symptoms: multiple alarms placed around the room, sleeping at friends’ houses before important obligations, constant anxiety about oversleeping or appearing unreliable. Even socially, she worried about how others perceived her if she became sleepy or disengaged.

“There are still moments where I feel inadequate,” she admitted.

As a neuropsychology fellow, her experience also forced me to reflect on how little attention sleep disorders sometimes receive outside of sleep medicine itself. Sleep affects nearly every domain we evaluate clinically: attention, memory, executive functioning, processing speed, and emotional regulation. Yet narcolepsy rarely entered the conversation during much of my own training.

Part of the problem is that many people’s understanding of narcolepsy comes from exaggerated portrayals in television and film. Meredith explained that one of the stereotypes that frustrates her most is the depiction of cataplexy as dramatic collapse.

“Hollywood tends to overdramatize people experiencing cataplexy,” she said. “People think narcolepsy is a condition where someone suddenly faints and falls asleep mid-task, which really isn’t what most people experience.”

For Meredith, finally receiving a diagnosis brought something unexpected: relief. “Being diagnosed was the beginning of my journey with Self-compassion,” she said.

That line stayed with me long after our conversation ended.

Sometimes a diagnosis does more than explain symptoms. Sometimes it reorganizes a person’s understanding of themselves. Experiences that once felt like personal failures begin to make sense through an entirely different lens. Shame softens into understanding.

This shift became especially apparent in the way Meredith now thinks about productivity and rest.

“I used to view my need for extra rest as a weakness,” she told me. “In a world where hustle culture is glorified, I was terrified that my condition would hold me back.”

Looking back, she realized that constantly fighting her body often made things worse.

“I used to rob myself of the rest I needed in order to feel productive,” she said. “Ironically, that behavior was the very thing that held me back.”

Her insight speaks to a broader cultural issue that extends far beyond narcolepsy. We often equate energy with worth. The ability to constantly produce, achieve, stay alert, and push through exhaustion is frequently treated as a marker of virtue. Rest, meanwhile, is viewed as indulgent or weak unless it has been “earned.”

But the body does not always conform to cultural expectations. And when it cannot, people often blame themselves before considering that something deeper may be happening.

Today, Meredith speaks openly about narcolepsy and works to increase awareness around sleep disorders and stigma reduction. She hopes greater awareness will lead to earlier diagnoses and a more nuanced understanding of what living with narcolepsy actually looks like.

More than anything, though, our conversation reminded me how easily invisible symptoms become moralized, not only by society, but by the people experiencing them.

Sometimes the most powerful thing a diagnosis offers is not simply treatment. Sometimes it is permission to stop fighting yourself.

I’m deeply grateful to Meredith for sharing her experience so openly in this post. Meredith Fox is involved with Project Sleep and advocates for greater awareness and understanding of narcolepsy. You can find her on LinkedIn. I spoke with Meredith at greater length about narcolepsy, identity, stigma, and Self-compassion in a longer interview published on my Substack. You can read the full conversation here.