It’s the bit that is most disbelieved to the point it’s ignored when someone says it here in the uk.So I've always understood that overexertion can lead to permanent detoriation in every ME/CFS patient. People often return to their baseline after PEM but that's not guaranteed. Plenty of people have become severe because they kept overdoing it when they were mild.
Is that not generally accepted to be a core feature of ME/CFS and PEM?
@DigitalDrifter is that different from what you mean?
As for myself significant PEM does often lead to permanent detoration. I've been sick for 15 years moving from mild to severe.
People assume when we say our limits or no that it’s ok to do what they do to us anyway and tell us that’s bs (or not, they just think it so obviously it shows) ‘because they aren’t going to change their behaviour’ and then when we get I’ll assume we’ll be fine later and when we aren’t they act as if it’s because we acted unhealthily.
Of course the other favourite and key bit is having enough rest to recover from each PEM - they don’t believe that either and think it’s something to be negotiated to give us a tenth of recovery time because for no actual reason just their assumption cutting it short will make us fitter. That’s how im this ill. And the iller you get the more cringingly low your threshold is so that more people can laugh at it being untrue and break it by miles ‘because who needs weeks to recover from a phone call’ or ‘you had your x hours in bed, I only interrupted it for a bit in the middle, what’s the issue’
@DigitalDrifter is right. When their eg get breaks someone’s body instead of saying sorry and writing it down as an outcome then that broken body is taken as misbehaviour or lies (they bridge it with some nonsense about how ‘delusion’ ie the mind ‘broke the body’ and not them ) so you get a double-down due to these really errant beliefs that become more fervent the more harmed someone gets, including if a new person gets to come in and ‘have their try at them’
I think the scary thing is that the mental health label has resulted in the stats being hidden of the outcomes of this attitude (that they call treatment as if it’s medical but is treatment in laypersons terms) - even when people die getting attribution to ‘mistreated ME’ rather than something else is very unlikely even now
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