Onset patterns of chronic fatigue syndrome and myalgic encephalomyelitis (2018) Evans & Jason

The effects of cognitive exertion on one person:

 

Stress, a controversial topic:

 

Another controversial topic: whether people might have been working too hard before they got ill:

 

Emotional impact and emotional support:

 

I wonder how many people in general have not had stressors in the years before and after any arbitrary event, though.

 

Sounds like hopelessness. But that can't be depression is biochemical...

 

It occurs to me that, for those whose initial illness was a slow and steady progression where they tried to maintain their workloads, there may be a risk of skewing results in questionnaires towards the Type A overworker stereotype.

As I became increasingly ill, with nothing apparently wrong, I tried to get on with it. I was aware that it seemed that I was working harder, achieving poorer results and it was taking me much longer.

If I filled in a questionnaire at this stage, or in the year or so after having to stop work, it might well look like I was a perfectionist overworking myself. This would be as a consequence of trying to cope with the illness rather than the cause of the illness though. The fact I was being told there was nothing wrong compounded this.

 

I do not have the spoons to read the full doc, so apologies if this is in there, but does it say anything about combinations of causes?

I.e., in my case, I had had a really traumatic two years of my life, which then ended with two viral infections one month apart, causing my onset of ME. I have no way of knowing this, but my hunch is that if only one of the factors was present I would have been less likely to get ME. That’s academic though really and easy to say in hindsight, maybe it would’ve happened anyway.

 

I think this is very much the case, it certainly was with me. Also, how many of us, healthy or not, are that happy with the label of not trying to achieve as much as possible?

 

There were only 14 participants in the qualitative part of the study but if one adds up the individual causes there are a lot more than 14 so many people mention more than one. The individual figures show the different case histories of some individuals.

 

I hope everything will become clearer and we will have a better vocabulary to talk about this sort of thing with more and better research into exactly what ME is.

Actual Myalgic encephalomyelitis came in epidemics, including the one at Tahoe, so an acute viral onset has to be a major cause. My personal belief is that most, if not all, cases come from an infection, though that infection could be subclinical so not noticed. The virus, could be different ones, attacks the respiratory mechanism of the cell, either directly or causing an autoimmune reaction against an essential element.

This makes the ONSET sudden, even if the development of symptoms is GRADUAL.

I hope this is the case because it means we could develop a test to pick it up as soon as the slightest symptoms become apparent so that all the serious effects can be avoided.

This has actually happened with MS. Before the mid nineties no one was diagnosed as having MS until they were very disabled. Now you get an MRI with your first symptom and then get drugs, but even better can modify your lifestyle to keep as much health as possible.

Ramsay described relapsing/remitting episodes after a sudden onset as being the course of ME in about 50% of patients. (He felt 25% recovered completely from the initial illness so it could be that ME is an abnormal effect of an infection just like polio. So being stressed physically, mentally or by having more than one infection at the same time could all lead to a chronic form of the illness.)