Many people struggle with the question of “who am I” and may find it difficult to pinpoint a single word that best describes them. One way to help narrow down the list of possibilities is by listing all of the qualities and skills that you associate with yourself. This will help you to discover parts of yourself that you may not have noticed before. It can also be helpful to ask family and friends for their opinions on which words they feel best describe you.
ME (Myalgic Encephalomyelitis) and CFS (Chronic Fatigue Syndrome) are a neurological disorder that impacts the brain, muscles, digestive and immune systems. It can cause severe and disabling symptoms, including fatigue, sleep disturbances and a heightened response to exertion (post-exertional malaise). It affects men, women, children of all ages, racial and ethnic backgrounds, and socioeconomic levels. Some people have a sudden onset of ME/CFS while others develop it over months or years.
Researchers have found that ME/CFS is a complex illness with multiple causes, not just one factor. It’s likely that ME/CFS is caused by a combination of genetic, central nervous system, immune and metabolic factors. However, research is still needed to develop diagnostic tests and treatments.
There are no biomarkers for ME/CFS, so it must be diagnosed based on clinical history and patient reports of symptoms. The most important criteria for diagnosing ME/CFS is post-exertional malaise, or PEM. This global increase in symptoms after physical, cognitive or emotional exertion is often delayed by 24-48 hours and can include a range of unpleasant symptoms such as muscle or joint pain, slowed thinking, lightheadedness or dizziness.
Brain scans have shown that people with ME/CFS have a different pattern of activity in the areas responsible for memory and concentration. This finding supports the theory that ME/CFS is neuroendocrine in origin, with an imbalance of hormones influencing brain function and possibly causing a breakdown in the hypothalamus-pituitary-adrenal axis (HPA axis).
In addition to fMRI, a technique called voxel-based morphometry has shown that ME/CFS patients have a smaller volume and lower density of brain cells. This may be due to the chronic activation of the immune system that occurs in ME/CFS and is exacerbated by stress.
While there is no cure for ME/CFS, some patients report improved functioning after following a treatment plan that focuses on managing symptoms. This includes pacing (maintaining a level of activity that matches the patient’s limited energy supply), sleep aids, anti-depressants and treatments for pain and inflammation. Health care providers can also assist with applying for disability, obtaining wheelchairs and accommodations at work or school. They can also help people apply for support groups and connect with research and advocacy organizations in their country.