“Push-and-crash” cycles are when someone with ME/CFS is having a good day and tries to push to do more than they would normally attempt (do too much, crash, rest, start to feel a little better, do too much once again). This can then lead to a “crash” (worsening of ME/CFS symptoms).
A push-crash cycle is when the individual pushes through the PEM, worsening their physical state, resulting in a crash. Further harm occurs when an individual pushes during the crashed state, never allowing for true energy restoration.
During PEM, any ME/CFS symptoms may get worse or first appear, including difficulty thinking, problems sleeping, sore throat, headaches, feeling dizzy, or severe tiredness. It may take days, weeks, or longer to recover from a crash. Sometimes patients may be house-bound or even completely bed-bound during crashes.
A person with ME/CFS should never be coaxed to push past their limit as this can be dangerous and cause long-term relapse. The goal is to balance rest and activity to avoid decreasing fitness levels from lack of activity and flare-ups of illness due to overexertion.
It is possible that ME/CFS is caused by a change in the person's immune system and the way it responds to infection or stress. ME/CFS shares some features of autoimmune illnesses (diseases in which the immune system attacks healthy tissues in own body, like in rheumatoid arthritis).
Alan Light's ME/CFS/MS study suggests that people with MS may be more fatigued than people with ME/CFS, but experience much less post-exertional malaise. MS is known to be one of the most fatiguing diseases but ME/CFS is significantly more impairing.
Some people with ME/CFS might benefit from trying techniques like deep breathing and muscle relaxation, massage, and movement therapies (such as stretching, yoga, and tai chi). These can reduce stress and anxiety, and promote a sense of well-being.
“Reclined or recumbent exercises are generally a good place to start for someone with chronic fatigue,” says Melissa Williams, an integrative physiotherapist. Floor-based strength exercises can counteract the de-conditioning of muscles that occurs when individuals go through prolonged periods without exercise.
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)
One study suggests that the average lifespan of an ME/CFS patient is only 55.9 years, which is over 20 years less than the average U.S. lifespan. And the vast majority of patients—75 to 85 percent—are women.
Rear-End Collisions: the Most Common Type of Accident
As their name suggests, rear-end collisions occur when one vehicle strikes the back of another vehicle, says the NHTSA. Many people wrongly assume that the back driver automatically holds the blame for these rear-end accidents.
There are actually three collisions in every crash: the vehicle collision; the human collision; and the internal collision (inside your body).
It is also important to do a thorough review of what vehicles have good safety ratings. Remember, when it comes to rear, front, and side impact collisions, car size and weight are important factors.
A diet rich in polyunsaturated and monounsaturated fats, avoiding saturated fats and refined carbohydrates—like the Mediterranean Diet—is reported by many people with ME/CFS to be helpful. Eat several small meals throughout the day.
Don't say: We all get tired
"They will say, 'Oh yeah we all get tired,' or, 'Come on it's just half an hour, you'll be fine,'" she says. "It's frustrating having to justify things the whole time and sometimes it can be quite upsetting. "It's not intended to hurt, it's just thoughtlessness."
The IQWiG concluded that graded exercise therapy (GET) and cognitive behavioral therapy (CBT) should be recommended in the treatment for mild and moderate ME/CFS based on two CBT and two GET studies.
There's no test for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS), but there are clear guidelines to help doctors diagnose the condition. A GP should ask you about your medical history and give you a physical examination.