The confusion of M.E and Chronic Fatigue is now widespread speaking on my experience of 10 years+. The origins of which can be traced back to the 1980’s and the liberal use of Chronic Fatigue with M.E as if they were one and the same thing by psychologists. For a variety of clear reasons, this is extremely misleading to say the very least.

First, many people day-to-day experience ‘fatigue’. Indeed, such is the relentless pace of the ‘modern world’ that ‘fatigue’ is common place. Nevertheless, the type of ‘fatigue’ experienced by most otherwise healthy people, is not the same at all as having M.E. On the contrary, the common place experience of ‘fatigue’ is often a normal and healthy response of  our physical body to indicate that its batteries have run down and it requires rest to recuperate. Often, a period of rest and/or sleep recharges our batteries and we feel ‘normal’ again and the ‘fatigue’ no longer presents. We’ve all ‘burnt the candle at both ends’ on occasions and know what it feels like to be ‘whacked out’ by too much partying or over-exercising etc. But this day-to-day experience of ‘fatigue’ is not the same as M.E in intensity, severity or prolonged duration; the like of which is not readdressed by any amount of rest or sleep.

Second, ‘Chronic fatigue’ (fatigue not relieved by rest/sleep and is persistent) often manifests as part of many illness complexes. Many cancer patients have ‘Chronic fatigue’ as do some people who develop heart disease, obesity, viral/bacterial/liver infections, MS, some neurological conditions and in the case of some severe physical injuries and accidents. This type of associated ‘Chronic fatigue’ is often only one of many symptoms of illnesses with a much broader symptom profile and underlying complexity, and is a natural response of our bodies to alert us to a defect in our physical environment that requires our attention and in order to recuperate, we should rest. Failure to do so, often worsens this type of ‘fatigue’ and makes underlying disease worse. The type, intensity and prolonged duration of this type of ‘Chronic Fatigue’ related to illness is clearly different to simply ‘feeling tired’ whereby sleep restores us to feeling ‘normal’. ‘Chronic Fatigue’ as part of an illness complex is often far more pronounced and severe in intensity and duration, to the point of debilitation; this is the type experienced in M.E. Some people with ‘fatigue’ as part of an illness complex, equally feel ‘down’ or ‘in low spirits’ in reaction to the fact they are ill, not necessarily because they have ‘a psychological problem’ and feel ‘fatigued’. This is true of many presenting with M.E because they are chronically physically-neurological ill and thereby have normal, reactive emotional responses, indicating their grief at what has happened to their lives; namely falling to pieces at every level.

Third, ‘Chronic fatigue’ can be related to psychological/emotional conditions not caused by underlying physical illness. This type of ‘fatigue’ has been rather grabbed hold of by psychologists as ‘their arena of speciality’, but without understanding the dynamics or physics of energy at any level. Moreover, they have confused this type of ‘fatigue’ with M.E as of they were one and the same thing, which they are not. People who experience depression or emotional trauma, often explain of ‘feeling down’ or ‘constantly tired/fatigued’ but without a specific physical reason for this. People who are experiencing severe grief through the loss of a loved one often report of being ‘Chronically fatigued’ as the grieving process unfolded, and as the stages of grief passed, so did their ‘fatigue’. Again, this is a normal/natural response of our body/mind complex to an external event acting upon us and affecting our energy level which then restores itself in time. These examples are not the same as having M.E day-to-day.

Finally, the very term ‘fatigue’ is distinctly misleading in M.E. People who develop M.E are not always ‘fatigued’. Rather, their internal systems no longer respond in a healthy manner to physical and mental demands placed upon them because they are dysfunctional and damaged. In particular, the brain and nervous system falter and like a computer after a virus, go haywire regarding their functional interrelationship with many other internal systems/organs. Moreover, the brain and nervous system no longer respond to exercise in an appropriate manner. Instead, exercise triggers extremely abnormal and damaging physical/neurological/immune responses in M.E that places a sufferer in exactly the same experience as if they were suffering a serious viral infection. This reaction is then stimulated/experienced for days/weeks after whereby the individual affected is unable to function any longer. Furthermore, the level and prolonged intensity of the pain/physical weakness/neurological dysfunction experienced by patients with M.E, is quite outside of ‘fatigue’ on a day-to-day basis or related to emotional/psychological conditions. Moreover, it is not refreshed by ANY amount of sleep or rest and increased by further exercise.

I know and have met many people who have ‘fatigue’ related to depression/psychological conditions, but they do not have any of the adverse physiological-neurological symptoms of M.E made worse by physical/mental activity. More importantly, many people with ‘fatigue’ related to depression and psychological conditions report exercise as beneficial; people who have M.E get rapidly and significantly worse because they are genuinely physically ill.

It’s clear from this brief discussion of ‘fatigue’ that it is a complex subject that encompasses many broad categories. Some related to genuine physical causes whilst others are of psychological origin (and sometimes together). The main difference being the underlying reason why ‘fatigue’ might be presenting in any individual. Clearly, it is intelligently observable that there is a distinct and clear difference between  an individual presenting with ‘fatigue’ as part of an underlying illness complex caused by physical/neurological causes and those related to emotional/psychological conditions. M.E presents as vastly different to simple ‘fatigue’ or ‘feeling tired’ and for very clear and definitive underlying physical-neurological reasons.

The lavish use of ‘Chronic fatigue/M.E’ by psychologists has been very harmful and entirely misleading. Moreover, WHO states that any disease entity cannot be classified under more than one rubic or title. The intelligent reader will make their own and obvious conclusions about this. That ‘Chronic fatigue’ and M.E are not one and the same at all. Rather, ‘Chronic fatigue’ is simply a small part of a broader profile of symptoms of many illnesses and M.E is a distinct physiological-neurological disorder that has, as part of its symptom profile related to physiological-neurological breakdown, a distinct inability to utilise, sustain and/or restore, an individuals energy level/system in a normal/healthy manner. Thereby resulting in the breakdown of the integrated function of the divine/mind/energy/matter complex of any affected individual presenting with M.E. The simple truth cannot be stated any more clearly.           

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‘The work of Dr Melvin Ramsay clearly defined M.E as a distinct neurological disorder induced by viral infection, significantly worsened by physical activity. It was only later in the 1980’s that ME and ‘fatigue’ was misguidedly confused which thereby encompassed a much less specific, and highly subjective, symptom profile and broader patient group. The dangers in confusing M.E with ‘fatigue’ was largely overlooked. The general public don’t seem to have been made fully aware of this.’  djl