I'm very curious to know because I feel like I'm on an island of my own here. Here's why; if I overexert it takes about 3-4 days for the "malaise" to start, but once it does, the effects are permenant. I have never once recovered even 1% from the changes in my brain after a period of PEM. Fatigue is not a big issue for me. It's massive, massive dissociation, memory loss, complete emptiness and silence in my brain and complete apathy and anhedonia don't even touch describing how little I can feel. There's just soooo much missing in my brain and experience of the world. I can't even describe how much is missing If I overexert the effects always happen while I'm sleeping. I will get woken up with a feeling of being "revved up"; intense nerve and muscle weakness and burning, sweating, intense cold, joint pain, pounding heart, pupils dilated as hell and the coup de gras- my brain will pull back further. As in, I will feel more emptiness and hollowness and dissociation. After a whole night of this usually the physical symptoms will calm down a bit and then mostly wear off in about a week, but I'm always left with some deficit. My brain, however, will not recover..... at all. I've been sick with this for 8 months now and it's like I have an entirely new disease from what I started with because of the effects of PEM on my brain. In 8 months I haven't recovered even 1% brain function from any setback I've had thus far. Honestly? If I could actually feel the real world I would probably be going into insanity at how bad I am but somehow I'm holding it together. I'm curious, has anyone who has had setbacks from overexertion spiral downward and have the effects be seemingly permenant?