I think many of us with this disease have contemplated suicide and I think that contemplation is justified given the loss of our functional lives. Sadly, there are many cases where contemplation leads to the final act itself. All of us can understand it. Having been bed bound, house bound and now moving forward again after more than 6 years of ME/CFS, I am back from a day's work at the lab (the only day I will work this week) courtesy of 100mg of Modafinil which I take once a week. The motivation to post was sparked by whispers on the BBC in an interview with a member of staff from London School of Hygiene and Tropical Medicine who organise the ME biobank. There was the usual nod to immune studies and ATP production dysfunction but what caught my attention was a brief mention of post mortem brain pathology indicating inflammation in the basal ganglia. How does this tie in with Modafinil use? For several years I have suspected neuroinflammatory processes to be involved in this disease, my suspicions based on symptoms of ME/CFS. The original Osaka study suggested that this might be the case and we are all waiting with anticipation for the results of their second study. If you are not familiar with brain anatomy it would be worthwhile checking out the simplified diagrams I posted last year in the neurological forum here http://forums.phoenixrising.me/inde...vidence-of-cognitive-dysfunction-in-me.53421/ How can Modafinil open the window for very ill ME patients? 1-increases hypothalamic histamine levels effectively helping to wake us up. 2 targets the activation of orexin neurons in the hypothalamus and so increases dopamine levels so we feel better. 3-increases norepinephrine levels in the hypothalamus so we feel more active. 4- arouses brain function by upgrading signal efficiency so we can think through the normal fog. 5-boosts serotonin in the amygdala so our mood brightens. There is a lot of information on the drug but self-hacked is a reasonable source with references https://www.selfhacked.com/blog/how-to-get-the-benefits-of-modafinil-without-taking-it/ It is worth keeping in mind that this drug is a replacement for amphetamine sulphate in many military outfits and Modafinil should be used with caution and should not be used regularly. I relate my personal experience of using the drug. My first usage was whilst still housebound and I was overjoyed to walk 50 metres down the road. It is now 4 years or more since that time and Modafinil remains in my armoury of supplements. I guess my point is this: if a person is in a depressed state in which he or she has forgotten how it feels to be 'normal' then Modafinil can give access for 8 hours to a window on normality. That window is enormously encouraging to a psychology riven by ME. For me, it spurred me on to not give in to the disease and to fight on. Now, it enables me to work a full day. I have maintained a pragmatic attitude towards trying to get better. I am certain that the drug is not suitable for everybody and I do not endorse its use but I am happy to relate my own experience.