I'm not familiar with the term 'irritable nerves'
Essentially a shorthand colloquialism for what I've been talking about in relation to what Rowe describes as: "
irritable peripheral tissues" subject to: "
movement restrictions" and "
neural provocation" associated with "
biomechanical and behavioural factors", and hence "
neuromuscular strain"
Nothing worked until I cut out gluten, reduced carbs, etc
I did the same during the autumn last year so I suppose that could also have been a factor with me
if I hoover the house I will get the adverse effects of exertion
Does PEM include a sinus issue for you then?
So I am asking: if you think that anxiety is an important factor in (causing? perpetuating?) ME/CFS, would you expect a reduction in anxiety to be followed by remission of physical symptoms?
I'm no clinician but, on a theoretical level, partial remission perhaps, yes, but there are many potential sources of temporal summation, or ‘wind-up’, including cognitive/emotional yes, but not limited to those, nor limited to anxiety within that group
Furthermore, because such forebrain products appear both psychophysiological and, to an extent, psychosocial, products
of the illness, as well as psychopathological contributors
to it (via descending pain facilitation, and other adverse mechanisms related to 'stress' and central sensitisation), it is difficult to disambiguate contributory cause and effect. If anxiety or depression are reduced that may only mean that one part of the symptomatological picture is improved, whilst core processes remain active, albeit probably at a lower level
I'm not sure about prevalence rates for anxiety but I understand that:
"..the Val(158)Met [COMT gene]
polymorphism is associated with obsessive-compulsive disorder in men and with anxiety phenotypes in women.(Harrison & Tunbridge, 2008)"
I do not suffer with anxiety and nor do many of the (admittedly relatively few) men I have met who have ME/CFS but I do have compulsive traits, and I have met quite a few female members of the community who do suffer with anxiety. In one
study 88% of those ME/CFS patients who had 'depressive symptoms' were female, but only 35% of those who did not were female
This narrow/anecdotal picture is, to me, suggestive that anxiety and depression are relatively highly correlated with illness in female patients owing to things like sexually dimorphic effects (associated with distinct hormone interactions) and distinct brain structure (enhanced limbic systems etc) and that an improvement in those features of the disease could be expected to be associated with a more general remission I suppose - rather loose to say the least but there you go!
Again, I was referring to preceding text, in this case your quotes of a study referring to
Oh right, it says: "
enhanced potential for" e.g. puts patients at a higher risk of developing such co-morbid disorders
People with ME/CFS appear to be generally extremely highly-motivated, indeed remarkably so in light of their problems
Indeed, and my sense is that psychological issues are in many cases a 'psychophysiological and, to an extent, psychosocial, product
of the illness'