Choline on the Brain? A Guide to Choline in Chronic Fatigue Syndrome
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Mental Exertion Only CFS?

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by Hip, Apr 5, 2011.

  1. L'engle

    L'engle moogle

    I am recovering some physical abilities but recovering cognitive energy is very slow for me. I get less PEM from a light or moderate physical activity than from even a small amount of mental effort. When brain fog lets up, I've been able to do some quite computationally intense work, but when it is in effect, even navigating to the files I work on gives me a headache and causes my eyes to blur out. I enjoy my work, so it isn't boredom or lack of motivation. I would love to be continually learning and expanding my mind.

    I think lowering of consciousness or awareness is a good description. I used to meditate with exercise and have fairly intense experiences. Now my mind often has pleasant experiences at rest but feels rather dulled. Keeping the thread of creative tasks is also quite challenging, similar to technical tasks. I can really see that mental activities use a huge amount of resources.

    Orthostatic intolerance and physical symptoms are still very much there for me, but I think the PEM from cognitive effort and the lowering of awareness are most severe. Also the descriptions here of mental PEM are good. A nearly headache and physical weakness, that becomes a very painful headache extending into the body. Mental PEM really hurts!!!
  2. Hip

    Hip Senior Member

    Brains's reward system is not working

    I wonder if it is lack of endorphins that is responsible for losing the feel-good feeling after exercise; and/or some other metabolic dysfunction? I know that the famous "runner's high" is due to endorphins.

    However, I find my entire mental "reward system" is not working now I have CFS. And not just for exercise.

    For example, I used be quite a tidy person, and would get a sense of satisfaction after I cleaned or organized my desk, my cupboards, my papers and documents, and so forth. Even cleaning the bathroom. And I would get a sense of satisfaction from say buying new useful item, like some new gadget, or new item of clothing, etc.

    Now I find that I get very little sense of satisfaction on completion of tasks; and very little satisfaction from buying things (which is great in one way, as I save lots of money!).

    I will do the tidying and organizational tasks anyway if they become absolutely essential, but I get little or no pleasure from their completion.

    So the impression I get is that there is something amiss with the "reward circuitry" in the brain.

    It seems that the areas / neurochemicals of the brain connected to reward are dysfunctional in CFS.


    I read that phenylalanine protects naturally-produced endorphins, extending their life span. Since phenylalanine (and tryptophan) are often low in CFS, I wonder if this is the reason we don't get endorphin highs?

    Dopamine is a another major neurochemical in the reward system, and phenylalanine is also a precursor of dopamine.

    It might be worth supplementing with phenylalanine, as an experiment to see if the sense of satisfaction returns a bit. Phenylalanine is not advised for those at risk for skin cancer, though.

    Tryptophan is a precursor to serotonin, which is another reward circuit neurochemical, I believe. However, tryptophan (and 5-HTP) should probably be avoided, as there is a slight risk in taking them (they can precipitate Eosinophiliamyalgia syndrome, if they are poorly manufactured).
  3. biophile

    biophile Places I'd rather be.

    Re: Brains's reward system is not working

    Hip, what you said about the reward system not working properly could be misconstrued as the anhedonia of depression, but I think I understand what you're trying to say because I have had somewhat similar experiences with CFS minus depression. I also went through a phase of probable secondary depression, and it seemed different than what I am about to describe.

    It feels like there is either not enough energy to squeeze out a fully normal energetic pleasure response due to exhaustion, or in other situations pleasurable sensations are somewhat masked or spoilt by strong flu-like sensations just like how a regular flu can ruin the normally pleasurable sensations of massage or music or whatever. I don't have a reduction of interest outside what would be expected ie because I can't walk that far anymore without intolerable symptoms I am no longer enthusiastic about the idea of hiking and would avoid it like the plague, it doesn't mean I'm "depressed" for "loss of interest", it means I am realistic, but I would love to do it if capacity allowed it.

    Although I dislike how some psychology/psychiatry material seems to view "pleasure" and "motivation/interest" as basically synonymous, they are related so consider this: If activities which bring greater pleasure and motivations which bring greater activity, also bring greater post-exertional symptoms, the brain/body may try to protect itself from over exertion by downregulating those systems. Some of the "behavioural" effects of ME/CFS are like hibernation or conservation, the brain/body is trying to protect itself from excessive demands on resources, worsening symptoms, and ignorant "all you need is X" armchair experts.

    Also consider the neurobiological effects of chronic sleep dysfunction, chronic pain, chronic sympathetic nervous system dominance, chronic immune activation, etc, for years on end without a break to recover from these demands. Another possibility is problems with biochemical synthesis, for example, when looking at a diagram on the methylation cycle(s) I noticed that it is involved in the conversion of tryptophan to serotonin and tyrosine to dopamine. But I would be surprised if supplementation of those amino acids made much difference in the long-term, the problem seems deeper than that. I would however be interested in knowing if anyone with CFS has ever taken L-DOPA and what their experience was.
  4. ukxmrv

    ukxmrv Senior Member

    I don't get any sort of "runners high" after exercise. However, if on a miracle day I do manage to tidy something I've wanted to do for a long time then I do feel the same sense of achievement that I did before. The trick for me is stopping before the overwhelming pain and exhaustion sets in straight away.

    If the pain and exhaustion are more powerful than the high of the achievement then they can cancel it out altogether. It takes energy for me to feel the glow of the achievement and if another factor occurs it can wipe it out.

    Imagine for example that one had chronic vomiting (like the winter vomiting bug) or another serious and powerful physical effect. It's hard to bask in the glow of achievement when repeatedly vomiting. One outweighs the other. The PEM after a task is so severe for me that is what it feels like.

    Just a personal note as we are all different. Hope this helps someone.

    p.s. Hip have you considered that simply being able to buy something or clean something is no longer enough to give you that boost now that you can do little else (maybe having an incurable, serious disease has brought home to you how pointless or worthless they really are in comparism to having ME?)

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