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Should Physical exertion and Mental exertion be separated for PEM?

Discussion in 'Post-Exertional Malaise, Fatigue, and Crashes' started by Firestormm, Aug 19, 2012.


Should Physical exertion and Mental exertion be separated for PEM?

  1. Yes, physical/mental PEM should be separately studied and given new names

  2. No, both physical and mental PEM should studied together

  3. We should leave things alone - no further clarification is needed

  1. soxfan

    soxfan Senior Member

    North Carolina
    peggy-sue....I think he was making a comment about your post responding to me about how if I don't have problems with physical activity then I probably don't have CFS. I guess I really didn't explain my situation clearly enough either. I really didn't mean that I can do everything physically that I could before illness. I use to be a longer. I use to be able to shop after more. I use to be able to go all day until I have to rest everyday for at least 2 hours. Just like other symptoms that go along with this illness...some have and some don't.
    I meant that I don't have alot of the physical limitations that many others have. I have many more mental limitations in such a way that it is truly disabling.

    We are all trying to find solutions to be able to live our lives to the fullest in spite of our physical/mental limitations.
    taniaaust1, L'engle and justy like this.
  2. peggy-sue


    "We are all trying to find solutions to be able to live our lives to the fullest in spite of our physical/mental limitations"
    We are indeed, soxfan!
    I get up and dressed every day. Then I need an hour to recover. But I can potter around the house, do wee bits of housework - some laundry or wash the pots and pans, run the dishwasher, or do a bit of baking. Not every day, though! Maintenance stuff; no "spring cleaning" or dusting or tidying and nothing that involves the stairs. I can get to the local high street shops a couple of times a week.
    I am physically very limited, but I'm far fitter physically than mentally. I struggle to read anything more advanced than teen fantasy novels or rubbishy magazines. (I was reading unabridged Charlotte Bronte when I was 7 - I couldn't read it now.)
    I can't do mental arithmetic, I have to ask my partner to explain what's going on in CSI when we're watching tv, because I get lost.
    merylg and L'engle like this.
  3. soxfan

    soxfan Senior Member

    North Carolina
    I feel lucky to be able to do much more physically than most with CFS. I get burned out mentally pretty quickly...I am able to physically shop but looking at all the items is what bothers my makes me feel very drained.

    We just took a trip down to NC and I was sitting in a car for 12-13 hours and just looking at the landscape and having conversations with people in the car wore me out terribly.
    So having such mental limitations is not great either...I have huge sleep problems as well. I would say those are my two worse issues.
    taniaaust1 and L'engle like this.
  4. Arise


    This sounds a lot like myself, I seem to be affected more on a mental level (i.e. poor mental stamina, brain fog, etc). mental exertion certainly causes an exacerbation of cognitive symptoms and slightly with physical symptoms. physical exertion doesn't seem to cause PEM as easily.

    Driving a car is one activity that can cause PEM for me, particulary in traffic where more mental effort is required. Social gatherings can shatter me also.

    With regards to physical activity I can probably work part time (long term) and maybe even more short term, but I am certainly not normal in terms of physical activity.
    soxfan and L'engle like this.
  5. soxfan

    soxfan Senior Member

    North Carolina
    I have problems with driving because of the intense concentration it takes. I can no longer drive any distances..luckily my job is only 9 miles from my house. I am usually very tired driving home after my shift. I will say that severe mental PEM does cause me physical exhaustion. I have to lay in a quiet room for at least an hour in order to function somewhat again

    Even talking on the phone for any length of time is also exhausting for me...I am definitely not normal in terms of physical activity either.
  6. Little Bluestem

    Little Bluestem All Good Things Must Come to an End

    I may change my mind and say that they should be studied separately. In reviewing my notes on B vitamins, I found that heapsreal had previously posted:
    If a person has PEM only after mental exertion, she might have asthenia rather than ME, so a trial of sulbutiamine (which is a synthetic derivative of thiamin [B1]) might be worthwhile. I don't know if ashenia produces PEM or is a more uniform level of cognitive fatigue. I guess that would be the first thing to find out.
  7. I prefer Post Exertional Nero Immune Exhaustion (PENE) to PEM not because it's a bit more catchy but because the name suggests the complexity of the reaction.

    I am physically affected more than mentally. Although during the early stages of the illness I found PENE affecting me both physically and mentally equally. Its difficult (ongoing detective work) to find out what is causing the most adverse symptoms on a daily basis. I have rounded it down to four usual suspects.

    1. Over Activity (sometimes under)
    2. Poor Immune Response
    3. Digestive Problems
    4. Life stresses
    This would be my first port of call regarding research. What is the main cause of PENE at any given time. I now group all four in a chronic inflammation category. This way I can address each issue daily. Only increasing activity very very slowly (as you will all know).
  8. Enid

    Enid Senior Member

    All as draining if overdone.
  9. Kinesis


    So far I haven't quite nailed it all down. Before a couple of months ago all I knew is that sometimes I'd randomly crash and everything would be worse for a while.

    Most recently I had a very stressful event happen and it hit me the next afternoon, mostly physically. I had to crawl to the bathroom and standing made me dizzy. It lasted four days then back to baseline.

    So I don't know which type of stimulus hits harder yet. Mostly it just seems like excessive stress of any kind lays me out across the board.
    L'engle likes this.
  10. L'engle

    L'engle moogle

    I think they should be studied together as phenomena with related causes but also separately because of their hugely different effects on life. The mental exhaustion that comes from ME is a physical symptom, not a psychological one. I think this confuses people a lot as it is assumed that anything affecting the brain must be psychological in nature.

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