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    Created in 2008, Phoenix Rising is the largest and oldest forum dedicated to furthering the understanding of and finding treatments for complex chronic illnesses such as chronic fatigue syndrome (ME/CFS), fibromyalgia (FM), long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases.

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Burn out.

Messages
29
Location
Montreal, Canada
Hi there.

My psychologist brought something up today. She asked me if instead of CFS I would only be a « burn-out » case. Looking up the burnout symptoms, they are quite the same as CFS. It got me pretty confused. How do you differentiate them ? How did you know at first that you were not Just burning out from work or just your life in general ?
 

Sushi

Moderation Resource Albuquerque
Messages
19,933
Location
Albuquerque
@warriorgirl PEM is one way to differentiate. Also most ME/CFS patients don't tolerate exercise--either not at all or only very gentle exercise. Cognitive problems are probably another difference. Many ME/CFS patients have abnormal brain scans and blood work--that is if they do the right tests!
 
Messages
29
Location
Montreal, Canada
@warriorgirl PEM is one way to differentiate. Also most ME/CFS patients don't tolerate exercise--either not at all or only very gentle exercise. Cognitive problems are probably another difference. Many ME/CFS patients have abnormal brain scans and blood work--that is if they do the right tests!

Are CFS patients normally able to exercice if they push through the fatigue ? (If they would force themselves)
 

Wishful

Senior Member
Messages
5,627
Location
Alberta
There are different subgroups of ME/CFS victims. My ME/CFS hasn't affected my physical limits. Muscle damage (such as from exercise) will trigger my PEM 24 hrs later. The baseline symptoms may make me not feel like going for a 6-hr bike ride, but the ME/CFS doesn't physically prevent me from doing it.

Other ME/CFS victims may lack the muscle strength and endurance to get out of bed. There is no one answer to your question.
 

Sushi

Moderation Resource Albuquerque
Messages
19,933
Location
Albuquerque
Are CFS patients normally able to exercice if they push through the fatigue ? (If they would force themselves)
It often isn't a case of pushing through fatigue, but pay-back a day or two later. You may not feel fatigue at the moment but you will pay for the exertion later. When you have been sick a long time you often learn to recognize the "stop-danger!" signals--meaning that you will be quite sick a day or two later. Whereas others can't even stand up--no matter how hard they try.
Other ME/CFS victims may lack the muscle strength and endurance to get out of bed. There is no one answer to your question.
Yep, there is a wide variation in severity.
 

Judee

Psalm 46:1-3
Messages
4,389
Location
Great Lakes
I think the 2-day cpet seems to indicate that that you will feel better on the second day of exercise if you are just deconditioned (feel tired maybe; but no PEM) but for ME/CFS patients, our performance (objective measurements they use with oxygen/co2 exchange) goes down in 95% of ME/CFS cases tested on day 2.

Edit: So I think exertion would be the deciding factor. Does exercise make you feel better--less stressed, etc. or worse?

The other thing psychologists like to say is we are just depressed :meh: but exercise makes people with depression feel better and more optimistic but not ME/CFS patients. We just get sicker. (I think there are studies about that as well.)
 
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Runner5

Senior Member
Messages
323
Location
PNW
Are CFS patients normally able to exercice if they push through the fatigue ? (If they would force themselves)
no, not at all and forcing might work a day, 2 days but day 3 they might have such muscle wasting and fatigue they might not be able to get out of bed i.e. they do not get better they get worse. The medical explanation, which is not set in stone, but which makes sense to myself, is that CFS patients are only able to exercise in an anaerobic mode (oxygen deprived mode - instead of burning oxygen they seem to burn amino acids, a very inefficient, slow and horrible way to fuel muscles). In order to exercise proficiently, gain muscle and to have endurance you need some aerobic activity in the muscle cells.

This is my understanding and like so much of CFS - it's not completely understood.
 

Dechi

Senior Member
Messages
1,454
Another distinguishing factor is the muscle weakness. To different degrees, but most people with ME will have that symptom. Using a muscle more than a few seconds, or minutes maybe, will be very hard. If I raise my arms in the air, after 15-20 seconds I probably feel like a normal person after 1 hour or more.

Dizziness also, and inability to stay upright for a long time (different variant of orthostatic intolerance). The shortness of breath. The dead brain. Having ME is really not about fatigue, If we were just tired, we would keep on going, I kept going with fatigue for ages, but I didn’t have ME then.
 

LINE

Senior Member
Messages
804
Location
USA
Burn out is usually related to poor adrenals (or adrenal fatigue). Adrenals work to keep things in balance, they are probably the most important regulators of metabolism. They are dependent on key nutrients to keep functioning. When you encounter stress then the adrenals are activated to maintain homeostasis, when stress becomes too chronic and prolonged then the adrenals can no longer react and become weakened.
 
Messages
34
For me, examining my thoughts played a big role. I've experienced periods of burnout in my life and they always involved feeling apathetic and uninterested in my schoolwork, hobbies, exercising, etc. as well as being pretty easily upset.

With CFS, however, I can think of lots of things I want to do other than lay in bed. I'd love to be able to get up and study and go to the gym.

While I do have mental bad days and can get irritable if my PEM is especially bad, the overall pattern of my thoughts is different than when I was burned out. This isn't the same for everyone, though, (like people who have more severe ME/CFS who, very understandably, may be more depressed about their illness), but this distinction helps me on the days when I wonder if my illness is all in my head
 

Shoshana

Northern USA
Messages
6,035
Location
Northern USA
Are CFS patients normally able to exercice if they push through the fatigue ? (If they would force themselves)


For myself, definitely not.
I tried many times, so I could know for certain.
And because I love to exercise. And to do countless other activities and jobs.

Some possibly could push through and exercise , but not usually at or near, a "normal expected" level,
for themselves or for someone else,
and not near their previous level, if they were more well in the past,
and not ongoing, not sustainable, and not on any regular schedule, that could be continued over time, and not without very substantial bad effects, that persist long past any normal rest time. Not without many definite, painful long-lasting symptoms. IN addition to fatigue.

IF, instead of being able to increase exercise or activity level, very gradually,
a person can do less and less of the exercise, and becomes more ill, and if it does more harm than good,
if it lowers a person's ability to do OTHER important more basic daily living tasks,
then seems more like CFS/ME.
If one has additional pains and symptoms, and cannot do desired, fun activities either, seems more like CFS/ME.

Burnout has more in common with depression than with CFS/ME, in my opinion. In CFS, most of us truly want to do the things we cannot do. They still have deep meaning for us. We are frustrated and still have interest and great desire to do them. Whereas, in depression or burnout (different but more overlapping it seems to me) one loses one's interest in activities one would normally want to do. And as was mentioned, exercise or a change of scene, even a vacation or lifestyle change, or a positive decision or action, or other counselling tools, often helps depression or burnout, but does not significantly or consistently or sustainably, effect CFS/ME.

DOing other activities and tasks could be extremely difficult challenges if one is burned out or depressed, yet there are good therapies available for those conditions, if there is any chance a person has those and NOT CFS/ME.

However, If the person cannot do fun, loved activities either, and if the harder they try, to ignore numerous symptoms, or to push through them, they become worse , overall, physically AND/or mentally, that would signal for me, the differences with CFS/ME.
If doing exercises, makes it harder to wash or to sit upright or to walk from bed to couch, or lowers one's ability to dress or to study or to think.

Also to distinguish ME/CFS , most of us (??) have many other painful and difficult symptoms in addition to the fatigue, which is way worse than any type of fatigue I ever felt from over-exercising or over-working. It is MANY symptoms of being very ill, not solely fatigued.

There are so many reasons that make my illness not anything resembling either burn out or simpler fatigue or even depression, though I can sometimes have any of those, in addition to the extreme illness.

Those other conditions, are real and serious, yet they have many wonderful treatments and options to try, changes in life decisions or therapies, that are available, that are very much worth trying, for anyone unsure if they have CFS.

If you have one of those other things, then those treatments could make you MUCH better.
If you have CFS/ME, they could help you with some of those other add-ons, IF you can manage to do them,
but the CFS/ME remains, is my experience.
If you must choose between showering and exercising, then showering is more important. Having to choose whether to chew and eat , OR to wash and brush teeth, OR to comb hair, while truly wanting to do all of them, is a sad hallmark of serious CFS/ME.

Systemic Exercise Intolerance is another name proposed for CFS/ME.
SO no, many of us cannot "push through" and at moments when we could, we would know, either very soon, or delayed, that it is causing our overall function to go down, not improve.

I have a huge love and passion for my past work and for many of my past activities, and if I could push through, to do any of them, I would.

If you are able to exercise, I suggest that you try it, in a gradual manner, and see what your results are, and i would suggest that you try some of the many wonderful treatments, lifestyle choices, and therapies, that could help you, that are available for any other conditions, but those do not help with CFS/ME, in my experience and knowledge.
Or they help with some aspect, but do not cure the illness. And often are not safe or doable or advantageous or possible, without a known treatment for the underlying CFS/ME.
 
Last edited:
Messages
29
Location
Montreal, Canada
For myself, definitely not.
I tried many times, so I could know for certain.
And because I love to exercise. And to do countless other activities and jobs.

Some possibly could push through and exercise , but not usually at or near, a "normal expected" level,
for themselves or for someone else,
and not near their previous level, if they were more well in the past,
and not ongoing, not sustainable, and not on any regular schedule, that could be continued over time, and not without very substantial bad effects, that persist long past any normal rest time. Not without many definite, painful long-lasting symptoms. IN addition to fatigue.

IF, instead of being able to increase exercise or activity level, very gradually,
a person can do less and less of the exercise, and becomes more ill, and if it does more harm than good,
if it lowers a person's ability to do OTHER important more basic daily living tasks,
then seems more like CFS/ME.
If one has additional pains and symptoms, and cannot do desired, fun activities either, seems more like CFS/ME.

Burnout has more in common with depression than with CFS/ME, in my opinion. In CFS, most of us truly want to do the things we cannot do. They still have deep meaning for us. We are frustrated and still have interest and great desire to do them. Whereas, in depression or burnout (different but more overlapping it seems to me) one loses one's interest in activities one would normally want to do. And as was mentioned, exercise or a change of scene, even a vacation or lifestyle change, or a positive decision or action, or other counselling tools, often helps depression or burnout, but does not significantly or consistently or sustainably, effect CFS/ME.

DOing other activities and tasks could be extremely difficult challenges if one is burned out or depressed, yet there are good therapies available for those conditions, if there is any chance a person has those and NOT CFS/ME.

However, If the person cannot do fun, loved activities either, and if the harder they try, to ignore numerous symptoms, or to push through them, they become worse , overall, physically AND/or mentally, that would signal for me, the differences with CFS/ME.
If doing exercises, makes it harder to wash or to sit upright or to walk from bed to couch, or lowers one's ability to dress or to study or to think.

Also to distinguish ME/CFS , most of us (??) have many other painful and difficult symptoms in addition to the fatigue, which is way worse than any type of fatigue I ever felt from over-exercising or over-working. It is MANY symptoms of being very ill, not solely fatigued.

There are so many reasons that make my illness not anything resembling either burn out or simpler fatigue or even depression, though I can sometimes have any of those, in addition to the extreme illness.

Those other conditions, are real and serious, yet they have many wonderful treatments and options to try, changes in life decisions or therapies, that are available, that are very much worth trying, for anyone unsure if they have CFS.

If you have one of those other things, then those treatments could make you MUCH better.
If you have CFS/ME, they could help you with some of those other add-ons, IF you can manage to do them,
but the CFS/ME remains, is my experience.
If you must choose between showering and exercising, then showering is more important. Having to choose whether to chew and eat , OR to wash and brush teeth, OR to comb hair, while truly wanting to do all of them, is a sad hallmark of serious CFS/ME.

Systemic Exercise Intolerance is another name proposed for CFS/ME.
SO no, many of us cannot "push through" and at moments when we could, we would know, either very soon, or delayed, that it is causing our overall function to go down, not improve.

I have a huge love and passion for my past work and for many of my past activities, and if I could push through, to do any of them, I would.

If you are able to exercise, I suggest that you try it, in a gradual manner, and see what your results are, and i would suggest that you try some of the many wonderful treatments, lifestyle choices, and therapies, that could help you, that are available for any other conditions, but those do not help with CFS/ME, in my experience and knowledge.
Or they help with some aspect, but do not cure the illness. And often are not safe or doable or advantageous or possible, without a known treatment for the underlying CFS/ME.

Thank you for this detailed reply. I was diagnosed with CFS not a long ago and I am still trying to figure everything out. Every professional I see has his own opinion. I feel like I am running everywhere in different directions :(
 

perrier

Senior Member
Messages
1,254
Thank you for this detailed reply. I was diagnosed with CFS not a long ago and I am still trying to figure everything out. Every professional I see has his own opinion. I feel like I am running everywhere in different directions :(
Whom did you see in Montreal?
 

valentinelynx

Senior Member
Messages
1,310
Location
Tucson
Hmm. Seems pretty simple to me.
If you are "burned out" from your work or lifestyle, then you would be sick of your work and lifestyle.
Most people with ME/CFS, however, will tell you that they are eager to get back to their work and life, if only they could!