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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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can one have anything to do with ME/CFS if one has only mental fatigue?

This ME/CFS seems to be a not very well defined thing, at least I can't find what exactly is within the scope and what not.

If someone has only mental fatigue, but not physical, can it have anything to do with the topics of this forum?

I find that especially two kinds of thins exhaust mentally much beyond "normal":

1) making decisions (even trivial ones, like which socks to wear or choosing the order in which to eat things from the fridge), but especially arbitrary decisions, so in fact some larger decisions can tire me much less if they have well defined reasons to analyze and progress one way or the other.

2) being with other people, especially in amounts larger then two

I find that after the above I need extensive amounts of time to regenerate by not making decisions (ANY decisions, even and especially super-trivial ones) and/or being alone. Only a small part of my day (like way less then 20%) can be occupied by decision making and interacting with more then one person, for me not to feel mentally exhausted.

Is this a problem within the scope of this forum at all?


Senior Member
If you look at this poll http://forums.phoenixrising.me/index.php?threads/what-are-your-pem-crash-triggers-poll.45031/

You can see that social events are just barely behind physical exercise for triggering fatigue.

I think people on this forum just want to understand fatigue in general so your problems would be within the scope of the forum. It isn't like we know the pathology of CFS yet, maybe some people get the same thing but express different symptoms depending on genetics or something like that.


Senior Member
This ME/CFS seems to be a not very well defined thing, at least I can't find what exactly is within the scope and what not.

ME/CFS is actually reasonably well defined, especially in the Canadian Consensus Criteria (CCC).

You might like to look at the CDC definition of ME/CFS, or the stricter CCC definition (see page 2), and see if your symptoms match those criteria.

Do you have any orthostatic intolerance symptoms, such as POTS or OH (which you can test for at home using the "poor man's tilt table test," and a blood pressure meter)? Those are characteristic of ME/CFS. Search for "POTS" in this document to see the testing technique.


Rebel without a biscuit
Hi @Omega Terus
Welcome to the forums.

I'll weigh in to say that I think what you are describing certainly could be the same as issues described in this forum. Problem is it's not limited to that. You may well be pursuing avenues of enquiry into the problem--if not I agree with @Never Give Up that your mental fatigue could also have some other reason and that is worth exploring to confirm or eliminate from consideration.

The experience you describe can be distressing and I don't have any easy answers. Given enough time we do learn to cope and solutions that work around the problem do arise sometimes on their own.
@Omega Terus, what you describe sounds quite similar to what you hear from people with depression. Contrary to what we imagine, people who've experienced depression say they don't necessarily feel that sad. Sometimes they just feel a bit numb, and they find that every small decision starts to seem onerous. They describe a kind of inertia weighing them down. A loss of drive, motivation. The things they used to like doing suddenly sound less appealing, or just all too much mental effort to even think about. They feel distant from people close to them. Social situations can start to feel overwhelming and onerous, and people often describe feeling very alone even in company. Does any of that fit with what you're experiencing?

CFS is different from that, because we - at least most of us - retain our drive and desire to do things, and have lots of thoughts about what we'd like to do (including what we'd like to wear and eat!). But often we physically can't manage to do them.

It might not be that, but its definitely a possibility worth considering. Especially since there's no effective treatment for CFS, but there might some good options if you actually have depression.
PS The other things that spring to mind are social anxiety (or anxiety in general, that would fit with the particularly crippling small decisions). Anxiety and depression can often occur together. Or mild autism spectrum disorder (ASD)? People with mild ASD find social situations especially taxing and exhausting, and also often have trouble making decisions. But if you had mild ASD, you would probably have had these problems for years. It sounds like your problems might have recently got a lot worse?


Some questions to ask yourself: Do you start off feeling ok in the situation and then notice your exhaustion setting in as you push to continue, or do you feel you have to push yourself to be motivated to do things? Also would you describe the exhaustion as feeling like sickness and pain, or more in terms of thoughts like "I don't want to do this anymore, I want to be at home".

I had social anxiety when I was a teenager and got very overwhelmed and depressed in social situations, but it felt quite different from the mental exhaustion I get with ME/CFS. Now I am careful about what social situations I engage in and so enjoy them on the rather rare occasions I can manage them, though I generally feel ill while I am out and have to shorten my social outings or cancel them. Also when I was healthy I had inexhaustible energy for things that I loved like studying whereas now I become ill even while I am in the middle of working on something intriguing and inspiring.

I guess a distinction is that with ME/CFS we can be exhausted and ill in situations that we are actively enjoying, and any negative emotion is a follow on from feeling ill. With depression or a social anxiety issue there would I think be a sense of not really enjoying social activity much or feeling primarily negative emotions from it.

With the decision making it might be valuable to observe what your mind does when you try to make a decision. Does it feels very slow and sort of dulled and try to shut down, becoming painful if you persist in the decision task, or does your mind become agitated, unfocused, upset overwhelmed. Contrasted with ASD and ADHD, ME creates a feeling of torpor or also a wired but tired effect, rather than an agitated or nervous feeling.

I don't want to put words in your mouth or tell you it sounds more like you have one thing or another. You might want to search the forum for threads on mental exhaustion and read other peoples' descriptions. I think most of us have some level of difficulty with physical activity as well as mental activity but I would not want to say that is universal.

Some people have no mental fatigue but profound physical weakness, other have both but in greatly varying proportions. Since we don't really know what is happening at a cellular level with ME/CFS we can't close off the possibility that some people are affected in only brain(mental fatigue with a physical basis) or only in body.

Anyway this is all just to give you some ideas of how to situate yourself. The other suggestions about neurological testing etc are important to look into too.


Senior Member
North Carolina
I am almost entirely affected by mental fatigue. I don't have problems with decision making but do get extremely tired with social...shopping...talking....even interacting with my 2 yr old granddaughter. It makes me feel very overstimulated and then the fatigue will set in. Sometimes I just get it from simply being on the computer too long.

I am much better with only one or two people socially and not a large group as all the talking is overwhelming.

I do not have depression as I still love to do whatever I can manage in a day. I also can engage in physical activity within certain limits. I believe I have minor anxiety but that all stems from the fact that ai can't do all I want or will have to cancel plans.

I 100 percent feel I have CFS as my fatigue is not relieved with rest...I experience PEM ...and have been tested for everything under the sun...I can relate to many of these posts so I know what it feels like....