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Crashing after joyful get-togethers with family and friends

Messages
1,082
Location
UK
I've just thought of an example of the whole switching off thing.
A few years ago i was in a loud pub with someone. I was running on raw adrenaline just to be able to hold a conversation in loud music. I was outwardly managing but descretely dying inside.

Someone came along and sat down on the other side of the person i was with and they started chatting leaving me to stare at the table as i couldn't hear. (Cue end of night for me) It was probably only for 10 mins or so but every minute they were chatting i was switching off and sinking deeper into the crash.

By the time the person i was with turned and asked if i was okay. I'd deflated and tranced out so much i had to leave, there is no re-engaging. I can't upscale; back up to chatting and engaging again because ive sank too many levels below to climb back up again.

The person i was with then thought i was peed off because they were chatting to someone else. I'm secretly upset because it does look like i'm being that petty from an outside perspective but too ill to explain why i've crashed.

Had the convo kept going i may have been out for another hour riding on adrenaline but once the cut off/rest break was inserted; that created an instant end to the night for me while leaving me feeling bad too because of what the person i was with thought i was reacting to :(
 

Keela Too

Sally Burch
Messages
900
Location
N.Ireland
It is interesting to hear different perspectives. My own is a bit different.

Like you @Hell...Hath...No...Fury.. I find the buzz of a social situation more difficult to handle, and I've no doubt that adrenalin plays a part in how I cope, but, unlike you, I've found I need to avoid that type of coping as much as possible.

Short breaks where I listen rather than converse help me to conserve some energy so I can stay a bit longer.

However I find I must never let myself get even close to the point where I am starting to crash out of it.... because the after effects of doing anything on adrenalin are too severe - and in my experience can be effectively permanent.

I think I mentioned up thread about my night out last Sat, well even though I felt good all evening, I've been struggling since. It's given me a bit of a fright to be honest, because I thought I could cope easily with the situation.

It's always a difficult balance. This is me trying to work it all out:
http://sallyjustme.blogspot.co.uk/2014/09/play-up-and-lay-up.html
http://sallyjustme.blogspot.co.uk/2014/09/pacing-and-unpredictable-events.html
 
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soxfan

Senior Member
Messages
995
Location
North Carolina
It doesn't matter whether the social situation I am in is relaxed or stressful....I still get severe mental exhaustion after anything like this. It can be a family gathering...social event...quiet dinner with friends...shopping etc. My body can't distinguish the difference.

I have also been know to start crashing during any of these situations. I just start getting extremely fatigued along with blurry vision/burning eye pain. I also have nerve pain and muscle twitching in my calves and this will also increase as my body starts to feel more and more fatigue.

Anything that has to do with mental exertion is one of the worse problems for me. I also seem to get extremely overstimulation afterwards and the stimulation won't turn off so when I go to bed that night I feel as though adrenaline is pumping through me. It is one of the most horrible symptoms I deal with. Nothing makes it top except falling asleep and then the next morning I feel like I have been hit by a truck.....

This was not a problem I had early on in my illness but over the years has become one of my worse...
 

soxfan

Senior Member
Messages
995
Location
North Carolina
@Hip- I just read through this entire thread and I found your post really interesting....it describes me perfectly and I do believe that is exactly what happens to me mentally in these situations. sometimes I do feel myself getting over excited/over stimulated and become kind of breathless while talking.
It is like I can't keep my body on an even keel when with a group of people but do much better with only a few people. I will still mostly likely crash and suffer afterwards but not as badly.

Also when with a group of people and everyone is talking it just begins to sound like a very loud mass of jumble. Even if I am only talking to one person it seems as though my brain is picking up every sound in the room and my brain just goes haywire.

Does anyone have the continuous adrenaline or cortisol rushing after mental exertion? It is probably the worse feeling symptom for me and nothing will calm it...I have tried Ativan in the past but have to take about 2mg if I really want to stop it and I don't want to do that. Then of course after a night of this surging through my body I wake up totally exhausted.

Just about any mental exertion for a period of time will bring this on for me so I am trying to learn when I feel it coming on its time to quit whether it is shopping...socializing...or just talking on the phone. Sometimes by then though it is already too late and I am in for 24 hours of misery....
 

Hip

Senior Member
Messages
17,824
Also when with a group of people and everyone is talking it just begins to sound like a very loud mass of jumble.

I think that aspect involves the sound sensitivity that ME/CFS patients often have. Sound sensitivity is where you cannot filter out non-relevant background sounds, so all the sounds hit you, and it becomes confusing and overloading.

The ME/CFS sound sensitivity really is a problem with the sensory information filter of the brain, that when working normally, filters out the unnecessary background sounds and properly focuses on the relevant sounds we want to listen to.

I find that on days when your sound sensitivity is bad, it is very unpleasant and very exhausting to try to listen to a group of people talking. It's painful for the mind.


One of the best things I found to treat sound sensitivity is very low dose amisulpride. Amisulpride is an anti-psychotic drug, which some people have concerns about because of potential serious side effects (such as the development of diabetes). However, I use just 12.5 mg daily, which is 1/100 th of the full dose used for schizophrenia, so I should think this very low dose will minimize any risk of side effects. I have been taking this daily for a couple of years now, and it's a great drug.

Amisulpride activates the dopamine D2 receptors, and I have read that the D2 receptor may be involved in the brain's filter for unnecessary information. So by activating the D2 receptor, you may boost the functioning of that filter, and so better filter out all those unnecessary background sounds that are so tiring and overloading on the brain.

Potentially other drugs that activate the dopamine D2 receptor should also work for treating the ME/CFS sound sensitivity issue. Amantadine is one such drug that activates the D2 receptor. Bromocriptine is another. Though I have not tested these drugs, so I cannot comment on them. The only drug I know works for sure for my sound sensitivity is amisulpride.


I find that once you have your sound sensitivity under control, you can much better face all the noise of social situations.
 
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liverock

Senior Member
Messages
748
Location
UK
I think that aspect involves the sound sensitivity that ME/CFS patients often have. Sound sensitivity is where you cannot filter out non-relevant background sounds, so all the sounds hit you, and it become confusing and overloading.

The ME/CFS sound sensitivity really is a problem with the sensory information filter of the brain, that when working normally, filters out the unnecessary background sounds and properly focuses on the relevant sounds we want to listen to.

I find that on days when your sound sensitivity is bad, it is very unpleasant and very exhausting to try to listen to a group of people talking. It's painful for the mind.

I have this problem and it can be embarrasing in conversation to keep having to move very close to the speaker to hear when the background noise drowns out what they are saying.

I found GABA to be helpful, when remembering to take 500mg before going out :)
and it also slows down the nervous system.

http://link.springer.com/article/10.1007/BF00242016#page-1

.
 
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Hip

Senior Member
Messages
17,824
@liverock

I do a similar thing: to help prevent brain over-stimulation, you can either activate the GABA receptors, or block the NMDA receptors. Both serve to relax neurons, and thus reduce brain over-stimulation.

NMDA receptors excite neurons, which you don't want, so you need to block these receptors to reduce brain over-stimulation. The GABA receptors relax neurons, which you do want, so you need to activate these receptors.

For this purpose, what I do before I go out socially is take:

Progesterone cream 0.6 grams — blocks NMDA receptors
Taurine 4 grams — blocks NMDA receptors and activates GABA receptors

This makes the brain more relaxed.


GABA, a supplement which activates the GABA receptors, will only work or people who have a leaky blood-brain barrier (BBB), because normally GABA does not cross the BBB. Certainly myself I find no effects from even high dose GABA.

Though taurine, in doses of 2 to 4 grams, works well, because this can cross the BBB, and it activates the GABA receptors, and blocks NMDA receptors.
 
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Hip

Senior Member
Messages
17,824
@Hip I was very interested to read your linked Wiki article re Arousal and the associations to introversion/extroversion. Described me. https://en.wikipedia.org/wiki/Arousal

Yeah, extroverts require more stimulation before their brains become aroused, so it might be that extrovert ME/CFS patients better handle social situations, because they get less arousal from stimulation.

Introverts are more quickly aroused by stimulation, and can get over-aroused in hectic social situations, and so often prefer quiet libraries to wild parties.
 

Lolinda

J'aime nager dans le froid style Wim Hof.. 🏊‍♀️🙃
Messages
420
Location
Geneva, Switzerland
Great thread! Special thanks to @PallasKat for verbalising what bugs so many of us, and to @Hip for offering solutions!

What I am looking for:
  • In me, this issue is much stronger when I am more sickish. Anyone any mechanisms how this can be?
  • I have a probably special issue, which however might be helpful to infer mechanisms for all of us: Surprisingly, I get the same "speediness" or "overdrivenness" when I eat animal protein. I try to understand the mechanism. So far I have found that ma 24h urinary 5hiaa goes down to zero on 400g of animal protein and is fully normal low protein. Mediium protein leads to somewhat below normal 5hiaa. My 24h urinary serotonin stays normal. And all other tryptophan metabolites such as kynurenine and quinolinic acid are normal. ==> Conclusion: the only metabolic pathway that could be faulty is the decomposition of serotonin to 5hiaa gets blocked. Now, this is done by MAO and by aldehyde dehydrogenase. If I am not wrong, this is what disposes also of other neurotransmitters such as dopamine and noradrenaline! If so, then we have it: blockage of MAO and/or aldehyde dehydrogenase causes the hyperactivation. Maybe both the protein-induced and the socially induced one, too. What do you think?
  • When we add up the sickishness-induced susceptibility to this hyperactivation and the animal protein induced one, it could add up to this: I do have autoimmune issues (see signature). Animal proteins could activate that. Sickishness could be that, anywise. -> immüne activation. ==> Now, for all of us: Certain types of immune activity (probably different in everyone) may lead to blockage of neurotransmitter disposal, thus overflooding our poor brains with neurotransmitters. Adding to that, mental activation in social situations leads to increased neuronal noradrenaline production. -> In sum, sympathetic overactivation. Please criticise!
 
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Lolinda

J'aime nager dans le froid style Wim Hof.. 🏊‍♀️🙃
Messages
420
Location
Geneva, Switzerland
What I have:

Happily, for me the issue is diminished. I need currently 2h to recover from socialising. No crash whatsoever. Earlier I had crashes and needed one or several days for recovery. And I feel what @Hell...Hath...No...Fury.. mentions that too much self-constraining removes all the fun. I wanted to seek real solutions that keep the fun, avoid crashes and increase health. My methods that brought me this, in order of time of discovery, seem to be about the parasympathic nervous system:

  • First, I addressed it as a mental-body issue: Before the situation, strengthen my connection to my body. It only works before the situation, not in the situation. Or, at least, it is very difficult to get it right in the situation but there were occassions when I succeeded. Just anything what strengthens connection to my body helps. For example stretching, or feeling into my body, or self-acupressure. With some practice, it is as little as a few seconds of feeling into my body before the event. Then go to the toilet to re-inforce before I lose connection to my body.
  • Transdermal glycine. Is an interesting neurotransmitter: calming for the CNS and activating for the ENS (enteric nervous system). Good for people who are too fast in the mind and slow in the guts.
  • Transdermal choline. Powers the parasympathic nervous system (PNS). Did you know this: not only that dietary choline turns into the neurotransmitter acetylcholine, but actually, acetylcholine is the sole neurotransmitter of the whole PNS! And many people are low on choline in their diet (check for yourself on cronometer.com) and the Naviaux study showed low choline metabolites in CFS. --> Get more choline. All my failures and the finally successful version: here. A quick summary here.
  • Transdermal alpha lipoic acid (Transdermal because I have SIBO and dont want to feed my bad bugs :) ). I am currently learning how to use it well. So on the positive side, at 1x200mg/day, it gives me a wonderful "heavenly peace" and energy at the same time. Could it be better? But at 2x200mg/day I get sleep issues. I guess because it lowers blood sugar and then cortisol goes up, also at night. And on 200mg/day since weeks, just today, I realised that I have more and more issues such as polyuria, urinary tract infection, pimples. ALA is immunosuppressive. Anyone experiences? I am very interested in bad experiences, too.
 
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hapl808

Senior Member
Messages
2,052
Just bumping this as lately my mental crashes have gotten much worse. A fun, long phone conversation can leave me bedridden for 2-3 days. It's hard to regulate as I can't point to exactly how long I can handle, and I don't feel bad at all while I'm on the phone - even the next morning I feel fine. But usually in the afternoon or evening the PEM starts coming - exhaustion, nausea, headache, blurred vision, burning eyes, etc.

I have tried Q10, BCAA, ribose, creatine, skullcap, etc. I have have regular oral glycine and choline (lecithin) that I haven't particularly focused on.

I'm curious if anyone in this thread has refined their protocols for avoiding or recovering from mental exertion PEM.
 

Wishful

Senior Member
Messages
5,679
Location
Alberta
In me, this issue is much stronger when I am more sickish. Anyone any mechanisms how this can be?

One thing I've noticed is that I'm sensitive to something in high-protein meals, and that sensitivity is much worse if I'm also suffering from PEM or what I assumed was a viral infection. Tryptophan (which converts into neurotoxic kynurenines) is my prime suspect, and I'm testing that hypothesis right now, since I had some protein and took BCAAs. If the problem is TRP, I shouldn't notice an increase in symptoms, since the BCAAs block TRP transport. What I'm not sure about is how the BCAAs in a protein meal affect this, since you're boosting those at the same time as the TRP.

As for a mechanism for increased symptoms during viral infection, IFN-g raises IDO in the brain, which is the main catalyst for TRP. Physical exertion can also increase IFN-g. To me, my increased symptoms seemed to be the same from both sources.

And all other tryptophan metabolites such as kynurenine and quinolinic acid are normal.

If that's from testing serum, the results are pretty much meaningless. Most of the kynurenines in the brain (especially during cerebral inflammation) come from in-situ conversion of TRP, and those metabolites don't cross back over the BBB easily, so serum tests won't reveal much.

Another thing to watch for is sensitivity to niacin, which affects the kynurenine pathway. It's hard to notice, since so many foods are fortified with niacin, but if you intentionally avoid niacin, you might notice a reduction in one or more symptoms. Niacin gave me strong suicidal moods until I figured out the correlation and took care to avoid it.
 

Wishful

Senior Member
Messages
5,679
Location
Alberta
If so, how do you deal with it and how do YOU prepare yourself emotionally and physically for the crash?

I try to avoid socializing, and I'm doing gosh darn well at it! :D

I also get PEM from driving, and I can't avoid that easily, but since I only need to shop every three weeks or so, I just accept feeling worse for a day or two.

What I recently discovered is that avoiding protein before/after the cerebral exertion helps me minimize the severity of the PEM. It makes a huge difference in PEM severity for me. Whether that works for other people, I don't know. I think it's worth experimenting with, by changing meal composition and timing. Maybe for others it's carb content, or fibre (slows carb absorption), or fats.
 

Wishful

Senior Member
Messages
5,679
Location
Alberta
If the problem is TRP, I shouldn't notice an increase in symptoms, since the BCAAs block TRP transport.

Well, I felt much worse an hour or so after having some peanut butter, despite the BCAAs, so TRP is far less likely as the culprit. Now I have to figure out what else might be the cause.