Stress Makes PEM Worse?

Does Stress Makes PEM Worse?

  • Yes for cerebrally-induced PEM

    Votes: 19 95.0%
  • Yes for physically-induced PEM

    Votes: 17 85.0%
  • No for Cerebrally-induced PEM

    Votes: 1 5.0%
  • No for physically-induced PEM

    Votes: 1 5.0%

  • Total voters
    20

Wishful

Senior Member
Messages
1,363
Likes
2,023
After my last drive into town, my cerebrally-induced PEM was dramatically worse than after previous trips. The difference this trip was that the roads were covered in snow and ice, which is somewhat more stressful. Aside from slippery curves at highway speeds, the center line is hidden, which is a bit nerve-wracking when encountering a tandem tanker with all those 'Flammable! Explosive!!!' stickers on it. So, my question is: does stress make your PEM worse? I've included choices for cerebrally and physically-induced PEM, since they are different.

I haven't experienced much in the way of stressful physical activities; no being chased by wolves on my daily walk, so I don't know if it affects that type of PEM for me. However, stressful social activities should be more common.

I suppose the effect could also be caused by the extra neural processing involved in judging traction, lane position, etc. If several people report that the degree of mental activity makes their PEM worse, I'll open a separate poll. Whichever it is, if this is a common effect for us, it might be useful for researchers, or at least offer some possibilities for reducing PEM severity.
 

Wolfcub

Moderator
Messages
2,263
Likes
5,513
Location
SW UK
Yes stress makes pem worse.

Stress (for me) is not too bad when it's happening except it makes me feel over-caffeinated (shakiness) but I cope well.
Then maybe the next day....maybe 2 days later I get symptoms again, feel like I'm coming down with or just one day recovering from flu, that horrible unnatural exhaustion and my brain goes mushy.
 

PatJ

Forum Support Assistant
Messages
3,462
Likes
10,252
Location
Canada
Whichever it is, if this is a common effect for us, it might be useful for researchers, or at least offer some possibilities for reducing PEM severity.
This is one of the reasons why the IOM/NAM came up with the new label SEID - Systemic Exertion Intolerance Disease. All exertion is a form of stress. The exertion can be physical or mental. For so many of us, exertion will eventually induce PEM, it's just an individual matter of how much exertion it takes to push outside our energy envelope.

From this key facts PDF :
"The Institute of Medicine (IOM) committee recommends the name systemic exertion intolerance
disease (SEID) for this disease. This new name captures a central characteristic of this disease—
the fact that exertion of any sort (physical, cognitive, or emotional)—can adversely affect patients in
many organ systems and in many aspects of their lives."
 

Wishful

Senior Member
Messages
1,363
Likes
2,023
The problem I have with SEID is that it's based on one symptom of this disease. Not all of us have physically or cerebrally induced PEM, and the two different types act differently, so might not even involve the same mechanism. In the absence of PEM, we (most of us?) still have significant baseline symptoms. The name for the disorder should take those symptoms into account too.

I don't see much point in arguing about what to call it, because I'm hoping that they'll discover at least part of the root mechanism of this disease soon, and then they can come up with a more accurate name for it.
 

Wishful

Senior Member
Messages
1,363
Likes
2,023
I'm leaning towards it being caused by the additional neural processing required by driving and other such activities, rather than adrenaline. I've driven my garden tractor with snowblower attachment to clear my 1.25 km driveway several times this winter. One time it was for 12" of snow, and it was painfully slow: just crawling along, trying not to fall asleep. No cerebrally-induced PEM from that, even though it took 5 hrs one day and another 3 to finish the next day. The next time was less snow, so I could drive faster (still slower than walking), but that required more attention to driving, since I had to keep the blower just scraping the edge of the snowbank, to avoid getting pulled deeper into the snow. That did cause cerebrally-induced PEM.

The most recent clearing was even faster, requiring even more attention to steering and keeping my speed just below the point where it would start clogging the chute. That caused more severe cerebrally-induced PEM. This was still walking pace, so by no means an adrenaline rush. The descriptions of adrenaline don't mention it being increased by basic alertness, but maybe that's just because they focus on other triggers. However, I don't recall significant PEM from events that would have spiked adrenaline (cougar encounter for example). So, for whatever it's worth, I think it's more likely that the elevated neural activity is depleting or accumulating something which causes cerebrally-induced PEM. More observations required....
 

Wishful

Senior Member
Messages
1,363
Likes
2,023
Another PEM-inducing activity for me: bank stuff. I had to do some online bank stuff, transferring an RSP from one bank to another. This required filling out various forms that asked for information that needed significant effort to find. Furthermore, my inkjet printer decided to stop working (they really are not meant for printing once every few years). All that took hours, and I find that dealing with official stuff, such as banking, is stressful, because there's always the fear that I'll enter the wrong number and send my money somewhere unintended. The next day was the worst cerebrally-induced PEM I've experienced in many months. I think the mental activity was the only significant variable that day.