My daughter is in a severe crash now for over a month and completely bedbound.
She thinks or knows that her thoughts worsen her PEM. She describes it as her head is burning.
Stressful thoughts often make my symptoms worse, and if I have them long enough, I can go into full on flare. Which for me, feels just like the flu. Pain and fatigue being my worst symptoms.
ME/CFS researcher Jarred Younger thinks that immune cells in the brain- (microglia) become sensitized or "primed" from infections, stress, etc.
This primed state causes them to be very sensitive to stimulus from stress or other forms of stimulation, and causes them to be chronically activated, causing low grade brain inflammation.
He believes this activates the sickness response in the brain, which is what causes ME/CFS symptoms.
He is looking into chronic immune system activation in the body, as the cause of this microglial activation and low grade brain inflammation. Whenever I have a flare, the lymph nodes under my jaw become swollen.
Which is a clear sign of immune system activation in the body. So I think he's looking for the answer in the right place by looking to the body for chronic immune system activation.
This low grade brain inflammation could be why your daughter feels like her head is burning.
From the reading I've done, stress can also activate these microglia in the brain, which could cause a worsening of symptoms. This is what I think causes my symptoms to worsen from negative thoughts or stress.
I think anything that can help her reduce her stress, would probably help her symptoms. I understand that's a very tall order for most of us, especially those of us that are severe.