But I have both seen and experienced an uncomfortable eagerness to dismiss the cases of people who had viral onset illness with PEM, who appear to fit ICC/CCC diagnostic criteria, because of some arbitrary reason. I feel it carries a real sense of "you didn't have real ME, because I have real ME" and "this is why we need biomarkers, because biomarkers would prove that I have real ME and you didn't, despite fitting the gold standard diagnostic criteria..." I really am also not a fan of the no true Scotsman approach, where if you recovered you couldn't possibly have had ME. It just feels self-defeatist.
I'm very sympathetic to this perspective. I think the best we can do at this point is to say if a person meets diagnostic criteria, then they have the illness. When we get more research we'll have more insight into the nitty-gritty of what's going on inside each of us. But it sure looks like the diagnostic criteria are describing a unique problem unlike other illnesses.
It's hard to hear stories of recovery without it bringing up some feelings. On the one hand, I have to hope that if I can just go some magic period of time without crashing myself, that I could get better. It hasn't happened yet.... but then I can't seem to stop crashing myself. I also have to remember that sometimes people do genuinely get better, and every recovery story isn't false hope.
However, I do draw a bright line in my mind (that may not be there in reality) between neurologic and psychiatric disease. I am definitely guilty of the one true scotsman thing when I hear stories that suggest depression, PTSD, etc. Of course, a person can have two diseases at once and might even have PTSD or depression from the ME/CFS "treatment", but I do try to differentiate the two. I'm sure much of this comes from the BPS brigade and trying to fight them. We surely shouldn't start fighting each other in the process.
Then again, I also think about this with other fatiguing illnesses. What if you have undiagnosed cancer, MS or who knows what other scary illness and read some stuff online about ME/CFS, and then think that sounds like you? Then I think it's good for the ME/CFS community to push back and encourage a person to seek further medical advice. It's so hard to get a real ME/CFS diagnosis which can create confusion for people. I know when I saw Unrest, I thought "That's me!" My doctors went along with my self-diagnosis, but it's always in my mind to wonder if I have something else. They've tested me for everything they can think of and nothing comes up, but I'm never 100% sure.
So the upshot is, I'm not keen on excluding people so I can have the one, true illness. But, I want to advocate and educate so there's less confusion about what ME/CFS is and less misdiagnosis, self or otherwise.