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Allostatic overload in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

  [ 7 votes ]   [ 1 Comment ]
By Megan Anne Arroll • • July 27, 2013

Editor's Comment: In this report, Megan Anne Arroll, a psychologist working with the Optimum Health Clinic in London, hypothesizes that ME/CFS is a stress disorder. Although this is a popular view among alternative clinicians and psychologists, it has not been borne out by medical research. The medical department of the Optimum Health Clinic is headed by Dr. Nicki Crowley, a psychiatrist.

By Megan Anne Arroll


Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition characterised by diverse symptoms such as fatigue, pain, sleep disturbance and autonomic dysfunction. There remains to be a singular biomarker identified for this illness, hence numerous theories about its development and perpetuation have been posited in the literature.

This brief report presents the model of ‘allostasis’ as a framework for understanding ME/CFS, specifically the notion that the physiological mechanisms employed in the body to deal with stress termed here as ‘allostatic states’ (e.g. elevation of inflammatory cytokines), may in and of themselves contribute to the perpetuation of the disorder.

This theoretical assertion has important consequences for the understanding of ME/CFS and treatment; rather than searching for a singular pathogen responsible for this condition, ME/CFS can be conceptualised as a maladaptive stress disorder and interventions aimed at addressing the allostatic states may be incorporated into current symptom management programmes.

Source: Medical Hypotheses, 15 July 2013. Megan Anne Arroll 

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Article Comments Post a Comment

If we can't cure it, we'll pretend it doesn't exist
Posted by: dfwmom
Jul 27, 2013

Doctors are extremely goal oriented. When they face a situation that they cannot resolve, they often attempt to explain it away, or shift the focus in some way that will allow them to claim that they have "succeeded", that they have made a diagnosis or treated the illness, in order to avoid saying those terrifying words..

"I don't know". And, "I do not have any medicines or treatments to make you feel better".

There is a very long history of doctors claiming that physiological illnesses were just "stress disorders" or "psychosomatic" or manifestations of depression or anxiety, to explain away their own inability to diagnose or treat the illness. History demonstrates that the diseases so often dismissed in this fashion were very real.

Yes, if you pamper someone with a horrible illness, give them a bit of hypnotherapy or a massage, spend time counselling them, they might feel a bit better, briefly. Thus, CBT receives its due. Most people do naturally feel a bit better if they get emotional support or have a chance to relax. But, it does not make the disease go away, and it does not mean the disease does not exist.

As the parent of a child with a related illness, I am HEARTILY SICK of dealing with doctors' fragile egos, and emotional crises. They need to arrive in the exam room ready to face the day, and that includes facing moments when they are NOT successful in helping their patients, without attempting to shift their burdens onto the patients, on top of what the patient is already coping with, which would probably drive a doctor to his knees if he had it dumped on him suddenly. When a doctor fails to help a patient, it may not be the doctor's fault, but IT IS NOT THE PATIENT'S FAULT, either. Blaming the patient is not the answer.

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