When I first developed ME, this was triggered by an infection. But I was also under a lot of physical stress (at work) and mental stress (at home) at the time. I know that ME isn’t just another type of stress disorder but stress does seem to play a role in both triggering and causing exacerbations in some people with ME. So what do we know about the role of stress in ME? And has there been any research into the role of stress?
There are two important points to note:
Chronic stress can disrupt the hypothalamic-pituitary-adrenal axis (an important method of hormone feedback and control) and the production of the stress hormone cortisol from the adrenal glands. So when a significant acute stressor then appears, like an infection, a past or current history of chronic stress could be creating fertile ground for an infection to trigger ME/CFS.
In addition, once ME/CFS has occurred, any form of ongoing chronic stress, or even an acutely stressful episode — relating to problems with doctors, family, benefits, finances, etc — is probably going to have a negative impact on any possible recovery process in ME/ CFS. It could also trigger a relapse or exacerbation of symptoms.
So where stress is present, these factors do need to be addressed in the overall management of ME/CFS
The role of stress and immune system stressors — acute and chronic — on the body cannot, therefore, be ignored in ME/CFS. And this is clearly an area where useful research could be carried out.
We have an MEA leaflet covering all aspects of stress and ME/CFS: https://meassociation.org.uk/product/stress-and-how-to-handle-it/
There is further information on stress and ME/CFS in both the ME Association ME/CFS/PVFS Clinical & Research Guide
(also known as the ‘purple book') and the Chief Medical Officer's Working Group Report on ME/CFS (2002), which can be downloaded from the document archive section on the MEA website.
I also cover stress (and a legal case involving stress) in my Living with ME Vermilion paperback — which can be borrowed from any public library.
Medical Matters is for information purposes only. The answers provided by Dr Shepherd and the ME Association’s other expert advisers should not be construed as medical advice. We recommend that any information you deem relevant is discussed with your GP as soon as possible. It is important to obtain advice from a GP who is in charge of your clinical care, who knows you well, and who can consider other likely causes for symptoms. Seek personalised medical advice whenever a new symptom arises, or an existing symptom worsens. Don't assume that new or worsened symptoms are a result of having ME/CFS.