CHRONIC FATIGUE SYNDROME & ME- Clinical Evaluation in Solving the CFS Puzzle - Dr Rege Explains

Dr Sanil Rege, Consultant Psychiatrist covers the diagnostic evaluation of Chronic fatigue syndrome and Myalgic Encephalomyelitis. These principles also apply to the evaluation of Long Covid but with additional aspects to be considered.
#cfs #chronicfatiguesyndrome #myalgicencephalomyelitis #longcovid
This video focuses on a practical evaluation of CFS by taking a diagnostic hierarchy approach.
CFS spans the brain and the body and taking a holistic approach becomes essential to the diagnosis and management of CFS.
The video covers:
1. Medical conditions associated with CFS
2. Psychiatric aspects in evaluation
3. Role of the Frontal Lobe
4. Role of Trauma
5. Personality traits
Long COVID and Post-Acute COVID-19 Syndrome: Pathophysiology, Clinical Features and Management - psychscenehub....

[@childoftheking2214]

I am exhausted from watching this. I have been sick with ME/CFS for 23 years now. I hope more doctors get educated in this condition so they can help those in the early stages. I am way too sick to even leave my home now. So different therapies and doctor appointments is not an option. This condition feels like a very long, very slow, exhausting and painful death process. Thank you for taking some of the painful stigma from this awful condition.

[@PsychiatrySimplified]

So sorry to hear. Hope you can get treatment. Wish you well.

[@burnyizland]

I agree with you on both points(exhaustion and slow death).

[@ShadowMan66]

I've had CFS/ME since 1993 and I have lost almost everything, my job, my sporting career and my dignity. I am just so stuffed all of the time, waking up feeling shockingly tired. It started after about 6 bouts of bronchitis and then a terrible flu and then all hell broke loose (M.E sufferers will know all of the weird symptoms I mean). After two years these calmed down and now I'm left worn out for about 18 hours of the day and suffer sore muscles and exhaustion after exercise. Life often feels not worth living

[@PsychiatrySimplified]

So sorry to hear . Hope you are able to get treatment as many aspects are modifiable

[@ShadowMan66]

@@PsychiatrySimplified Thanks I just don't know what to try next. Life is almost meaningless at this stage and it is so hard to keep on trucking. Thanks for your kind thoughts they mean a lot to me!

[@PsychiatrySimplified]

please have a read here - ps not advice but this may provide an understanding as over lap - also CFS and ME article is covered. psychscenehub.com/psychinsights/long-covid/

[@ShadowMan66]

@@PsychiatrySimplified Thank you, I will have a good read, I appreciate this greatly.

[@garywesthoven1745]

Your path is interesting. I also had a number of awful bouts of bronchitis and the the first bout of flu which was a bad one, making me not able to leave bed. Within a year, my Lyme symptoms began developing and that was about 8 years ago and the Lyme tests are not very conclusive so I’m left feeling paranoid about a disease that’s just in my head.

[@markmooch]

It is good to hear a psychiatrist talking about biology of ME instead of the ‘mind-body’ ie mainly psychosomatic based belief.

[@Jennifer_150]

Wow!! Thank you SO much for this!! 🙏 I’ve been dealing with CFS and depression/anxiety my entire adult life and this video hits the nail right on the head! I finally feel validated and that you truly understand that CFS is not only real, but deserves the same attention, research and treatment that any other person with a more visible ailment should receive. You seem authentically passionate and compassionate about this complex condition that few doctors are interested in approaching because it *is* so complex! Thank you again for your insightful videos and especially for your advocacy for those of us plagued with this horrific condition; and who have been dismissed for years by society and the medical community alike. You give me hope for a brighter future!! 🌈✨❤️

[@PsychiatrySimplified]

Thank you for your feedback. 🙏🏻

[@Truerealism747]

Check out Dr lenz if you have ADHD asperger's hypomobility the reason the genes for this 27 years fir me muscle pain worst

[@PsychiatrySimplified]

New video kzbin.info/www/bejne/q6PNnaGjpd-cgdk

[@LaurieAnnCurry]

I finally got my disability after me/CFS has destroyed my life. You were spot on throughout this video. The nonstop exhaustion with insomnia is literally mind numbing. I’m going to share this with my therapist and explore some possible therapies between she & my primary care. Trauma is deadly in so many ways. Thank you.

[@sandytherry8647]

As a Counsellor with chronic fatigue and ADHS, thid is the best explanation of chronic fatigue syndrome I have ever come across. Well done.

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏼

[@psychshell4644]

I'm in grad school for Forensic Psychology & have ME/CFS, fibro, IC...I was a RN for 20 years. This is the best explanation of the disease process yet. Especially about being awake all night (it's 5am)

[@PsychiatrySimplified]

Sorry to hear. Thank you for your feedback. Hope you are able to get help for the condition.

[@garyanderson5446]

I totally agree, Michelle, the best! Clarity because of the absurd level of complexity presented with Long Covid is rare and this guy with 42 years in healthcare is grateful!

[@PsychiatrySimplified]

@@garyanderson5446 thank you for your feedback 🙏🏼

[@Truerealism747]

Had CFS 27 years though for me now it's fybromyalgia 6 years I had pots years ago to.related to hypomobility Asperger's ADHD OCD fhtmr gene my father had CFS turned out was thyroid.my.mither has severe ms hypomobilty

[@lucyilly428]

Where can we look for help please? I have been referred to various people, physio, mental health team, health and well-being coach, none of these understood M.E and told me they couldn’t help.

[@janisedmondson7132]

So good. I see why doctors just shake their heads at this illness. Most doctors give about a five minute appointment while running to the next appointment. It’s very helpful to know someone, somewhere understands and is trying to help when we feel helpless. So complex, therefore there is no one pill to solve. Thank you for your thorough explanation and compassionate understanding. At first I didn’t want to watch because you’re a psychiatrist and (mistrust showing up) I thought you would say it’s all in your head. You ended with it is not in your head (something we who experience the devastation know) but seldom/never hear from our doctors. Thank you.

[@PsychiatrySimplified]

Thanks for your feedback. Appreciated 🙏🏻

[@janejarve]

Most interesting, and very well presented too. Another expert to be consulted is the patient themselves. Never forget who is at the centre of the complex puzzle. Consult often. Can be challenging to accomplish, but cannot succeed without their co-equal participation.

[@PsychiatrySimplified]

Good comment. Thank you - important point

[@craigsurette3438]

As someone who both has recently come down with CFS ,and who went to school for neuropsych, this talk is EXACTLY what i had been hoping to find. THANKYOU! Hopefully i can find a medical care provider who is as qualified and dedicated as you

[@alizamorallos6339]

How are you now?

[@AJansenNL]

Thank you for listening to patients and incorperating their expertise in this video. You speak of trust. Many patients no longer trust doctors and mental health professionals because of their lack of faith in their patients' expertise of their own bodies and their own experience.

[@PsychiatrySimplified]

Understand. Thank you for the comment.

[@Chyrese3]

This is so incredibly validating! What we’ve been trying to tell doctors for years. It’s not a simple condition, so many factors. THANK YOU!

[@PsychiatrySimplified]

It isn’t a simple condition and highlights Osler’s quote “There are, in truth, no specialties in medicine, since to know fully many of the most important diseases a man must be familiar with their manifestations in many organs.”

[@Cepar.]

My god where have you been all this time, its beeen 3 long years I am at my wits end. You are so knowledgeable that is something special. All doctors 10 of them Ive been to are clueless. I am praying the word gets out soon. How complex this condition is, just wow. It doesn't look like there is a way out.

[@PsychiatrySimplified]

I’ve since added additional videos on long COVID , POTS etc which cover the management principles. Have a listen to them.

[@rndm4642]

Many, many thanks for this video and your others. I am very appreciative to have found them!! You are helping more people than you might realize. CFS and it’s trickle-down illnesses (both physical and mental) can be excruciating, and the common medical system does not properly understand or acknowledge how they interplay.

[@PsychiatrySimplified]

Thank you for your feedback. 🙏🏼

[@polyanthesis]

The medical system seems to find sexual pleasure in mistreating ME patients.

[@OntheMC]

I wish every doctor would be so educated. This explains everything.

[@kellyofthehead]

Extremely helpful! I believe I became unwell with M.E 6 years ago after all my adult life struggling with undiagnosed ADHD. A death in the family lead me to have an emotion breakdown, then a nasty viral infection. I've never been well since. I'm currently suffering badly with POTS, noise intolerances, pulsatile tinnitus, night time anxiety, MCAS, IBS and insomnia. You've explained this so well! I have cauda Equina syndrome, h-EDS, ADHD, OCD, M.E, dysautonomia and IBS. You've basically spoke about everything I've had or currently have, even the perfectionism and a highly active person. I now have severe depression because of Cauda Equina and spinal surgery making everything so much worse. I wish I had a doctor who understands. 😞

[@PsychiatrySimplified]

Sorry to hear. Hope you can get help to address the issues you’ve outlined. Here is an article where treatment is described in more detail psychscenehub.com/psychinsights/chronic-fatigue-syndrome-myalgic-encephalomyelitis/

[@kellyofthehead]

@@PsychiatrySimplified thank you for that. I have an M.E nurse now, and I'm also under the affective disorders team, and now have a wonderful Dr, just trying to find a medication that helps with my depression, ADHD that doesn't make my M.E worse, which is a challenge. I have medical trauma now from the years of being dismissed, but I'm fortunate now to have finally found a good mental health Dr who actually listens.

[@PsychiatrySimplified]

@@kellyofthehead good luck. You might want to look at the adhd video to look at medication 💊 options. Here is an article to look at gender differences in ADHD as females have a higher emotional arousal model than males. Also females with adhd have a higher risk of cfs . Wish you well psychscenehub.com/psychinsights/attention-deficit-hyperactivity-disorder-in-females/

[@kellyofthehead]

@@PsychiatrySimplified thank you for the link. Definitely understand emotional disregulation, as well as eating disorders, if only I knew then what I know now, my life might of been so different! Now I have M.E, I have no life, it's sad, and I feel quite angry about that. 2022....we know so much, but still so little. Now we just need them to realise long covid is in fact the same illness as M.E, then hopefully it will actually help the M.E community finally get the help, belief and care they so desperately need.

[@PsychiatrySimplified]

@@kellyofthehead very good point re Long COVID. This article I’ve covered long COVID and treatment options. As you will see Dopamine plays an important part , reduction of hyperarousal becomes important and ruling out hyper coagulability. psychscenehub.com/psychinsights/long-covid/

[@kasmakate4222]

This video is everything. So thankful for you and your explanations. I hope this knowledge continues to disperse and educate others.

[@PsychiatrySimplified]

Thank you for your feedback.

[@serenityseeking01]

This is spot on!! 👌 Suffered and healing for 13 years now. From a patients experience and self discovery this is incredibly accurate. Please teach our health professionals everywhere asap!! ☺ Something that has assisted my nervous system for the last 4 years has been orchestra type music. The bodies muscle memory has been hacked by stress hormones majorly with long term cfs.

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏼

[@elizabethread6878]

Hi Tina. Do you have any other tips on what has helped you heal? ❤️

[@serenityseeking01]

@@elizabethread6878 hi Elizabeth. A few years ago my CFS was worse with my son being bullied at school. I found from the ongoing stress on my body and mind that I couldn't relax even in the shower my body was in high alert and I couldn't stop that or do simple things you'd normally do to calm the body and system. I began listening to epic music, search haunting womens voices and you'll find a beautiful mellowing tune to listen to. I love Ivan Torrens also. Such amazing listening. I had people recommended meditation in the past but nothing main stream worked so I began lying down listening to the haunted women's music without interruptions I'd just allow my body to take me with the music and calm me. I did this every day for 3 solid year's and within a short period the constant anxiety that comes with your nervous system being bombarded by CFS symptoms my body began to feel like mine again. I'm learning about what's called PEM within a cfs community on Facebook and able to put a name now to a system I found valuable for me in the earlier days. Id over do it with 3 children on my own but I'd be bed ridden for 2 weeks after catching the train 2 hours away to see a specialist and stuff like that. I had to conserve energy in order to used energy when I really needed it which can be hard but if I didn't it surely ensured that I'd crash for 2 weeks with complete exhaustion. I found the more I implemented this type of meditation for my body that that itself began to ease. The crashes were less extreme. So I discovered that it really is linked to your nervous system and it's just been pushed to it's limits. Trying not to sleep through the day to restore poor night time sleep can be hard but I still have alot of days where out of no where I can't keep my eyes open so avoiding or removing any unnecessary things in our life is a must. Alcohol = not good don't feed the social pressures and protect your health at all costs. Don't feel guilty or bad because of how you are now and think back too much as to how you used to be and what you used to do. Just try your best to be in this moment and take baby steps that you need until you can walk/run etc. Hydrotherapy is amazing for CFS. Like amazing. Because land activity takes a toll on your body/joints etc and holding yourself up will over work your muscles and make them feel weaker with that type of exercise. In hydrotherapy the water will hold you and so wading in the water will assist the exercise side of things and get the systems going in your body that need to work to help you feel refreshed and sleep better too. With cfs because exercising on land tires us out quicker we do it less and leaves us wired. I don't recommend it if you aren't ready for that and if you can't handle the water. Also an exercise bike. For as long as you can. Slow steady sounds silly I know but it also gets your lymphatic system going so toxins aren't building up in your body making you feel worse. A good foot detox spa. My first one ever was black as tar. A result that you'd have from either chemo patients or CFS. Heavy metals build up in the body. Some people don't believe in it and that's fine but it did help me. I saw results. I was in a bad way I'm 2012 where I'd burnt out and couldn't function. I was at the emergency department every other day being told I looked fine but I knew I didn't feel fine. I have high inflammation levels and it's like a needle in the haystack finding out what is going on. Just don't give up and trust your body is telling you to be gentle. In time and small steps to find healing you'll begin to feel better. Not every one thing works for every person. What didn't work for me was anything over stimulating. Acupuncture didn't work, Chinese medicine, the tonic gave me such bad stomach pain. I could smell the mixture in my foot detox spa months later when pain killers didn't help the pain I used the foot detox and that's when the pain eased. Obviously there's a link in things building up in our body and potentially even our bowel. Massage isn't good as it too is over stimulating but Bowen therapy worked for me because massage is just too much on the system but Bowen is gentle calming and relaxing. Same as the music meditation. So I say begin with some ear phones put on a calming soothing tune to assist you just lying there as if you're asleep but remain awake and let that music guide you to where parts of your body aren't relaxing and allow them to ease each time. Also diffusing frankincense/sweet orange and lavender at night will help also. Although I've been suffering from bad insomnia for 3 years since having a slip injury. It set me back alot and created a barrage of more physical symptoms but this stuff has still applied and helped me. I only tried the water therapy after my slip injury and not before and wish I'd done so sooner. Write down what works and what doesn't and stay away from what you know doesn't help. Diet, low GI helps cut out the main things that will induce brain fog, white bread. I can't eat whole meal. Rye is good. Eat as clean and healthy as you can lots of greens. Berry's anything you prefer and take note of anything that doesn't agree with you. I can't eat margarine or cook with any oils other than olive oil so it's replaced with olive oil spread. I had some serious breathing difficulties with food and oils. The vege oil seemed to be a dominant thing that affected me. I couldn't have a bath early on because my body temperature was affected still is a lot with extreme changes in temperature. But aside from fatigue, and pain from my injury now alot of those extreme CFS symptoms have eased. Also I addressed vitamin deficiencies first I was defiencient in magnesium. I found my body absorbed it best externally than internally. Some years later having b12 infusions helped my breathing difficulties and gave me energy for a short time but assisted long term also. I apologise this is probably long, I hope it helps you in some way and wish you all the best and healing life has to offer you. 🙏

[@serenityseeking01]

@@PsychiatrySimplified your very welcome. I appreciate that there are medical practitioners and people out there that have considered and seen that it isn't just in our heads or laziness. There's nothing I've wanted more than to do things and no one would ever wish to suffer like we have with something so debilitating on purpose. We are not lazy and we certainly haven't been making it up. It's been a very lonely road for alot of us just hoping and praying to come across the information from a health provider that believes us. 🙏 Keep up the amazing work. 👏

[@elizabethread6878]

@@serenityseeking01 thank you so much for taking the time to write this all out. I’m so happy you have found what works for you .❤️

[@markmchugh5049]

What an excellent video! Many thanks for putting this up. Multi-dimensional approach is indeed the key, it's refreshing to see someone who clearly has a grasp on this much misunderstood and invisible illness...

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏻

[@Meadmon]

I’ve never heard another person mention low dopamine in the frontal lobe and why it happens. Very clear and concise.

[@PsychiatrySimplified]

Thank you for your feedback.

[@mr.anindyabanerjee9905]

Thanks a bunch Sir for your nice explanation of the Biopsychosocial model of CFS. This hierarchy will help the students of Clinical Psychology in their elaborate understanding.

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏼

[@Hayleism13]

Another thank you. Glad to find you. Look forward to more of this. It's therapy in and of itself.

[@courtneymorris2293]

Which specialist should I seek? I’ve been to rheumatologist, neurologist, pain management, psychological even tried acupuncture and I just keep getting passed around with no help. I appreciate you mentioning depression being secondary from CFS, I’ve told so many doctors that I get depressed because I’m in pain and tired and can’t do the things I need to do or want to do. I just feel really hopeless sometimes and stay away from the medical community. My experience has been terrible and providers don’t listen. If I try to explain my history it’s never well received.

[@PsychiatrySimplified]

Sorry to hear. It is difficult to say as it depends on the symptoms. Usually, a general practitioner carries out an assessment and then makes appropriate referrals to physicians based on symptoms. But of course, this depends on the country and health systems. Hope you find the help you need.

[@psychshell4644]

It took me 13 specialists & an opiate addiction to realize that I was better off swigging coconut water, eating 3 bananas a day, and taking magnesium. I got rid of tons of stress which made a big difference. I avoid extremes in temperature & just pay close attention to my body. Most doctors really don't know how to treat you. Print out articles and bring them with you. Best wishes

[@larryc1616]

Look for CFS/ME/long covid specialist, research college or medical center. So many people are getting CFS/ME from covid now there is 1B poured into long covid research.

[@elizabethread6878]

@@larryc1616 any advice for those in California in the US where to look? Really need help.

[@larryc1616]

​@@elizabethread6878 yes, i can help you with that. youtube doesn't allow outside links but i'll post the link with spaces if i can here. i just posted and the link won't allow me to post so i'll just describe it here instead. Goto WebMD, goto doctor "providers", then under "conditions" and choose Chronic Fatigue syndrome, then choose the "location" which for you is California. there is a list of CA cities and when you click on the cities, there will be a list of CFS doctors with their bio. i wish the link went through to make your life easier. but do try it, good luck Elizabeth!

[@scopeway]

I've had CFS for over two decades and I fully believe that if a treatment or cure is found it'll happen in a lab not a psychiatrist's office.

[@elizabethread6878]

Probably doubtful given that it’s autonomic dysfunction for the majority of the people so the psychiatrist office is not too far off. It is not a psychiatric issue but when they autonomic system is off everything is off and there are many different medication‘s I can regulate it well you do things to heal it

[@scopeway]

@@elizabethread6878 Well, in reality I don't care if it's magic, science, a stroke of luck or a miracle. Just make it happen, I say. I'm thankful and encouraged that people like the doctor in this video are throwing their weight behind it. Let's hope they crack it.

[@rebeccareza3240]

Thank you for this. I have been suffering from h ch ronic fatigue for several years. I also have RA so its been a big challenge to figure out where exactly the fatigue originates from. Its extremely debilitating and isolating, but more so frustrating to find a diagnosis and treatment. I used to be very active and worked a lot in a high paced environment. Now, I am lucky if i can clean the house and get through basic tasks without needing several naps. This was very informative and will help me during my upcoming doctor visited. Thank you.

[@PsychiatrySimplified]

Glad you found it useful

[@lizmonard]

I am 100% sure I have adhd, bpd, and cfs. Past diagnosis include multi nodular thyroid, fibromyalgia, depression and ptsd. I have been brushed off by psychiatrists and so haven’t seen one for a few years, and just the thought gives me incredible anxiety even though I know it’s my only hope of treatment. Unemployed and no income of any kind for nearly a year (this time) can’t afford one anyway. Never felt so helpless and lost in my life. I listen to this and wish I knew a psych doctor who understood all this, I might be encouraged.

[@PsychiatrySimplified]

Sorry to hear. There is a greater understanding of these disorders now so you could try reconnecting . The disorders you mention overlap significantly and is often how patients present. Wish you well.

[@canadianboyharman725]

Hi sir please help me🙏 im harry and im 16 when i was 11 and my mom-dad went to canada and after that i was living with my grandmother and grandfather and like i was so sad at the starting but i started managing it and at the age of 14 I’ve gone through biggest shock of my life and huge stress like i left my grandpa’s house and started living in my aunts house and there at evening I suddenly felt like weakness and tiredness like im dreaming but not physically it’s mentally and I’ve seen so many doctors some say it’s depression and some say it’s nothing but I don’t fell like depression and this is the weirdest thing of my life and im still going through it its the same since 2020 august and idk if I’m not explaining it well to the doctors or doctors are not diagnosing it idk what is this i just wanna get rid of this and i never felt like before I think it’s gonna be lifelong please help me sirr🙏

[@Truerealism747]

Do you have hypomobility check out j Eccles larger amalgamia in the brain

[@canadianboyharman725]

@@Truerealism747 what is that??

[@canadianboyharman725]

me and my aunt’s son got nausea, vomiting and diarrhoea, he was 2 years older than me and i ate medicine my aunt brought for us from a small clinic actually not even a clinic just a small looking room and the guy who gave us medication used to work with a clinic owner.

[@user-hz6vd1lh6c]

Had this hell for around 28. Years if doctors had this they would change their minds in seconds

[@PsychiatrySimplified]

Sorry to hear. It's a very misunderstood condition

[@DA-ln5kz]

Thanknyou very much for this lecture. Unbelivable how precise you are. You are the best doctor!

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏼

[@nataliedavies3770]

Thank you so much for this podcast. I am a specialist rgn with ME diagnosed 8 years ago. I have really struggled of late having viral vzv activation twice in 3 months thus leading to a major flare up of ME pain extreme fatigue and low mood subsequently as the knock on to my daily life (as you conveyed spot on with personality trait). Ive seen gps over the years (on specialist neurological waiting list) and being a hcp i am very aware of time constraints ect but this multitong approach you convey is so pivotal for patient care and their quality of life outcomes so forth and as the NICE guidelines stipulate patients should have a personalised plan but this has never happened. Unfortunately im greeted with your depressed take this and in the kindest of ways fobbed off. This has led me to having no faith in a treatment and led me to researching myself which is how ive stumbled across your lecture. As i was watching it just resonated and has given me some faith that there are people like yourself who do care and will think holistically. Unfortunately im yet to find the support I need. Not even onward immunology or endocrinology even when ive asked for blood profile given my history of vsv3x in a year and symptoms just to try anti depressants. I really hope the future for all ME and umbrella patients starts to improve, thus hopefully more encourage more clinicians to take an approach as you discuss 🙌

[@PsychiatrySimplified]

Sorry to hear and thanks for sharing your experience . It is a challenging condition due to the multiple systems involved and hence siloing of symptoms and specialties. Hope things improve for you

[@lizarosa156]

I think it means the important brain substances not reaching the frontal lobe

[@Canyondwellings]

The best informative video I have seen. Grateful to you. Will be discussing with my doctor. I have. been telling different doctors (the last 3 years) I have many symptoms but they never said CFS

[@PsychiatrySimplified]

Thanks for the feedback. Do have a look at the other videos on long COVID and CFS as well as it provides a broad overview of the conditions helping with understanding management

[@gabigabriela2802]

neuro-immuno- endocrinology. In the aftercovid era, so many of us suffer! Thank you for your efforts to help and understand! Rara avis! 🙏❣️ Thank you!

[@elizabethread6878]

Is this a type of doctor? I have seen so many too and need help badlu

[@SamSam-ih6nt]

Keep up the good work Dr.

[@Stefanosinf]

I'm suffering from CFS & RLS for over 20yrs. All my lab tests are comming out clear. Despite that i'm in constant "pain", in both of my legs, i cannot sleep more than 4.5hrs, i cannot recover from my activities and i suffer during the day from fade outs (don't know the excace word) but i bassically turn off momentarally, if i'm not doing something that can keep me stimulated. Despite that i cannot fall asleep durring the day. I'm on Neupro patches 3mg for the last 9 months, but still nothing better. My legs are constantly tired. I do a lot of cycling as an amateur and this has helped me not to get worse.

[@PsychiatrySimplified]

Many individuals with CFS have normal lab tests. Very likely iron deficiency is present ( has that been looked at - also including ferritin) - have a read here ( LC but similar ) - also treatment options are covered . What you are describing is hyperarousal with subsequent fatigue during the day. This is treatable. Hope you get medical advice . psychscenehub.com/psychinsights/long-covid/

[@catzenhouse]

Here's to the psychiatrist my then lousy GP sent me to when I was trying to get disability for ME/CFS and Fibromyalgia. For a one hour chat. The expert: "Oh, it's just depression" and sent me on my way. And of course my employer jumped on that diagnosis like a extra large trampoline. Declined.

[@PsychiatrySimplified]

Sorry to hear. There is a lack of understanding of the condition unfortunately.

[@jewelleryaddict]

As soon as the new doctor reads our chart in the hall seeing CFS sets up a diagnosis of anxiety and or depression before we ever get a chance to speak. Might as well get up and leave.

[@jonfrancis59]

Dr. Sanil Rege, Thank You for the vast depth and breadth of your research and for revealing the many interlinking symptoms and triggers of this frustrating and depressing syndrome. I have been dealing with every symptom and debilitating trauma that you have described. I was very athletic in my youth, Track & Field, Baseball, Basketball, Bicycling and long distance walks. I have always excelled in most everything that I put my mind into accomplishing. I was always outdoors as I seemed to irritate my family with my activity and fascination with information and exploration.

[@jonfrancis59]

My Blood type is AB- I am now 63 years old, Caucasian with mostly French and some German Ancestry. Blond hair, Blue Eyes, 6' tall 195lbs and just beginning to show some gray hairs. I look physically athletic and in shape. However, this is one of the frustrating parts of CFS. People who know nothing of my character and achievements or physical endurance and work ethics in my past, conclude that I am just a lazy selfish person and a hypochondriac even though I do so many things for them with quality results and very cost effective as well, because I have to stop at any given moment to lay down due to any number of issues such as migraine, dizziness, severe fatigue, mind fog, severe pains randomly attacking a part if my body for a few hours or days, then switching to other parts with no continued pain in the previously affected area. I had to quit my job last year, though I really enjoyed the work, and desperately needed the income, due to the increased occurrences of dizziness and fatigue and mind fog. I had to leave work nearly every other day and it was affecting my reputation and performance let alone I feared I had some form of cancer or other life threatening issues. I have tried to figure it out alone as my doctors just did the routine basic tests usually revealing good health and suggesting depression or diet, which I do believe can contribute to this issue, but I am generally upbeat and eat fairly healthy foods.

[@jonfrancis59]

I have been drinking a lot of Sodas over the past few years, and appear to be stage 2 Hypertensive if not Stage 3, and possibly prediabetic, but having to lay down for long hours over the past year may contribute to this state. I have been dealing with this problem for over 20 years but it was longer periods of time between episodes and shorter affected periods. Now I am laying down or sleeping in my room for nearly 20 hours a day or more, and when I have a good moment of energy, I try to get things done and stay at it as long as I can. I have days of sleeplessness, and days of seemingly narcoleptic periods. My wife and mother in law do not understand and actually intensify the effects and length of these periods. It is humiliating and hurtful to hear their opinions and thoughts as they are very shallow and insulting to me especially when they both are undergoing various joint surgeries and replacements, severe stomach issues, and depression themselves.

[@jonfrancis59]

I want to return to my job and be able to enjoy the world outside again. I am financially broke now and unable to support my wife or myself and with the Pandemic shutting down most Gov Assistance buildings and their intentional computer site blocking of any communication with actual humans to get assistance, I cannot afford any more doctor visits or tests due to being denied health care by both MediCal and California CA because my income level was right at the border line of criteria for both programs, until just recently, but I believe they will subject me to the same scenario any day as my wife just had dual hip replacements from bone on bone joints and has been bed ridden in excruciating pain for over 6 months, but is now beginning to walk though infections are causing pain again. I took care of her at all hours of the night with little sleep. It has been so traumatic seeing her in so much pain, begging to make it stop. I am completely overwhelmed with possibly PTSD as well as more than likely CFS.

[@jonfrancis59]

It is difficult to focus on research and doing the things I need to correct or reduce the episodes. I do not know if We will be homeless soon or where to get help. I live near Monterey in California. I will try to follow your suggestions for reducing the effects and look forward to whatever information that you share on youtube.

[@jonfrancis59]

I had a traumatic childhood that had two sides. My stepfather crushed all of my siblings and my own spirit and we lived in fear when in his presence. He was hard working, fairly educated, and liked his space and control of his surroundings. It was when he drank his beer that we knew we had to distance ourselves, and he drank every night after work. This constant fear from physical punishment, and his anger when triggered, caused me to have years of hate for him and feeling I was only a burden in life. The good side was I experienced many beautiful and educational things from being outdoors and exploring all that I could each day. It also caused me to maintain a calm demeanor with people, yet just below the surface a rage that I knew could seriously harm a person that pushed me and triggered a loss of that control. I chose to talk things out or walk away rather than possibly falling into that state. I am a generous and caring person. I am strongly defensive and aggressive to bullies when encountered, so I maintain a limited family of friends and social activities that decrease the chances of a bad event. Simple Logic, Wise Thinking.

[@MeeraRaju1111]

You are an angel. Thank you for your work❤.

[@PsychiatrySimplified]

Thank you for your feedback.🙏🏼

[@valeriesummers9865]

A lot of citations to research papers flashed on the screen before I could write them down. Would you please share a list of these citations so we can review them? Nice tie!!

[@PsychiatrySimplified]

Thank you 😁. Here is a detailed article with references. psychscenehub.com/psychinsights/chronic-fatigue-syndrome-myalgic-encephalomyelitis/ . You could also try pausing the video to grab the reference.

[@Fomites]

Thanks Sanil for this great learning video. It's top class and describes this highly complex condition.

[@PsychiatrySimplified]

Thank you for your feedback. Appreciate it. I've gone into detail here for long covid which you may find interesting. psychscenehub.com/psychinsights/long-covid/

[@IamMimi_2017]

This could not be more spot on! (At least in my case!)

[@6friend]

This was super helpful to watch. I have POTS, ASD, & ADD. Helped connect a lot.

[@marlamaxwell9158]

I need you and a whole team to figure me out. I feel like my life is just dwindling away from chronic fatigue. I have so many of these symptoms 😫 😭

[@PsychiatrySimplified]

Sorry to hear. A first step would be a meeting with your doctor to discuss your symptoms and then deciding the appropriate specialists to be involved. Good luck. Wish you well.

[@bell4textu973]

@@PsychiatrySimplified You represent garbage. You do not know what it is, but still you make assumption!

[@nikhilwagh7314]

It works like a circuit breaker brain gives signals to the Central nervous system (cns) in night. I feel this is why fatigue, being ill and other symptoms occurs. which I think is a Restless Leg Syndrome. I also had 10-15 weird dreams every night yes you read right! In night my body sleeps but my brain constantly running marathon which sometimes causes insomnia. So deep sleep plays important part in this puzzle.

[@PsychiatrySimplified]

Yes it does. Sleep plays an important part here. Here is a detailed review. Inflammation associated cytokines which reduces iron - linked to RLS. Other factors also covered psychscenehub.com/psychinsights/long-covid/

[@wetelectronics238]

It's interesting that despite the fact that a large portion of these patients have elevated Spinal fluid protein indicating a central inflammatory process they are generally never treated for central deficits.

[@janakamunasingha1529]

excellent explanation

[@PsychiatrySimplified]

Thank you for your feedback

[@user-hz6vd1lh6c]

You are spot on brilliant thank you so much

[@PsychiatrySimplified]

You are welcome

[@themidstream]

Incredible. Spoken like a true Biohacker.

[@artstar4]

Brilliant. Thank you!

[@godofallgodswithnoothernam920]

Vitamin B1 thiamine 500mg - from solgar - is very good for tachycardia rythmia and exceptional for adrenal fatigue induced thyroiditis/cardiac issues and adrenal fatigue itself.

[@princesssaffy3]

Thanks!

[@PsychiatrySimplified]

Welcome!

[@moogdome2562]

Thank you so much.

[@PsychiatrySimplified]

You're welcome!

[@circuitdotlt]

shit, it's like about me. aspergers, adhd, very active perfectionist, suddenly unable to get out of the bed for whole weekend.

[@elizabethbrauer1118]

We need to consider the vast amount of people with c-PTSD. Early childhood neglect and trauma act as a "catapult" for many of these biological issues.... Okay, 13 mins in you finally get to this. _Trauma IS the key factor for far too many of us._

[@PsychiatrySimplified]

You are correct: trauma affects the HPA axis which changes the hormonal profile making the individual more prone to inflammation which indirectly interferes with adequate function of the fronto-striatal circuits and activates the amygdala.

[@jewelleryaddict]

Problem is everyone who experiences trauma does not get CFS.

[@PsychiatrySimplified]

Ofcourse not - but when we think of trauma for the brain - infection, inflammation, pain are also 'traumatic insults' best to think of entities that try to disrupt homeostasis.

[@elizabethread6878]

Do you think it’s better to see a psychiatrist with a biochemistry background or a pharmacology background for treating cfs? I found both. Otherwise no luck with basic psychiatrists and actually been turned away by some. I have seen endo’s , neuro, and cardio’s and autonomic specialists… but all aren’t doing anything to alter my brain function which i know is a massive problem. None have helped me. Whatever meds they have made things worse.

[@DrGearHeadSS]

Wow. I wish you were my doctor. How do I get my physician to watch this video?

[@aaroncarter6735]

Psychiatrist in Mississippi almost never run any test. They ask you are you depressed or do you hear voices then slap a subscription in your hand and out the door you go.

[@PsychiatrySimplified]

Sorry to hear! Not ideal

[@markmooch]

I am wary and cautious around personality effecting illness, it can border on patient blaming and pseudoscience, these personality traits may be downstream of the biological illness, or the ME and personality may be downstream of another illness or condition perhaps on a genetic level, for eg perfectionism is a trait also found in ADHD ASD which are highly comorbid with POTS MCAS etc.

[@jamescullen-657]

Hi Sanil, Can the “tired and wired” state be a used by something other than a psychiatric illness? For example, is it possible that an autonomic neuropathy can present with the symptom of “tired and wired”?

[@chaudang7589]

Can you share a video of treatment of chronic fatigue syndrome? Thanks

[@PsychiatrySimplified]

We have recorded one that we will release in near future. Thanks for the suggestion.

[@burnyizland]

Hahahaha OMG I have almost every one of these traits/syndromes/etc... WOW. I guess this is either proof it's what I have or the reason I have it - chicken or egg, eh? I appreciate your presentation on this. I have to admit I was wary of listening to a psychiatrist's take on this as there is such a stigma about this syndrome being all in our heads. But every part of this I'm already familiar with checks out so I'm taking the rest of what you've added seriously. While my healthcare team and I have treated many of my symptoms, I've never reached the remission stage I've heard talked about. I'm going to speak with my head doctor about the possible usefulness of alpha 2 presynaptic agonists or alpha 1 adrenergic antagonist in calming hyperarousal of the anatomic and paralimbic systems because we haven't really explored that yet, thank you for that bit of info. Very useful information throughout, and thank you for educating not just the public but those trying to treat this disease. I'm very interested in a researcher, Dr. Robert Phair, who I've been learning from lately who has looked into the possible involvement of the GABA pathway in mitochondria in ME/CFS because a few years after getting the ME/CFS I acquired what they've termed a "functional movement disorder"(because there are no neurologists near me to figure out WTH is going on). I get intense muscle seizures many times a day and take maximum doses of Gabapentin throughout the day to dull these. Baclofen made me catatonic and didn't calm them either but the GP has helped a lot. I still have to be careful not to strain - or even USE - many muscles, but at least they're not constant anymore, as long as I'm careful. I also had complete cessation of muscle seizures when on T3s. Can't stay on those, obviously. I only mention it as a point of observation. I agree with the person below saying watching this is exhausting and they feel like it's a slow death. But until we figure this out better we all have to be our own advocates or else give up and die. I'm contemplating applying for MAID (medically assistance in drying, available in Canada). I often wish the people who kidnapped and assaulted me just prior to my onset had just killed me. I could have gone out a success instead of destitute, isolated, helpless and suffering so much. Please, to anyone working on this, keep at it. We need to solve this. It truly is a fate worse than death.

[@PsychiatrySimplified]

I’m sorry to hear about the trauma. There is hope. I did a second more in-depth video on this. Yes psychiatrists are often not heard here but not surprised because it’s recognition in psychiatry is also minimal. Hope that changes. Many patients I’ve seen have diagnoses of FND kzbin.info/www/bejne/mnrWoal_gtymaLcsi=6jCsFl3otl2KtsEZ

[@burnyizland]

@@PsychiatrySimplifiedThank you, and I'll watch your other video on this so thank you for that as well. Oh yes, I got that wrong - it is FND I've been diagnosed with, not functional disorder.

[@PsychiatrySimplified]

Added the latest video which you may find beneficial. kzbin.info/www/bejne/q6PNnaGjpd-cgdk

[@999rob9]

After failing on multiple different classes of medications, my doctor finally prescribed me Vyvanse for chronic fatigue and its the only thing that has consistently helped with my horrible brain fog and fatigue. My question is why don't more doctors use stimulants off label for cases like me that are horribly treatment resistant? Also do you know anything about low dose abilify for chronic fatigue, apparently it's had incredible results for some people with CFS, something to do with brain inflammation and dopamine

[@PsychiatrySimplified]

Good to hear. Thank you for sharing your personal experience. 🙏🏼 As I've said in the video - often medications can be used to target specific symptoms. Aripiprazole is a partial dopamine agonist and can be helpful to address the mesolimbic system symptoms. But it is individualised and may not work in all cases. There are other agents that can do the same. A discussion with the doctor with symptoms and then using psychopharmacology to address it provides better outcomes. Wish you well.

[@brobinson8614]

ADHD meds caused the opposite for me, was an awful experience

[@PsychiatrySimplified]

@@brobinson8614 Sorry to hear. Were they prescribed on their own? Any activating medication without adequate reduction of mesolimbic system activity (hyperarousal etc if present) can lead to significant side effects.

[@brobinson8614]

@@PsychiatrySimplified Yes on its own, I actually think brain fog from ME/CFS is misdiagnosed as ADHD, because the few (7%) that recover from ME/CFS the brain fog and ADHD like symptoms disappear for good. The same with those who have Long Covid and fully recover, their ADHD resolves too. So Post Viral brain fog is most likely not the same cause or mechanism as traditional ADHD

[@PsychiatrySimplified]

@@brobinson8614 on its own in CFS it can cause side effects of activation or other somatic side effects. Individuals with ADHD are at higher risk of long Covid and cfs. However brain fog as you say is not adhd. It has an inflammatory origin. But dopamine is involved in both conditions. Hence why there is an overlap between cognitive symptoms of adhd and cfs. But they are different etiologically.

[@beldeusingh483]

If CF is associated with synthetic perfume toxicity and aluminium which crosses the BBB and establishes low grade inflammation and over time there is oxidative damage or oxidative stress inhibits the ATP->ADP->ATP cycle how do treat the underlying contributors to the disturbed biochemistry and the syndrome? Treating the symptoms is just about what allopathy can do but how do you remove the toxicity agents and their metabolites in cells to restore the patient to society?

[@frcfun8328]

18:52 this point is key imho: doesn't "ruling out organic aspects" imply that we know all the organic causes? It is not plausible in my opinion that we know everything already, or that we even have the technology to see every existing organic cause for that matter, YET. History of medicine is disseminated of such examples, eg. Diabetes, MS, HIV, ulcers...all with an organic cause that wasn't known before..well.. before it was discovered. It amazes me sometimes how absence of evidence is mistaken as evidence of absence.

[@PsychiatrySimplified]

True. It’s to say we rule out known causes that we can modify while knowing that there are many aspects we don’t know. We have to keep an open mind

[@projectvince1982]

Thank you for the good explanation!

[@PsychiatrySimplified]

Thank you for your feedback 🙏🏼

[@garywesthoven1745]

I am undergoing treatment for late stage Lyme Disease and have been reading everything I can about it. Tests I have undergone are not fully conclusive in confirming Lyme, which has led me to wonder if I’m not right in the head, as many with Lyme do. I read many articles where researchers suspect a connection between Lyme, Parkinson’s, Alzheimer’s, Chronic Fatigue Syndrome and other such degenerative diseases, so I watched this video with interest, wondering if an auto accident may have played a role in my condition of the past 8 years or so. Is my condition Lyme, CFS, or just in my head? Geez, for a straight answer to that!

[@elizabethread6878]

For those on benzos.. is there another medication that can calm the nervous system the way they do since they are not good to be on long term? Also since benzos are nervous system depressants.. do they calm both an over active parasympathetic as well? Obviously they calm the sympathetic. Thanks!

[@larryc1616]

Magnesium glycinate, kava kava, l-theanine, valerian root, medical marijuana THC/CBD

[@elizabethread6878]

@@larryc1616 thank you. I think people need to be careful with thc. Always made super anxious back in the day so wasn’t a fan!😂

[@larryc1616]

@@elizabethread6878 THC never bothered me when I was healthy because I was a light social user. Now with CFS, I need to combine it with CBD or it makes me anxious and wired. I only use THC 1 hour before bed only. CBD alone is not enough for sleep. Other patients swear by sativa or indica, but neither works for me during the daytime as it just adds to the brain fog and fatigue.

[@elizabethread6878]

When feeling farigued and tired like your body /brain is shutting down, watery eyes and what feeling like too Much parasympathetic activity is that typically a lack of , stimulation in the frontal lobe? It feels like there is a blood flow issue as well like blood is not circulating properly up to the upper part of my body even laying down.i acrually can feel it pooling in my upper arm under near my arm pits in a crash.

[@PsychiatrySimplified]

Sorry to hear. Yes frontal lobe symptoms can include mental fatigue, cognitive issues, depressive symptoms.

[@estanard]

Affordability is THE number one problem. Even if practitioners aren’t entirely informed, they can help at least some. But so few of us can afford anything more than basic care. Until practitioners address the extreme poverty in the richest country in the world, we’ll continue to be chronically ill. Lack of education is not the biggest issue.

[@PsychiatrySimplified]

Good point

[@arizonahighways7287]

I'm so ill with this after decades that I can't even keep one appt with a doc, no way diff disciplines. I need a doc to come to me like in the old days. Incidentally, about 10 yrs ago I was given percocet for an MRI diagnosis of two ruptured discs- degen disc disease and spinal stenosis. Those pills has the side effect of giving me back my strength and energy. No other opiate had the same affect but good luck obtaining that drug

[@PsychiatrySimplified]

Sorry to hear.

[@susanbrush758]

Have Hyperadrenergic POTS & this form has TOO HIGH Norepinephrine, Dopamine so taking Stimulants would further increase catecholamines causing harm. Also Hyperadrenergic Pots has HIGH Blood Pressure vs Low Blood Pressure & often scary high Bp Spikes so Midodrine would further increase Blood Pressure and not good for Hyperadrenergic Type Pots

[@susana5052]

Sir, please help. I was told by nurses, acupuncturist, chiropractors, and friends that work in pharmacies, that if you take supplements such as vitamin D, C, all the Bs and any other supplements, they CAN NOT BE MAN MADE. If they are man made they will not absorb it the body. The vitamins & supplements may show in blood panels aka tests but not absorbed in the body. People, especially with MS/CFS must have their vitamins and supplements from a natural and stable source. CAN YOU OR ANYONE direct me to a brand, place or WHAT VERBIAGE I need to find that shows it’s a “natural” source of vitamins and supplements that will absorb in the body??? I discovered that taking a man made vitamin D can show on panels that you have great levels of vitamin D BUT it is only in the bloodstream and does nothing for the whole body. Please do not say eat healthy in order to get the vitamins and supplements needed. Unfortunately in order to get those vitamins and supplements needed I would have to eat an astronomical amount of food. That’s due to soil erosion and many other things that are out of my control. In addition I don’t think I can eat that much food. I’m 5 foot tall and 98 pounds. I eat all day long but could never eat as much food to get enough vitamins and supplements especially to help ME/CFS.

[@PsychiatrySimplified]

Thank you for sharing. It's difficult to give individualised advice as there are so many variables to consider. Vitamin supplementation on it's own is unlikely to address the condition as a whole. Discussing this with a medical professional may help.

[@susana5052]

@@PsychiatrySimplified I want to thank you for your reply. I wish they did help but they don’t. Truth. It seems like doctors want to keep you sick so you can keep taking medication. There’s no cure in their plan. I’m screwed.

[@lizblock9593]

Good stuff. Unfortunately, American medico/pharmaco/insurance complex is sicker than I am.

[@ladymuck2]

If you know all this why can’t we get this investigation and help from the NHS?

[@PsychiatrySimplified]

Very difficult question to answer - systems are different across different countries and even within countries. Bringing multiple specialties together in this condition is often a challenge in clinical practice.

[@RoxieWank]

Which doctor is in charge of solving the CFS problem when multiple doctors are needed?

[@PsychiatrySimplified]

Usually depends on the predominant symptoms. As a clinician with neuropsychiatric issues I take the lead with expertise added on depending on aspects that need reusing out.

[@cyyoung9175]

Hi Doc Boy have you hit it out of the ballpark with your presentation!!. Wondering how the anhedonia , limbic system , dopamine disorder etc. can explain the fact I have zero euphoria with opiods? Even when given Fentanyl patches in ICU (sepsis) I never said I was needing something for pain so picked them off of me until nurse caught me ! Anyway as you know without euphoria from my meds maybe provides protection from addiction . What do you think ? Decades with Cfs/ fibro and feel fairly well managed with tramadol bid. Thanks again for your interest in cfs/me.

[@PsychiatrySimplified]

doc boy! (: Opioids can have variable reactions with many. Also, opioidergic tone follows a Goldilocks effect - too low and dysphoria, pain etc ; too much and emotional numbing and sensitisation to reward (blunting / anhedonia). . Of course difficult to say - but tramadol has a SNRI effect (so has this additional DA and NA action which helps with cognition/ activity and reward.

[@PsychiatrySimplified]

This latest video may help where we unravel the complex connection between dopamine, endothelial dysfunction, cerebral blood flow, and the autonomic nervous system, shedding light how they mediate the symptomatology in these conditions. kzbin.info/www/bejne/mnrWoal_gtymaLc

[@dansmith9724]

Testosterone is never mentioned especially for men. It can help improve low dopamine. It's very good for improving general recovery from activity/exercise and possibly reduce pem. It increase nitrogen which improves muscle recovery. Testosterone also improves glycogen storage and creatine phosphate storage. These nutrients help improve energy and recovery. Testosterone also improves neural drive so increasing energy directly. Most men with chronic illnesses and men with cfsme have low Testosterone and are in a catatonic condition ie a tissue wasting disease. Once you are on top of infection immune side of cfsme, testosterone can replace many psychiatric drugs like antidepressants used for depression and anxiety in men. Sorry I'm referring to men but I'm sure there's good drs who can optimise female hormones to help treat symptoms of cfsme. The other thing is adrenal hormones such as dhea and pregnenolone are also important to replace and can also replace psychiatric medicine. I'm not against psychiatric medicine but hormones should come first.

[@PsychiatrySimplified]

Hormones are important and testing is done as part of overalll picture . However in treatment in moderate to severe cases hormones alone are unlikely to address the entire picture. They can be useful in Sx like brain fog, fatigue in both sexes if at milder end . . I’ve written about neurosteroids as a whole here psychscenehub.com/psychinsights/neurosteroids-in-psychiatry/

[@dansmith9724]

@PsychiatrySimplified thanks, I've saved that page to have a second read through. I've had more success replacing pregnenolone, dhea and later testosterone compared to using antidepressants. I'm not against antidepressant use but have found I just get the side effects but see it some people they work well. Have you done any videos or articles on restorative sleep in cfsme? Thanks👍

[@PsychiatrySimplified]

Here is a new video release where we unravel the complex connection between dopamine, endothelial dysfunction, cerebral blood flow, and the autonomic nervous system, shedding light on how these seemingly unrelated elements interact to influence these conditions and mediate the symptoms kzbin.info/www/bejne/mnrWoal_gtymaLc

[@djVania08]

Did you test T with your GP?

[@john316-tetelestai]

Thank you for your videos.Blessings to you

[@markmooch]

Did you ever do the follow up that you mentioned you were working on doc?

[@PsychiatrySimplified]

The follow up video? If that's what you mean 👉kzbin.info/www/bejne/mnrWoal_gtymaLcsi=4jZyh0V00EwAah7X

[@elizabethread6878]

What do you recommend for fatigue and when you barely moving your hr shoots up even laying down? And for crash symptoms triggered by every thing you ingest, food and meds, doesn’t matter what kind.

[@elizabethread6878]

Do most psychiatrists know all this about cfs or do you think they will be open to watching this and treating accordingly? Most don’t trust anything except large academic facilities which DON’T study cfs.

[@PsychiatrySimplified]

We are hoping this changes - we have developed a 10 hr course. the main issue is the split between medicine and psychiatry when the brain and body are connected.

[@liam.4454]

I've tried all the Cfs therapies and treatments and I've declined each time I've done one, it's wierd, I feel so confused

[@PsychiatrySimplified]

It’s really difficult to answer this. In CFS - it’s about targeting a Sx with appropriate pharmacology. In most cases there isn’t one Rx that targets all Sx hence augmentation is needed. For example a stimulant can target fatigue but can worsen sleep so full benefit is not obtained. Hence targeting sleep first and then prescribing a stimulant is more likely to help. This is only one example and may not apply to every individual. It’s not medical advice .

[@justinebourke-ih9zh]

I waited almost 5 years to see a rheumatologist who diagnosed me with fibromyalgia after 15 minutes ( all he did was the point pressure test and about 5 questions at most that were not the most relevant in a scale of priority..I asked him if perhaps it was CFS because chronic fatigue and insomnia are my biggest symptoms for the past while. He said definitely not, those with that syndrome can and will sleep more than most.. I know he is useless to me, but who do I see for proper diagnosis? Psychiatrists here are not interested in holistic health, they know nothing much about it. General Practitioners here are the same and also refuse to do anything other than the routine, insufficient bloodtests.

[@PsychiatrySimplified]

Sorry to hear. Here is a detailed account - . psychscenehub.com/psychinsights/chronic-fatigue-syndrome-myalgic-encephalomyelitis/ The most appropriate doctor to see is one that will listen and look at the entire picture. the mechanisms behind fibromyalgia are similar - one can address both irrespective of labels. On the website we have also covered fibromyalgia and a physician has specifically outlined strategies that may be helpful in discussion with your doctors.

[@justinebourke-ih9zh]

@@PsychiatrySimplified thanks for the prompt reply and information. I guess finding a competent doctor is the challenge I face , beyond doing all I can to stay healthy day to day.

[@PsychiatrySimplified]

Here is a video we released where we delve deeper into the brain connection with endothelium , ANS, the role of mast cells etc. kzbin.info/www/bejne/mnrWoal_gtymaLc

[@joyllywoodb5402]

Are there really no other conditions that highlight mind and body in a similar way to cfs? MS? Parkinsons? Isn't trauma also present and contributing to other illnesses? Or is it just that cfs is more of a mystery? Thankyou Dr. Sanil for your dedication and understanding. We really appreciate you

[@PsychiatrySimplified]

The majority of conditions in medicine involve mind and body. See the videos on APS ( Hughes syndrome) , autoimmune encephalitis - this are examples of how the brain and body are closely linked. Thanks for your feedback.

[@PsychiatrySimplified]

This latest video may help where we unravel the complex connection between dopamine, endothelial dysfunction, cerebral blood flow, and the autonomic nervous system, shedding light how they mediate the symptomatology in these conditions. kzbin.info/www/bejne/mnrWoal_gtymaLc

[@elizabethread6878]

Also the Alpha Stim device for those crashing from medication (likely not treated properly to stop this) but..couod you explain how that device works?

[@PsychiatrySimplified]

coincidentally the next video being released is on TMS - I show the actual application and mechanism. Stay tuned

[@elizabethread6878]

@@PsychiatrySimplified thank you. Will be watching for it and the next cfs video. Will you be speaking at all in the video how tms may help cfs? It seems a risk to try it but for those of us really needing help it may be worth it. Also, are you familiar with the at home alpha stim device?

[@Truerealism747]

But when we have àspergers ocd from.birth albeit undiagnosed until midlife after sins diagnosis even though i saw syche as a chuld for depression it wasnt picked up.whats the treatment when its asperger's add heds causing it

[@elizabethread6878]

What are your thoughts on LDN for calming the limbic system down? Can it work for anxiety and being set off by tiny things? For helping a “crash?”

[@PsychiatrySimplified]

There is some evidence for LDN in CFS but if one is very wired or agitated it does not provide optimal control. It can help with pain and inflammation overall.

[@elizabethread6878]

@@PsychiatrySimplified thank you! That video was amazing you linked! Many psychiatrists just give antidepressants for anxiety but it is not working for calming my limbic system and autonomic nervous system. Do antipsychotics work on the limbic of frontal ?

[@PsychiatrySimplified]

@@elizabethread6878 they work on both frontal and limbic Especially the second generation antipsychotics- please see video here. Although on, schizophrenia - it shows how AP work. Understanding Schizophrenia - Linking Neurobiology to Clinical Symptoms kzbin.info/www/bejne/rXmvdmmKibGbfK8

[@justinebourke-ih9zh]

What about metabolic disorders , parasites and microbiome of the digestive tract and brain?

[@PsychiatrySimplified]

Can also lead to a similar profile e.g Mitochondrial dysfunction. covered in detail here. psychscenehub.com/psychinsights/chronic-fatigue-syndrome-myalgic-encephalomyelitis/

[@justinebourke-ih9zh]

@@PsychiatrySimplified thank-you very much

[@squashscience]

Good on you mate! I (myself) as a patient have been assembling my OWN medical team (cancer, cardio, psychiatry, Sleep, etc.) & researching since ZERO help in last 4 years. Great framework:) The ONLY thing that helps me is Low Dose Prednisone which I use in weekly cycles (5-5-3-1-0-0-0) which nobody will prescribe (pass the buck:) Next up: I'm going to check out LDN as sub for prednisone. Thank you so much! (B-Cell depleted, ragweed allergic, brainfogged ADHDer:)!

[@cyyoung9175]

Hi squash are you longhauler? I doubt if here in U.S.A.I would find a doc to write for prednisone for my fibromyalgia but who knows. Are you an Aussie bloke?

[@elizabethread6878]

Is it better to use a mood stabilizer /antipsychotic or one of the adrenergic Medications to calm the limbic brain? Considering if you have pots and also very unstable mood. Sorry for so many questions. I’m finally starting to underhand and just need to find a psych willing to help.

[@PsychiatrySimplified]

One can conceptualize it as a hierarchy with regards to action on ML system. Benzodiazepine - mild. Alpha 2 - mild but more than BZD. Mood stabiliser - moderate. AP- strong. A clinician this uses the properties of medications either alone or as combination depending on the severity. Ps not medical advice. Hope this helps

[@elizabethread6878]

@@PsychiatrySimplified this is very helpful! Benzos tend to help me not crash as badly so I’m not sure what that means really. I posted another about blood follow to the brain in a crash and the fatigue /shut down. It’s interesting the benzo was helping crashing. It’s so hard to know when taking something to calm you more when you feel your body and brain are shutting down and you feel terror like you don’t feel familiar with anything around and thinking feels too stimulating

[@elizabethread6878]

@@PsychiatrySimplified and if you have severe depression and cognitive issues as well and anxiety all mixed up over the place .. would that mean a mess limbic calming med would he used along with antidepressant?

[@andybreedlove]

@@elizabethread6878 same - how have you been? What’s worked?

[@elizabethread6878]

Also what makes you so different from other psychs? I am trying to find one in the us with your knowledge. Forums don’t work bc in the us there is a very general treatment of cfs. ldn or abilify. Are there specific types of psychiatrists we should be searching for? Also, do you work with patients in the us?

[@rndm4642]

This isn’t a definitive answer but perhaps seeking out an integrative psychiatrist would fit.

[@elizabethread6878]

@@rndm4642 how do uou did those? Like dr Amen? Any other ideas?

[@elizabethread6878]

@@rndm4642 i have been looking acruallt

[@cammag4619]

I've had Trauma and severe infection. Misstrust becose medical gaslighting. Hypotyroid, POTS, big rashes that seems like MCAS. How do you know where it comes from?

[@user-jc4du1xf8e]

I want to listen but I am so tired right now. Thanks for sharing.

[@Truerealism747]

Watching your new short on amagadalia cauding lot of problems it diesnt say hiw to cure it it also.includes sleep apnea you say

[@lazchurchyard1229]

Newest research: this bedbound person needs at least 6 types of doctors to all work together. Insurance company: lol

[@elizabethread6878]

What would you think would be helpful to someone who has a crash or sorts from anything they eat or medicine they take. How would you go about getting this under control? This has been happening for 2 years now and i haven’t been able to improve because of it. Comes with severe anxiety and depression or rage. Not medical advice i know.

[@PsychiatrySimplified]

Really difficult to say without a full evaluation. Any comments would be pure speculation and not helpful.

[@elizabethread6878]

@@PsychiatrySimplified ok. A psych evaluation? I’ve been evaluated by neurologist, cardiologists, immunology, infectious disease and only thing that downs up is pots and one said cfs. Also my psych has tried to help with ssri which crashed me but helped my focus and mood some and Ativan which is the only thing that’s really helped the crashes form food. I don’t know what else to do or who to see?

[@PsychiatrySimplified]

@@elizabethread6878 i can;t directly give advice but in the video, I have outlined the medication combinations that can be considered. Here is an article on Fibromyalgia - in the treatment section you can read more on how to address DA and NA aspects in different parts. References provided. this will answer your questions Although it's Fibro- the same principles for CFS. as often they coexist. have covered the same in the video but recognise that it might take a bit to get head around. psychscenehub.com/psychinsights/neuropsychiatry-of-fibromyalgia-etiology-and-management/

[@elizabethread6878]

@@PsychiatrySimplified thank you!! Just is i know what is DA and NA? Thanks again! I’ll watch there video. .) thanks for being so patient with me . I can’t tell you enough how wonderful uou are.

[@PsychiatrySimplified]

@@elizabethread6878 No probs. Noradrenaline and dopamine.

[@bettercallm7md318]

Doc I feel that am suffering hard of that , which specialist should I go to?

[@PsychiatrySimplified]

Sorry to hear. It’s best to speak to a general physician or GP who can then guide you depending on the range of symptoms. Wish you well

[@stariadreamtea]

Thanks

[@PsychiatrySimplified]

You are welcome 🙏🏼

[@godofallgodswithnoothernam920]

D ribose and chromium and vanadium are good taken together. D ribose is a mitochondria sugar, which lowers blood sugar, but brings blood into cells where they are used for energy. Chromium and vanadium just makes insulin and insulin sensitivity which reverses type 2 in three months on their own, without diets changes, yet also helps in type 1 ofcourse due to those above mentioned modus operandiis. Type 1 benefits from intravenous D-glutamic acid (this protien has the potential to alliviate half the type one condition. Yet golden seal and chromium and vanadium and d ribose and d-glutamic acid intravenously (pubmed). Works the best. I must say this though, a fecal transplant from a predominantly raw whole food plant based eater has great potential. Otherwise probiotics.

[@tnijoo5109]

Does Adderall help?

[@PsychiatrySimplified]

We've covered the mechanisms here in more detail - so it may answer your question. See stimulants later in the video. Ultimately it's all about targeted treatment kzbin.info/www/bejne/mnrWoal_gtymaLc

[@elizabethread6878]

What type of flushing comes with the mcas? Where on the body?

[@PsychiatrySimplified]

Could be anywhere as it’s skin flushing. But many will feel it on face.

[@elizabethread6878]

@@PsychiatrySimplified i do get that when i am crashed bad or symptoms are bad. I wasn’t sure if it is related to pots or mast cell.

[@elizabethread6878]

@@PsychiatrySimplified i get it on stomach . All red and warm. Didn’t know if it was blood pooling

[@clarissericardo2313]

Do you do zoom consultations? Thank you

[@PsychiatrySimplified]

Sorry due to medicolegal reasons unable to do so. Wish you well