How to manage PEM using a mind-body approach (CFS, Long Covid, TMS)

[@LastSongOfTheNight]

Thx. I've gone from 5 tough hikes and 6 workouts a week to struggling up 20 stairs. This is very useful. You are a kind and honest soul.

[@Rising497]

PEM is the one thing that makes me doubt about mind body as it feels like it’s “proof” my body is “broken” so thank you for this. Really helpful.

[@mindbodyintegrate]

I'm glad the video has been helpful :)

[@genevievebaril4746]

I believe that the physical findings of PEM are generated by the CNS or ANS. Which can also cause muscle clots necrosis etc. My scientific analyse would explane it thus way

[@Rising497]

@@genevievebaril4746 very reassuring. Would love to hear more

[@gitteodk]

Amazingly good explanation of the flare ups of symptoms👏👌🙏❤️

[@j0e1s2s3]

Really helpful! Once I saw PEM as a regular mind-body symptom flare-up, things have so much improved. PEM just like any other mind-body symptom can shift and leave the body very fast. It's a lot about knowledge, mindset and thoughts. Think psychologically not physically!

[@dougmorse]

Thank you for this great video. I think it's important to talk about the length of time PEM occurs. I found if I knew the length of time it would last (which became predictable if I did the same routine) the time would eventually reduce and I'd know when I could do the activity again. At one point my PEM after 10k steps was three days, but eventually moved down to one and then none. Then I knew I could manage, and begin to increase exertion either in step count or incline.

[@healingjourney722]

Thank you! Content on PEM is so helpful because like you said it’s not mentioned as much as pain and this can be such a blocker to handling it well.

[@Josh-if7to]

Anger seems to be the biggest trigger for me, not sure how to move past out other than gradual exposure to situations that would bring up that emotion.

[@julianamoreno2846]

what techniques do you use?

[@me-cfs-strategiesforhealing]

PEM is caused by the lowered anaerobic threshold in ME/CFS which is itself driven by low blood volume, microclotting, and autoantibodies against Beta-2 receptors that limit blood perfusion into the muscles.

[@ezza1236]

No you are just a very weak victim

[@Meowshra]

The mind/body perspective holds that the biophysical manifestations are THEMSELVES a symptom of a nervous system that is responding to a perceived threat. For example, limited blood perfusion may be the proximal cause of muscle fatigue, and autoantibodies may be an intermediate cause, but the ultimate cause is a mistaken or stuck "danger signal" in the nervous system that perpetuates all the biophysical cascades. By using a mind/body approach to address the perception of danger on the conscious level, we influence the unconscious processes to stop the symptom cascade at its source.

[@stephanieduguay3786]

@@Meowshrawow, such a clear explanation, thanks

[@me-cfs-strategiesforhealing]

@@Meowshra That may - and does - work for some people. For others, the secondary dysfunctions may be so strong and embedded that brain retraining can't shift them. Also the secondary dysfunctions, once established, will feed back into the primary ANS dysfunction: eg low blood volume will stress out the brain further. There are plenty of people who do brain retraining and don't recover, all the while being told that the ANS dysfunction is the only thing that is wrong with them.

[@OptimisticPessimist33]

​@@me-cfs-strategiesforhealingGreat explanation. I agree that viewing everything as a reaction to a danger signal from the nervous system is too simplistic. It's logical that if, for example, you have been lying awake all night because of CFS/PEM that your physical capacities are going to be reduced.