Chronic Fatigue Syndrome
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I recently sat talking to a lady who had completed a free course for people with chronic health conditions provided by the local hospital. Her opinion was summed up as “It’s ok if you believe you can think yourself healthy”. It was not the time or place to question that, but it was interesting to hear her opinions. On the face of it the course had covered many of the things we include on our courses. However, this lady had obviously discarded much of the content as it had failed to open her mind to the possibility that her thoughts do effect her health.
The lady did go on to mention that at least one member of the group seemed to have their own agenda, interrupting others when they spoke and attempting to monopolise the conversation. This of course is the draw back of free courses put on by the public health system, by their nature they are open to anyone with the relevant condition, so it becomes a matter of chance whether you get a group of like minded individuals who support and revel in each others success or a group closed or scared of the fact that their thoughts and emotions effect their physical health.
Many people argue that if a process works it does not matter whether you believe in it or not, although that opinion is dis-proven by most drug research. For a change I wont go on to talk about the placebo effect but rather tell a story often told by those with an interest in hypnotherapy. In Auo. 23, 1952 the British Medical Journal printed an article entitled “A case of -congenital ictrhyosiform erythriodermia of brocq treated by hypnosis”. The article described how Dr Mason treated a boy who he believed had an extreme case of warts using hypnosis. The warts originally covered much of the boys skin, for example it was recorded that 80% of the boys arms were covered. However, 10 days after a session of hypnosis using suggestions that the skin would heal 95% of the arm was clear. Other areas of the body responded with vary success rates too. This in itself may not have surprised Dr Mason if it had not been for the fact that the boy did not have warts but a genetic condition known as congenital ictrhyosiform erythriodermia known at the time to be ‘untreatable’.
Interestingly I have heard it said that Dr Mason went on to try and help many people with that condition with far less satisfactory results. When asked about this Dr Mason believed that his lack of success with other patients stemmed from his knowledge that he was now treating a condition known to be ‘untreatable’ and the seed of doubt that created in his mind.
I do think that is a nice story and it goes some way to explain why we think belief in the process is important. Hence we do our best to ensure that by the time you get on one of our courses you have the belief that that you can improve and the course will help.
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Lets look at the science underpinning what we do. Because there is research underpinning our approach. Some of it mentions CFS while others mention ME but it is all relevant.
Whether ME and CFS are the same condition continues to be a contentious issue; there are those who state quite clearly that they are different. However, as frustrating as this is for those that believe and support this hypothesis, people in the UK are diagnosed by Doctors in the NHS where the guidance says ME and CFS are the same thing. So any studies that apply to CFS may also apply to those diagnosed with ME/CFS in the UK.
The myth that mental stress cannot affect health is simply wrong and outdated. There is now significant amount of evidence (*1) suggesting that stress responses can cause immunosuppression and other types of immune dysfunctions. We are not saying ME/CFS in all in the mind, far from it, we believe that ME/CFS is a physical illness with biological markers (see our other posts). However, it has become well recognised that our thoughts do affect our physical condition and can result in those biological markers. For example studies(*2,3,4,5) have found links between markers of oxidative stress and psychological distress. There have also been psychological factors correlated with DNA damage. (*6). Another study (*7) found that prolonged stressors interferes with our natural regulation of inflammation which is involved in many diseases. So there is plenty of evidence that mental stress, which is a thought process, physically effects us and long term is detrimental to our health. Research like that mentioned above has fuelled many articles such as: Stress May Be Tougher on Women’s Hearts Than Men’s, Stress, Inflammation and Cancer, chronic stress damages our DNA and of course most relevant are the articles that state physical, mental, and emotional stress exacerbate CFS(*8,9) There are also studies that suggest that the biomarkers associated with CFS/ME could be perpetuated by chronic stress(*10) . Other studies (*11,12) point out that stress has also been shown to cause changes in the immune system through the alteration of the ratio of T cells, lymphocyte proliferation, natural killer cell number and activity, and antibody responses. So the next issue is…
Can Changing thought patterns positively affect my health? This is often disbelieved by many CFS/ME sufferers as well as those suffering from other chronic illness, is becoming more scientifically believable all the time. The relatively new study of psychoneuroimmunology has shown that there is a relationship between the mind and the human immune system. For example one study(*13) found that the ‘relaxation response’ invoked by meditation, yoga, tai chi, Qi Gong or repetitive prayer etc positively affects DNA, with just 8 weeks of meditation changing the expression of 1561 genes. Many of genes expressed differently were were involved in cellular metabolism and in the body’s response to ‘oxidative stress’ and the researchers proposed that the ‘relaxation response’ via any method may counteract cellular damage due to chronic psychological stress. Another study(*14) found Mindfulness-Based Stress Reduction (MBSR) produces demonstrable effects on brain and immune function. However, while research suggests psychological stress is a perpetuating factors for ME/CFS (*15,16) studies on the effectiveness of various techniques to alter this situation are still in progress with various organisations working to gain more acceptable scientific evidence that support the vast amount of anecdotal evidence that is there.
Of course there are plenty of other hypothesis about CFS/ME, some believe its a virus, some beleive it’s caused by differences at a genetic level, but non of them have actually helped anyone recover. They are stuck studying the problem, rather than looking at similarities in those that have recovered.
So it seems that those sufferers of ME/CFS who are looking for more concrete evidence at this precise moment in time have to consider two options: You need to ask yourself whether it is preferable to
1) remain in your current situation, waiting for someone to prove to you that their hypothesis for CFS/ME is correct, or
2) recognise that there is a scientifically justifiable benefits for our programme and find out more.
If you are one of those that would like to know more we often run free webinars.
(*1) Pruett, S.B. (2003). Stress and the immune system. Pathophysiology 9, 133-153.
(*2)Irie M, Asami S, Nagata S, Ikeda M, Miyata M, Kasai H, 2001 Psychosocial factors as a potential trigger of oxidative DNA damage in human leukocytes. Jpn J Cancer Res 92: 367-376.
(*3)Irie M, Asami S, Nagata S, Miyata M, Kasai H, Ikeda M, 2001 Relationships between perceived workload, stress and oxidative DNA damage. Int Arch Occup Environ Health 74: 153-157.
(*4)Irie M, Asami S, Ikeda M, Kasai H, 2003 Depressive state relates to female oxidative DNA damage via neutrophil activation. Biochem Biophys Res Commun 311: 1014-1018.
(*5)Epel E, Blackburn E, Lin J, et al, 2004 Accelerated telomere shortening in response to exposure to life stress. PNAS 101:17312-17315.
(*6) Biol Psychol. 2006 Jun;72(3):291-304. Epub 2006 Jan 10.
The relation between psychological factors and DNA-damage: a critical review.
Gidron Y, Russ K, Tissarchondou H, Warner J.
(*7)Cohen S, Janicki-Deverts D, Doyle WJ, Miller GE, Frank E, Rabin BS, Turner RB. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proc Natl Acad Sci U S A. 2012 Apr 17;109(16):5995-9. Epub 2012 Apr 2.
(*8)Toni Whistler, James F Jones, Elizabeth R Unger and Suzanne D Vernon, Exercise responsive genes measured in peripheral blood of women with Chronic Fatigue Syndrome and matched control subjects, BMC Physiology 2005, 5:5 doi:10.1186/1472-6793-5-5
(*9)Jens Gaab, PhD, Dominik Hüster, MSc, Renate Peisen, MSc, Veronika Engert, BSc, Vera Heitz, BSc, Tanja Schad, BSc, Thomas H. Schürmeyer, PhD, MD and Ulrike Ehlert, PhD, Hypothalamic-Pituitary-Adrenal Axis Reactivity in Chronic Fatigue Syndrome and Health Under Psychological, Physiological, and Pharmacological Stimulation, Psychosomatic Medicine November/December 2002 vol. 64 no. 6 951-962
(*11) Vegard B Wyller, Hege R Eriksen and Kirsti Malterud Can sustained arousal explain the Chronic Fatigue Syndrome? Behavioural and Brain Functions 2009, 5:10
(*12) Marketon & Glaser, 2008 [ref]Marketon, J.I.W., & Glaser, R. (2008). Stress hormones and immune function. Cellular Immunology 252,16-26.
(*13) Dusek JA, Otu HH, Wohlhueter AL, Bhasin M, Zerbini LF, et al. (2008) Genomic Counter-Stress Changes Induced by the Relaxation Response. PLoS ONE 3(7): e2576. doi:10.1371/journal.pone.0002576
(*14) Richard J. Davidson, PhD, Jon Kabat-Zinn, PhD,Jessica Schumacher, MS, Melissa senkranz, BA, Daniel Muller, MD, PhD, Saki F. Santorelli, EdD, Ferris Urbanowski, MA, Anne Harrington, PhD, Katherine Bonus, MA and John F. Sheridan, PhD Alterations in Brain and Immune Function Produced by Mindfulness Meditation, Psychosomatic Medicine July/August 2003 vol. 65 no. 4 564-570
(*15) Maes M, Twisk FN. Why myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) may kill you: disorders in the inflammatory and oxidative and nitrosative stress (IO&NS) pathways may explain cardiovascular disorders in ME/CFS. Neuro Endocrinol Lett. 2009;30(6):677-93.
(*16)Maes M, Twisk FN.Chronic fatigue syndrome: Harvey and Wessely’s (bio)psychosocial model versus a bio(psychosocial) model based on inflammatory and oxidative and nitrosative stress pathways. BMC Med. 2010 Jun 15;8:35.
There is a nice blog on Edie Summers and her experience with CFS/ME <a href=”http://thedeliciousday.com/health/chronic-fatigue-syndrome-cure/#comment-2200″>here</a>