Managing Stress in ME/CFS

The latest theory about CFS/ME has issued from research by Harvard University and the Center for Disease Control. It points to faulty genes, those which control the body's reactions to accumulated stress and to unusual proteins in the spinal cords of ME/CFS patients. Once someone has ME/CFS, stress certainly exacerbates the symptoms and interrupts recovery. Many patients report high levels of stress before onset. We robustly reject a psychiatric approach to ME/CFS but recognise that managing stress better is part of the recovery regime. However, we hold that stress management (e.g. cognitive behavoural therapy) by itself, does not aid recovery from ME/CFS nor will it aid the complex healing because ME/CFS is physical not mental. It requires dietary and allergy treatment (and other measures set out on this website).

Whether genetics are the direct cause of ME/CFS, whether the effects of accumulated stress exacerbated by genes, or some other factor relating to the immune system is the cause of ME/CFS, remains to be discovered. This latest research certainly proves that the condition is not "in the mind". Instead it is in the genes or, at least, one predisposiing factor is in the genes. So a very important part of recovery from ME/CFS is to learn stress management. To be able to react to stress in a way that is positive rather than negative must become part of the ongoing lifestyle of patients with ME/CFS.

A successful way of managing stress, in the short term, is listening to music (as set out on our Music page).But there are also other approaches to stress which will start to put ME patients on the path to eventual freedom from the negative effects of stress.

Try starting to identify and control stress by taking the Holmes Rahe Stress Test. Illness itself can create serious stress. this is part of the suffering. Additional troubles like divorce or unwanted separation in ME/CFS will add to that. ME/CFS can create more stress in areas of relationships and finances, even though it protects against other kinds, like overwork. But always remember that time heals: if one holds on, things will get better. Also remember that if someone leaves you in ME/CFS, you are not to blame, particularly if the illness is genetic. It is just a fact of life and a question of levels of values and commitment in your partner. It is our belief that a partner who is a committed Christian is less likely to abandon their spouse in ME.

Our approach to stress is Christian. It is based on seeing our reactions to stress as part of "who we are". There is no right and wrong way to react to stress, just a unique way. We are all differently made. If we accept that we are all made in the image of God, it may be that the genetic "failures" of ME/CFS are put there by God to develop other spiritual qualities, that could be developed in us in no other way.

Sources of Stress

Stress occurs in our minds, not in our outer circumstances. Stress is all about how we see something and seeing something in a different light can eradicate stress.

For example, I was visiting some Italians. It was Easter Monday and one o' clock, the time at which the whole of Italy sits down to eat lunch. Italians are rightly more precise about shared meal times than northern Europeans. We had taken the bus - but the bus did not come. We were still at the bus stop at two pm. Everyone got stressed, except me. This was because I had no "conditioning" or "expectations" about when to eat lunch. Over lunch, at two thirty, I pointed out that the stress had come from the expectations about when lunch should be. All that was required was an adjustment in our thinking. In the same way, we need to think more flexibly in ME/CFS, to avoid putting extra stress on ourselves through expectations. Be kinder to yourself in ME.

Stress is also caused when there is a gap between expectation and reality. So stress management could be seen as "expectation management".

Stress is caused when there is:

a) a sense of personal inadequacy (handle this by recalling successful problem-solving in the past or better, asking God to guide you)
b) a lack of control in a certain situation (handle this by seeing stress as a challenge - not a threat. Better advice is to pray)
c) lack of a coping mechanisms to face the challenge to our status quo or expections (handle this with patience and faith)
d) restricted "space" to find solutions through other resources (oppressed by the expectations of a dominant parents etc)
e) exaggerated expectation of life or of others (handle this by putting expectations "in perspective" and accept the will of God).

Stress is often caused when we have framed our own self-centred expectations outside the will of God i.e. we have not sought His will for our lives. We may have automatically "assumed" certain things but our dreams and expectations do not guarantee that they will happen according to our own, neat ideas. For example, some people have no "Plan B" in life and this causes them stress. They may have assumed that we would find a "life partner" without knowing that up to 50% of people now live most of their lives single. Start by making adequate calculations and do some background research.

Others may have expected a top job, which someone else got without honestly facing the fact that the stresses of the job would have not suited our personality.

Others, often single women, feel vulnerable all the time and imagine that being in a secure partnership would solve "free-floating anxiety" for them, little realising that marriage brings other, equal stresses. We must see things in a larger picture, not always related to us at the "centre of the Universe". The gap created by false or high expectations can in itself cause constant "free floating anxiety", over which we cannot get a grip. We need to "unwrap" ourselves, layer by layer, and take a look at what is going on underneath. Often we are the ones causing our own stress!

Stress may be caused by traumatic events. We may have been assaulted, physically or emotionally. We may have been bereaved or divorced. We can do little about these, except wait. Time heals most traumas in time, though it may take up to ten years. Prayer and patiently waiting is the best way of handling the worst traumatic stresses in life.

"I am not Superhuman"
According to the Bible, suffering, tears, loss and anguish are an integral part of this earthly life, from which those who trust in Jesus' death for sins on the Cross, will be released in eternity. Scripture states that "all our tears are in His bottle", that God has compassion on all our stresses and woes. Genesis says that Man is made from the "dust of the earth". Psalm 103 says that "God knows how we are made". In other words we are very frail and must not expect ourselves to be "superhuman". Stress is unavoidable in life and it will take its toll on us. All we can do it learn to how to handle it a little better. The Bible never suggests that life is easy and stress-free. In fact it states categorically that people have trouble all their lives. Jesus says that each day has "enough trouble of its own" and that worrying about events further ahead is sin. We must not expect a stress-free life but we must not pretend to ourselves that we are more than "dust". There are limits to what we can expect to do and achieve as one person.

Understanding Panic
Panic ("fight and flight") is a God-given mechanism to gear up our reactions so that we can "give our best" in certain situations, whether it is escaping from a fire, or singing in public on stage. So panic is not a bad thing in itself. The only thing that makes it bad is when certain personality or genetic types cannot switch panic reactions off. Then they start to damage the immune system, which may already be depleted by a poor diet and genetics. Handle this with stress management techniques.

Pattern of Positive and Negatives in Stress
The pattern goes like this: stress leads to mental turmoil which leads to learning and self knowedge which leads to problem solving and growth and this leads to fatigue. There is a mixture of "positive and negatives". The positive sides of stress are learning, self-knowledge, creativity and problem-solving. The negative is only "fatigue". If we see panic and stress not as if we are a ^victim" of it but as a challenge, we will reflect the reality better. I find this motto helpful: "I am not "a victim" of the negative sides of stress in my life: I am a beneficiary of the positive sides of stress".

The Cosmic/Spiritual Battle behind Stress
Some of us believe that behind some extreme stresses are unseen spiritual forces. There is a continual invisible "fight" going on between good and evil, falsehood and truth. If we are fighting for truth, we may be badly wounded in this spiritual battle. We may become, for some time, a "casualty". We will be "touched" by some injury in our bodies, minds, emotions and souls. However, God never allows truth-believers and seekers to be destroyed, even if they are almost "paralysed", for some time. The answer is to pray and wait on Him. God knows better than we do the causes of the wounds and scars we bear. They may be the direct result of this hidden Cosmic Battle of good and evil (remember C S Lewis's book "The Last Battle" which describes the culmination of this confrontation?). However our wounding may be the result of our own idolatry, unbalanced emotional reactions, guilt etc. C H Spurgeon, the great preacher, had little comfort for someone grieving over a lost love, if that love was, in fact, idolatrous i.e. one put the loved one before God. If we have been genuinely fighting on the side of God and have been invisibly wounded, then that is our "badge of honour". To fight for Gospel truth is to serve God. God may actually want us have wounds and scars. An ongoing illness is a severe wound but He can turn it to an opportunity to learn and grow. We have to learn to rely on His strength, not on our own. In order to do that, we may first have to be made weak.

Anger is a response to stress
There are two kinds of anger: righteous and unrighteous. Righteous anger is directed against injustice and oppression. Our regular anger is likely to be more about ourselves, our wounded pride and our worries (which is sin). One cause of anger is fatigue but we must not be too upset if we "blow our fuse" in ME/CFS. We are made from "the dust of the earth". We must not become a victim of ongoing anger or bitterness. We must not harbour anger overnight but calmly tell someone that we are upset with their "behaviours" (not with them), the same day.If someone repents we must forgive them and to be willing to forgive them at all times. This prevents ongoing resentment building up. See the pages on assertiveness.

Keep a Stress Management Diary
The first step to handling stress better is to understand what kind of personality we have, in relation to stress. We may not be able to make up for faulty genes in ME/CFS, but we can start to rationalise our reactions in the light of our frailties and specific personalities. Start to note down for one week: "What makes me least/most stressed?", "How did I react to stress?", "How should I react?". After a week assess how well you are adjusting to stresses and what you can learn about minimising the effects of the daily stresses that you feel most keenly. Always remember that the rule is : only do 70% of what you are able to until you are able to return to fll time work.

The Most Effective Treatment for Immediate Stress Relief
Lie down in a dark room in loose clothes with earphones gently playing Mozart (preferably sopranos singing duets). Listen for 20 minutes twice a day: Mozart is proven, scientifically, to calm the brain and to counteract mild "brain seizure" which seems to happen in ME/CFS.. Start breathing regularly (do the breathing exercises explained elsewhere if you want) and then concentrate on breathing out on the strong beat of the music, Visualise you brain neurons "firing" in line with the music (and not sporadically and chaotically). Imagine that your brain is operating in some ways in time with the music. Monitor yourself to make sure that you are just relaxing. Be sensible. Don't overdo this. Do not continue for longer than 20 minutes. You will feel really relaxed and more comfortable even after this short time. Make sure you do this twice a day, every day, to get the full positive effects.