Weekly recovery guidance for ME/CFS and related illnesses.
- s-porter4
- Jul 14, 2025
- 2 min read
Weekly inspirational quotes, guidance & tips to support recovery from ME/CFS, Long Covid, Fibromyalgia and related illnesses.
Week 9 - 14/7/2025 (Post 12)
"Why do people get PEM?"
A phrase commonly used in the ME/CFS, Long Covid and Fibromyalgia world is Post Exertional Malaise (Often abbreviated to PEM). So what is PEM, what is actually going on in the body and what can we conclude about why this is happening?
This is what we do know.
People with these and other related conditions experience a significant increase in symptoms. These can develop suddenly, or there can be a delay of a day or two (Sometimes even longer).
People are generally able to link the rise in symptoms to a particular event, period in their life, or to a decision that they have made, but not always.
The rise in symptoms will nearly always happen as a result of one or more of the following.
1. They have experienced an extra degree of stress. This may not have been handled as well as possible. 2. They have pushed themselves too far, too quickly, beyond their baseline.
3. Pushing may arise from increased physical, mental, or emotional exertion. Often a combination of all three.
From research, work with clients and my own personal experience, I cannot accept that the body has run out of energy (a belief held by some). The energy must be there somewhere! It makes no sense to say that you have used more energy that you actually have. However, there is no doubt that this can leave people with extreme pain and a very high level of fatigue.
So what is going on?
The nervous system is already in a hypersensitive, dysfunctional state and the brain is constantly scanning for danger. It will protect at all cost. That is it's primary function. PEM then arises from a situation that the brain considers dangerous. This might be accurate, but often it is operating off misinformation.
The challenge when it comes to good levels of progress and recovery is to avoid serious PEM. This is far from easy, but not impossible. The key is not to shock the brain too much. It could set you back a long way and the brain will then need even more reassurance that you are safe.
Keep going. Recovery is very real.
Until next week
Stuart
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