M.E. for short, is a strange and tragic illness. The history of medical attitudes towards ME highlights the incompleteness of scientific understanding of the human body.
The problem of ME still inspires controversy because of a battle between medical schools of thought. Clinicians believed they understood ME's causes and treated it appropriately, only to discover that their understanding was flawed and their treatment protocols were harming patients and not helping them. Due to the tendency to brush over failure in the UK medical establishment, this problem took a long time to get official governmental recognition here, which it now has. The scientists who recognised the problem had to argue their case with the less progressive members of the medical establishment to make the case of ME patients heard above the din of presumption and prejudice.
ME was first recognised by the press as "yuppie flu". While ME often starts with a flu like illness, it is certainly not limited to yuppies, nor to any particular sex or race or age group. However the treatment people receive when they complain of ME symptoms is influenced by their social setting and the attitude and depth of knowledge of the person they are complaining to.
ME seems to result from the immune response to a virus which gives the sufferer chronic symptoms only partly related to the initial infection. Often an ME patient will have a history of viral illness like glandular fever or viral meningitis and if not then commonly reports a bout of flu like illness prior to onset. In addition to this an allergic tendancy is common, if not before the onset of ME, then afterwards. Further effects on the immune system can alter its effectiveness in combatting other diseases allowing recurrent opportunistic infections to cause further illness, which has been called chronic fatigue immune dysfunction syndrome (CFIDS) by some. These chronic opportunistic infections can exacerbate the whole syndrome considerably.
Direct effects on the nervous system seem to explain many of the more unusual symptoms. The effects of ME can disrupt the autonomic and voluntary nervous system to an unpredictable degree, sometimes causing bowel disorders and skipped heart beats. It will often result in muscle and joint pain including a sensation of painful weakness and cramps. The patient's ability to respond normally to stress is noticeably altered by the onset of the illness, perhaps due to direct interference with the nervous system. This is the basis for the facetious description "yuppie flu", as young upwardly mobile professionals stereotypically thrive on stress and this illness makes that lifestyle pretty much impossible.
The symptoms of ME have a neurological bias and range, in my personal experience and from talking to others, far beyond the perpetual fatigue which earned it a place among chronic fatigue syndromes (CFS) in the medical literature. Neuralgic pain and discomfort in muscles, joints and nerves is common, as is hypersensitivity to stimuli of all sorts eg smell, light and sound in particular. Cognitive disorders and emotional changes such as might be expected with a bout of flu or fever are commonly reported and also increased allergic responses eg asthma, hayfever or eczema. However while flu lasts a few weeks, ME lasts months at the least and often lasts years and in some cases is perpetual.
ME can effect different people in different ways and to different degrees. The symptoms of an individual may change over time through various combinations of those mentioned. While the severely effected may be bed bound in considerable discomfort, the less severely effected may be able to lead an almost normal life. The phenomenon causing these symptoms has yet to be discovered.
ME is comparable with fibromyalgia and is considered by many to be a different form of the same syndrome. There are also resemblances with Multiple Sclerosis (which is poorly yet better understood than ME), probably because both illnesses involve some form of systemic neurological trauma. However there is no evidence that demyelination is the cause of the neurological disturbances in ME, though the altered immune activity in ME points towards a role for the immune system in causing ME which is also comparable with MS.
Although the controversy between medical professionals outlined above has tended to reduce the chances of diagnosis in the past, this is still a very essential key to recovery. The proper treatment for ME is counter-intuitive in that it is not best to try to return to a normal life by overcoming the malaise using willpower. Sadly this only serves to prolong or even exacerbate ME. Accurate diagnosis is still by no means certain due to inexplicable prejudices concerning the nature of the disease among a proportion of doctors and psychologists.
Currently there is no cure. The best you can do is encourage the body to heal itself with prolonged rest while the patient optimises their environment and nutrition and adjusts. Patients learn to live with ME by pacing activity, though exertion tends to exacerbate symptoms, long term inactivity can be harmful and is ubiquitously reported as being very frustrating. However the sooner that rest begins after the onset of ME the quicker the recovery and the greater is the likelihood that recovery will be complete. Gradually stepping up the amount of activity can be achieved with luck, but while the condition persists it tends to be the degree of recovery which dictates the degree of activity and not vice versa. ME patients are plagued by constant relapses of the condition, some of which are brought on by exertion and some of which have no apparent cause other than the fluctuation of the condition itself.
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