Sometimes, when I tell someone I have chronic fatigue syndrome, they tell me it's all in my head. A few family members even think that, and I even had a doctor say that once!
When my brain fog is bad and I get confused and emotional, I sometimes wonder if those people are right and this is all some delusion or something. Is chronic fatigue syndrome all in my head?
Researchers have had a hard time pinning down exactly what's going on in ME/CFS. However, we know enough to confidently say that the condition involves a lot of physiological abnormalities.
For starters, the immune system appears to be stuck "on," as if it's continually fighting an infection. Evidence for this includes:
- Low function of natural killer cells and T cells, which are specialized immune-system cells that help fight infection;
- Elevated levels of pro-inflammatory cytokines, cells that help regulate the immune system;
- Autoantibodies, which are made by cells that mistake healthy tissues for infectious agents and try to destroy them.
That's not all that's going on in ME/CFS. Researchers have found dysfunction in several other body systems, including:
- The sympathetic nervous system, which deals with the fight-or-flight response;
- The HPA axis, which regulates the body's stress response, temperature, mood, digestion, energy usage and sexuality;
- Neurotransmitters (chemical messengers) in the brain, including serotonin, norepinephrine and dopamine.
ME/CFS may involve heart abnormalities as well. These can include irregular heart rate, physical differences, and reduced function.
Researchers also theorize that ME/CFS involves central sensitization, which means that the body is hyper-sensitive to stimuli. Central sensitization is a known feature of conditions such as rheumatoid arthritis and migraine.
These physiological abnormalities clearly show that this condition is not imaginary and is not the result of hypochondria or neurosis. To get a diagnosis, you likely went through a long process that involved extensive testing. Believe in that diagnosis, and ignore the people who make you doubt your illness.
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