Taming the Tiger: Managing Feelings in ME/CFS & FM

By Bruce Campbell

Sadness, worry, grief, frustration and guilt are normal reactions to serious illness. They are an understandable response to having your life turned upside down.

Consider the effects of ME/CFS and fibromyalgia:

Limits: Fatigue, pain and other symptoms restrict what you can do and diminish your enjoyment of life.
Frustration & Helplessness: Lack of control creates frustration and feeds a sense of helplessness.
Uncertainty: It's often hard to plan each day and the long-term future may be a big question mark.
Loss: Besides losing your health, you may be forced to leave your job, lose friends and sometimes even family, and also lose the future you had envisioned for yourself.
Isolation: You may spend long periods of time alone and also feel psychologically isolated because you feel different from others.

And there’s more to the challenge. Not only do ME/CFS and fibro trigger strong emotions, they usually make emotional reactions stronger than they were before and harder to control. The technical term is labile.

One person in our program wrote, "My emotions are much more sensitive than ever before. I cry more easily, and I have less emotional reserve." Another said, "Just recognizing that emotions are heightened as a result of CFS really helped me. Before learning that, I was quite puzzled by why I got upset about little things."

And a third wrote, "I have found by logging that emotions play a bigger part than most anything else in my symptoms and the effect lasts for several days after the emotion has passed." I believe this increased intensity of emotions is part of the physical basis of ME/CFS and FM.

The strength of emotions can create a vicious cycle. For example, being in constant pain can trigger worries about the future. Worry leads to muscle tension, which, in turn, increases pain, which feeds back into worry and the cycle starts again.

You can interrupt this cycle in several ways, such as by using relaxation to reduce muscle tension, by changing your “self-talk” and by using other strategies to reduce worry.

The process by which feelings intensify symptoms occurs even with positive emotions, as suggested in a comment from another person in our program who said, “I cried at one of the classes because I was so happy to be around people who understood me. Almost immediately, I had an attack of brain fog.”

Any experience that triggers the production of adrenaline intensifies emotions and often makes symptoms worse as well.

But, like other aspects of long-term illness, feelings can be managed. Some strategies mentioned in other articles may be useful for managing emotions. The stress reduction techniques outlined in articles in the Stress Management archive may help. Relaxation, for example, can short-circuit the feedback effect in which symptoms and emotions reinforce one another.

Also, changing your thinking using Cognitive Therapy may help. This approach has been proven to be especially effective for treating anxiety and depression. Another general approach is to identify those situations (and sometimes specific people) that trigger strong emotions and plan a strategy of response ahead of time. Often, avoiding or minimizing stressful situations can reduce emotions.

In addition to self-help measures, the management of emotions can include professional help. Emotions such as depression and anxiety can be caused or intensified by changes in brain chemistry and may be treated using prescription anti-depressants or anti-anxiety medications.

Also, counseling can be helpful. Talking with a therapist about the problems triggered by your illness does not imply that “it’s all in your head.” Rather, counseling offers help dealing with a difficult situation.

The help may include support, suggestions of coping strategies and perspective on your situation. If you think talking with a counselor might be helpful, you might seek out one who specializes in treating people with long-term illness.

Other articles in the Emotions archive explore ways to tame different emotions and turn them into positive forces:

Depression
Anxiety and worry
Grief
Rumination
Frustration and anger
Guilt