Understanding Post-Exertional Malaise
I would like to dive into a topic that many of you might be familiar with: post-exertional malaise (PEM). At first glance, it seems straightforward—exercise leads to fatigue and symptoms. But what if there’s more to it?
When we talk about PEM, we often assume that the exercise itself is the direct cause of the symptoms. However, my experience and conversations with over 1,000 people with chronic fatigue syndrome suggest otherwise. I, too, have battled post-exertional malaise, and it was one of my most persistent symptoms until the end of my healing journey.
The Hidden Triggers Behind Post-exertional malaise
I believe that exercise only indirectly triggers post-exertional malaise (PEM). The real culprits lie in our subconscious. Many of my clients and I have found that underlying stressors in the unconscious mind are what truly cause the brain to produce these symptoms.
Yes, I do believe that our brain creates post-exertional malaise as a protection mechanism; therefore, it is serving us in some way. It is easy to dismiss this and claim that the brain is failing. But what if that isn’t the case? To dive deeper into this, you would need to know a little about MindBody symptoms. Dr. Sarno first coined this term when he realized that the limbic brain, together with the amygdhala, can create all kinds of symptoms to protect us. Common manifestations of Mindbody symptoms include pain, fatigue, migraines, and depression. It produces these symptoms whenever it perceives a danger.
It then stimulates the hypothalamus, which stimulates the pituitary gland, which stimulates the adrenal glands, which changes the muscles, blood circulation, digestion, and immune system by causing a slight oxygen deprivation and tension in certain tissues, like the mitochondria. (Ozanich, 2020, The Great Pain Deception)
As a result, you would feel slugish, tired, and unable to move, and you would probably go to a safe place: your bed. As soon as you retreat yourself, you are no longer exposed to outside danger. The same principle applies to pain or fatigue. Unfortunately, the real danger is not external, but rather internal. Once we identify and address these internal stressors, the brain no longer needs to create post-exertional malaise. See the blog, Turn Symptoms On and Off.
The Role of Stress and Emotions in PEM
It’s always helpful to gradually expose yourself to exercise with a technique like pacing. But by gradually increasing your activity, you are not addressing the root stressor that your brain perceives as dangerous.
Imagine gradually increasing your steps each day to build stamina. But then, life throws a curveball—maybe a stressful event like a breakup or a significant loss. Suddenly, you’re back to square one, struggling to even take a few steps. This isn’t just about physical exertion; it’s about the emotional and psychological stress stored in your body.
A Different Approach
Instead of fearing exercise, we need to understand that our bodies store trauma and emotions in our tissues and muscles. Exercise may trigger the release of stored stressors in our muscles and tissue, which may initially feel like a setback. But this release is actually a positive step towards healing once you are able to fully process it.
An activity goes beyond moving your body. There are thoughts, emotions, and triggers at play. Perhaps completing grocery shopping triggers an emotion like fear or shame? If we then develop symptoms, we can think it was because of exercise, but it doesn’t have to be that way. When the brain perceives these emotions as dangerous and doesn’t want you to be triggered, it probably thinks you’re better off in bed.
In our release program, we love to show you how this mechanism work by turning PEM on and off on demand. We explain wht your brain started producing this symptoms and how to reverse this. We focus on identifying and processing theunderlying stressors. By doing so, we can often alleviate PEM in a matter of minutes rather than days. This approach transforms exercise from a feared activity into a tool for uncovering and addressing deeper issues.
Embrace the Journey
Remember, PEM isn’t just about the physical act of exercising. It’s a complex interplay of physical, emotional, and psychological factors. By shifting our perspective and addressing the root causes, we can reduce the impact of PEM and improve our overall well-being.
Thank you for reading, and I hope this new perspective on post-exertional malaise helps you on your healing journey.
