Myalgic Encephalomyelitis Symptoms

Post-Exertional Malaise (PEM)

The key and cardinal symptom of M.E. and how it affects people, is known as post-exertional malaise (PEM). Simple physical or mental activities (as well as sensory and emotional experiences), or combinations of actions, can leave people with M.E. feeling utterly debilitated. They can also experience an increase in other symptoms (such as sore throat, headaches, dizziness, increased difficulty with cognitive tasks, pain, and much more). The impact of physical or mental activities may be immediate but is often delayed in onset by hours or days, even appearing in a day or two.

During PEM, any other ME/CFS symptoms may get worse, and symptoms are not significantly improved by resting and can be disproportionate to the activity that caused PEM. Sometimes people with ME/CFS describe this as a “crash,” “relapse,” or “collapse.” ME/CFS patients may not always be able to predict what will cause a crash or how long it will last.

Sometimes patients may be house-bound or even completely bed-bound during crashes. For example, attending a child’s school event may leave someone unable to do needed tasks like laundry. Regular everyday tasks such as shopping at the grocery store or taking a shower may result in a crash. Working in “mild” cases of M.E. may result in spending evenings and weekends recovering from the effort. It should be noted that even “mild” ME significantly impacts that patient’s life. They may appear normal to look at, but please remember that you don’t see these individuals when they are resting prior to doing a task or an event, or when they are recovering in their beds in order to cope with everyday tasks and events that healthy individuals do not even have to think about.