Myalgic encephalomyelitis or chronic fatigue syndrome is a condition that causes a multitude of symptoms. As the name suggests, fatigue is the hallmark symptom, but there’s a lot more to it than just that. In fact, fatigue is actually my least bothersome symptom these days. It’s all of the additional symptoms that are problematic for me.

But let’s start with fatigue because that is usually where it starts for most ME/CFS sufferers.

You probably know what “fatigue” is. It’s the kind of tired you get when you stay awake for longer than your body naturally prefers or the kind of tired you get when you’re ill. You can’t do much in a state of fatigue without sleeping it off (recommended) or getting off your tits on some sort of stimulant (not recommended). For most people, fatigue is temporary. Once you catch some z’s or chug a Red Bull, you’re ready to get on with life.

This isn’t so much the case for people with ME/CFS. Their fatigue is unrelenting, and sleep and/or stimulants have little to no effect. Some days it’s better, and some days it’s worse. But it’s always there in some capacity. And it often doesn’t matter what you did to “cause” it. You could literally fold one too many pairs of underwear or worry about one extra thing in a day, and tomorrow will be an uphill battle.

This particular phenomenon is called post-exertional malaise (or PEM). Anything that your body or mind considers “too much” can cause your symptoms to worsen from anywhere from a few hours to a few months. There’s no real way to figure out what not to do to avoid PEM. Something you’ve done many times over without affecting your symptoms could suddenly one day become a ~problem~, and then there’ll be days when you can do what feels like everything without affecting your future energy levels.

ADHD also causes fatigue. When your brain spends most of its time trying to compensate for itself to “function” in society, it can be draining. I discovered just how much of my fatigue was due to ADHD when I started taking my medication.

When I first fell ill, my fatigue was so bad that I didn’t leave my bed for anything other than work, or cleaning and feeding myself. I slept for upwards of 14 hours a day and even hanging out in the living room with my family without a huge freakin’ effort. Eventually, my fatigue got to a place where as long as I got my daily 1-2 hour nap, I could make it through a somewhat productive day but I still had to be aware of what could cause PEM and pace myself appropriately.

After starting my ADHD medication, the fatigue thankfully lessened to the point where daily naps were no longer necessary and I was able to do more in a day without having to worry too much about PEM. Of course, it still happens and my medication isn’t a miracle drug or anything, but I do think it reduced the fatigue that was being added by my untreated ADHD and I’m now at a level of fatigue that seems a bit more reasonable for someone with ME/CFS. If that’s even a thing. 😂

Right now, I am feeling more fatigued than what’s the baseline for me, but I am still able to pump out this blog entry, so it’s not as bad as it could be. This morning, I suffered from a flare-up of my sinus and ear problems and my throat is still scratchy from the drainage, so I assume that’s what’s causing the fatigue I’m still feeling. But as I’ve said a lot in this entry already, you can never really be sure!

This is why the fatigue from ME/CFS and ADHD can be so bothersome. Being able to do something one day without issue but not being able to do it at some other point in time is not only frustrating, but it appears to outsiders that you’re faking a disability or some other ignorant bullshit. But really, you’re just doing battle with a brain that simply can’t deliver energy consistently and predictably.

PLEASE NOTE: I am not a medical professional. Any information or advice provided in this entry is for general purposes. Please read the disclaimer for more information, if you haven't already done so.