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The original was posted on /r/cfs by /u/Few_Fan5453 on 2025-01-25 22:24:25+00:00.

I have realized after 2 years of mild then severe CFS that emotional stress is far more destructive to my health and creates a longer lasting PEM. I found this out when I had to actually work on my car once to prepare it for sale since I no longer can drive them.

First car was easy to clean up but during the process i received a stressful call from insurance company over a denied claim and i was emotionally distraught. Within 48 hours i had a PEM that lasted 2 weeks despite aggressive rest right after the event. I was also on LDN which is supposed to reduce PEM severity but it wasn’t working.

The second car i worked on two months later. This car was much harder to work on and prep. i had to pull parts out and install factory ones back in and the entire process took an hour. 48 hours later I was prepared to pay heavily for this physical exertion but nothing happened. I had a bit of chills and pain but nothing serious. I still was resting in bed all day as usual but no significant malaise.

Many examples like this have happened over the years. For example visiting my parents for Christmas but I would be just sitting there calmly, not speaking nor moving much, preserving my energy. But another time i had a video call with a few coworkers and it was very stressful, i immediately crashed after the call with PEM.

Interestingly another curious thing I noticed is sometimes I have a really bad PEM and am sweating and in chills heavily but then all of a sudden the symptoms disappear and i sit there feeling like i have just barely survived death but generally start to feel better. no idea what this sense of relief is or what causes it. it’s rare tho.

I find emotional pacing is actually much more difficult than physical one. for one thing i can’t really do therapy sessions as the stress from it throws me off into PEM. So it’s hard for me to learn skills to keep my emotions in check. i just need to avoid getting angry or emotional.