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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Child Abuse and Chronic Fatigue Syndrome

Allan N. Schwartz, LCSW, Ph.D. Updated: Jan 10th 2009

 It seems as though every time we discover how truly damaging child abuse is to people throughout their lives, we learn even more facts about the effects of abuse and neglect. Emory University School of Medicine, in Atlanta, Georgia conducted a study that draws a direct connection between child abuse and neglect and the onset of Chronic Fatigue Syndrome during adulthood. The study was published in the January 2009 issue of the Archives of General Psychiatry.

People diagnosed with Chronic Fatigue Syndrome have a high incidence of experiencing neglect and/or abuse during their childhood. In addition, the subjects in the study with CFS also had suppressed levels of the hormone, Cortisol.

Chronic Fatigue Syndrome is characterized by:

1. Constant fatigue even after a full night of sleep.
2. Muscle and joint pain.
3. Exhaustion without any exertion.
4. Swollen glands or lymph nodes.
5. Depression.
6. Hypersensitivity to things in the environment, such as people with allergies experience.
7. Poor immune response in the face of viruses and infections.

For some reason, a much higher perentage of women suffer from CFS as compared to men.

In terms of a doctor making a diagnosis, the patient must have experienced most of these symptoms for a period of a least 6 months.

Cortisol is a hormone produced by the adrenal glands. It is vitally important for life and helps restore the physical system to a state of homeostasis.
If you think of cortisol in terms of cortisone cream, used to relieve minor cuts and insect bites, you have some idea of what cortisol does. Without an adequate amount of cortisol the body's ability to reduce inflammation is lowered.

What this means is that, reduced levels of cortisol causes the immune system to become activated more than it needs to. The increased activation of the immune system causes inflammation that cannot be reduced because of the inadequate supply of cortisol.

It is known that chronic stress and trauma, as occurs in abusive situations, ramps up the immune system, keeps it activated more than it should be until the system reaches a point where it is no longer able to produce enough cortisol to keep things running smoothly. In this case, the result is Chronic Fatigue Syndrome.

This degenerative process can continue into adulthood if stress and abuse continue. In addition, there is nothing to prevent the same process from starting once already into adulthood. In other words, trauma and stress, if they are chronic, has damaging physical effects at any point during life.

It is estimated that 2.5% of the adult U.S. population suffers from CFS. It is also estimated that four in every 1000 people have experienced abuse when they were children.
How do we stop this problem?

Your comments are welcome and encouraged.

Allan N. Schwartz, PhD

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    I agree - Bird - May 6th 2011

    I have ME/CFS, and I do think that this aticle hits it right on the nose. I don´t think you can go to a physcologist to get rid of CFS, because the cause of strees is do deep rooted ties and a part of the CFS patients identity. But I do think it has something to do with abuse and futurmore still ongoing life-threatning psykological bonds. Why else would the body still not be producing Cortisol. 

    Most times we are blind to our childhood and the way we live, in order to function on some level. But the body can´t stand constant stress, and disolves it self, attacs itself.

    I think that we all, humanity, could benifit from leaning more about the way the psyque functions, also in relation to the body.

    Chronic fatigue syndrome and child abuse. - - Nov 26th 2010

    I was abused as a child and i have chronic fatigue syndrome. I wasn't abused as bad as some of the storys i have read but i used to pray my dad never came home and when i saw his van go past the window i used to run upstairs and pretend i was asleep. i was born in 1995 and have had M.E/CFS for a year now... i found this article very interesting..

    theory about child abuse and CFS - annon - Sep 19th 2010

    Even though i was abused as a child (although not severly) I did not get ME or CFS as the medical profession want to degrade it too. Or to make it out to be a mental condition! IT IS NOT! I didn't get sick with ME until after a bout of Ross River Fever & Bar Epstein virus & having had my appendix removed! Before this i was reasonably fit & healthy. I was able to a lot of things i can't do today. I am now a shadow of my former self, & struggle to do the most basic of things, some days are better than others, & yes i am better than i was when i first got sick (2002-now). I am still not 100%

    Trust this to come from a Merely Male perspective! There maybe some of whom this is true & are sufferers because of abuse. There are many more of whom aren't! Their symptoms of ME have nothing to do with an abusive past!

    Instead of the Medicos trying to find reasons to disprove ME or CFS(as the medicos want to describe it). Why don't they try & come up with something that will actually help heal those of us with it. It isn't just being tired, it is having the symptoms of having flu or a virus or cold etc; on a regular basis. Having an immune system that doesn't work properly, or having muscles that don't work properly, and ache without even having to do any exercise that would make them ache. Or having constant cramps in muscles. Headaches, joint pain...etc.

    Stop trying to make out it's all in the head! Please-we are not Depressed or suffering from feeling sorry for ourselves! Thankyou

    LINK BETWEEN ABUSE AND ME - jamie bond - Feb 5th 2010

    An ME sufferer myself in my younger days, I have recently written a book.  This book (soulcrushersbook.webs.com) is an autobiography about my abusive marriage, the subsequent sexual abuse of my children, and the horrific fight with the family court to protect my children for their abusive father.  With all of this stress I wasn't surprised when I developed a relapse of ME so severe my neck at one stage was held up by a neck brace and my foot did not have enough sustained energy in it to drive a car.

    However since the day my abuser left home, even with the stress of family court and other obstacles I was able to work and study for a degree as my ME quickly disappeared.  Now with no abuser beside me I can make my own decisions no longer in constant fear, denial, anxiety and pain. 

    Bearing this in mind along with the research thus far into ME concerning the link with stress to ME I would tend to agree that domestic violence, whether psysical or psychological, is a dangerous factor in triggering or retriggering ME.  Our body needs time to relax.  How can we relax when we are on edge every minute of the day not knowing where the next abusive fist or word will come from or what will set it off. 

    I would encourage people to check out the power and control wheel on google and you can quickly determine if psychological abuse is a factor in your everyday life - whether it be at home or work.  Chances are if your body is constantly tense and you feel as though you are walking on eggshells this relationship is no good for you and no good for your ME. 

     

    loving relationship? - - Jan 11th 2010

    I have had CFS since 1995. 1998 being the worst year. I do feel that I have been prone to sudden physical collapse before I this. There were times where I was putting in so much and then could just do no more. I wouldn't say I was abused or neglected. Yet perhaps experienced just a little bit of harsh treatment from my mum for what should have been the case at times. There was lots of expectation on her. Fulltime working mother of three and living 25 miles from town in an isolated farm. I did get CFS after mastitus six months after my husband of seven yrs walked out on myself and our two children aged 8mths and 3yrs. I had just moved towns and left my friends to live not far from my ailing grandmother. I was a positive person. Had CFS 2yrs without depression. Got remarried and bashed then had severe CFS and major depression. Bedridden 9mths. Husband had axes under the bed. If stress exacerbates the illness. Societies system certainly worked hard at continueing it by paying his legals for him to stalk me through the family court. All sorted now. No access for him. He just wanted to hurt our daughter. Still ill. Has anyone heard of people improving if they find a loving relationship?

    CFS, Fibro, Abuse - tsalas - Dec 13th 2009

    If you are a survivor of abuse it is likely that your cortisol is low because of fatigued adrenals.  This causes a weakened immune system and low hormone production and low endorphine production.  Adrenals also help regulate blood sugar and pancreatic function so diet becomes very important to keep from weakening the body more.  you could replace cortisol along with hormones and treat with low dose naltrexone in order to help the body heal itself.   Do not do this yourself, get a dr who will do saliva testing and treat accordingly.  Or you can get saliva tests done yourself and try to naturally support your system with vitamins and proper diet, along with licorice (helps lengthen time that cortisol functions within the body) and mild exercise (walking is best).  You want to balance your blood sugar, increase your endorphins and support the immune system.  These imbalances cause low thyroid and also make your body more suceptible to disease and cancers.  Wether CFS & fibro is caused by this run down system or some other bug caught after the system is run down is really a mute point if the immune system, adrenals and thyroid are not given the proper support you can cure the secondary virus/pathogen and the door will still be open for the next disease when it comes along.   Start out with LDN (low dose naltrexone) and then support and test for secondary invaders (canadisis, herpes,epstinebarr, mono,lyme, ect.)  Abuse weakens the whole system, ages one faster and contributes to the body being more suceptible to cancer.  Long term stress such as abuse  weakens the whole immune system causing it to be confused and start "shadowboxing".  This is why people under undue stress are prone to infection, lupus, MS, CFS, cancer, fibro, reynaud's, addisons disease, IBS, allergies, eczema, psorisis, and other autoimmune system disorders. 

    This Supports the Viral Theory of CFS - Hip - Oct 16th 2009

    Actually, the fact that people whose AMYGDALA was damaged by extreme childhood stress are morel likely to later of CFS does in fact help support the viral etiology of CFS. Whenever the body is under stress (where the sympathetic nervous system dominates over the parasympathetic nervous system), this tends to shift immune response from its Th1 mode into its Th2 mode. Now, to fight viral infections, you require a Th1 immune response, not a TH2 response. But if your immune system is shifted into Th2 mode by your general stress, you will find that viruses are not easily cleared, and they may continue running amok in your body as a long-term infection. Thus it is clear that a damaged amygdala that is stressed will make it much easier for a viral infection to take hold and cause CFS. Whereas someone who is by nature relaxed will fight of the virus more easily, as their immune system has no problem entering into Th1 mode, where it can fight the virus. So this research is in fact in very much keeping with the viral theory of CFS

    Empirical Definition - keir farnum - Sep 10th 2009

    To add to what John is saying above, the original definition of "CFS" was created by people (other than Komoroff) who really didn't know much about the illness and were not treating patients, and who had a bias to a "mono-like" illness with emphasis to things like swollen lymph nodes (which usually only occur during the initial years.)  These "Chronic Fatigue Syndrome" definitions have always been vague and more about exclusion of other conditions than identifying what the actual illness was (turning doctors away from the illness since it had such an unconventional definition that made it seem vague and hard to understand as opposed to the original definitions of Richardson and Ramsey for ME.). 

    It has slowly changed in evolution to the "empirical definition" and the Oxford Definition (which it followed) and these definitions intentionally included people with mental health issues and excluded any sign that is physiological (such as the classic MRI "UBO's that are similar to Post Polio and AIDS dementia.)  By taking the idea that most patients with these illnesses do not have any abnormal results on "standard" testing and illogically extending this to include any physiological finding (i.e., the CDC's famous "Type 1" patient that has NO physiological findings at all.)  In essence, they are taking findings that have been found to be common to most patients (such as the "UBO's) and using then to exclude the patient from the study under the excuse that the organic finding "must be caused by some other process" without explaining what that other process is.  What they are left with are "pure fatigue" patients which they believe are what this illness comprises, leaving out folks with neurological symptoms and any sign of organic illness (which are what the majority of ME/CFS patients are.)  It's no coincidence that the CDC's main experimental patient group in Georgia can work an average of 48 hours per week.  By and large, they are extremely mildly affected patients or are people with mental health originated fatigue issues, not the typical ME patient.   It's a bit like taking the skin manifestations (the "pox") of chicken pox and using it as reason to rule out the diagnosis of chicken pox; it's absolutely illogical. 

    In short, they are defining "Chronic Fatigue Syndrome" and picking study patients in such a way as to confirm their own initial biases toward a mental health origin.  This results in studies such as the Emory study which shows this bias to finding patients who have MH caused fatigue.  If you would like further evidence, look up Leonard Jason's work in which he compared the different definitions to the Canadian Consensus Document and found that they did indeed pick different populations. The Oxford and CDC Empirical Definitions overwhelmingly tended to pick MH fatigue patients more and the Canadian Consensus Definition picked the most ill and neurologically affected patients.

    And because the "CFS" and FMS definitions are so vague it has allowed the inclusion of what we now know are many similar illnesses into one group (viral ME with various viruses involved including all of the herpes, enteroviral, parvo virus B19, etc subtypes, bacterial such as chlamydia pneumonia, gram - and + staphs, borrelia, erlichia, babesia, bartonella, etc. subtypes and non pathogenic sources such as organophosphate and marine ciguatera poisonings.)  This has resulted in a great deal of confusion in experimental studies.

    From what I understand, the Canadian Consensus definition includes shrunken adrenal glands as a sign of illness and it is thought that during he initial stages of the illness (first several years) that there is hypercortisolemnia followed by years of hypocortisolemnia and adrenal insufficiency due to years of basically "running on adrenaline" since our mitochondria are not producing energy and our aerobic systems are so incapacitated that we rely on adrenaline and anaerobic over-compensation to function for years with negative result (this is why no amount of exercise will ever help many of us; it's like trying to fix a broken engine by revving it up and trying to push it even more.)  Exercise that is not controlled with an emphasis on maintaining anaerobic strength and keeping aerobic exercise limited to small amounts will make the diastolic cardiomyopathy and it's systemic results (such as peroxynitrite and endogenously produced toxemia) worse until the cardiomyopathy and it's viral (or possibly bacterial) cause is treated.

    Thanks, Keir.

    Glutamate/NMDA excitotoxicity - keir - Sep 10th 2009

    From what I have been able to glean, many of the cognitive and other symptoms of Myalgic Encephalomyelitis and fibromyalgia can be pinned on glutamate excess (partly due to direct brain damage/dysfunction and partly due to peripheral factors such as the NO/peroxynitrite dysfunction which also has an effect on NMDA/glutamate systems.) My own hypothesis is that either the downregulation of GABA (more in primary fibromyalgia with peripheral affect on the CNS) and/or the down regulation of beta-endorphin (more in secondary fibromyalgia that comes with M.E. which has peripheral affect AND primary CNS dysfunction) allows glutamate excess.

    The glutamate excess then causes a form of "microseizure" that is the cause of the alpha/delta wave sleep anomaly, problems with focus and attention, problems with short term/rote memory, dysfunctional startle reflex, and hyperalgesia (basically the brain is turning itself off for about a tenth of a second, every few seconds and this will affect all these functions. All of these symptoms were improved to some degree when I started long acting opiate medications and the effect has been consistent, long lasting, and I have developed little if any tolerance.  It's not been a panacea but it's been good enough to keep me from commiting suicide from the direct effects of the pain, complete and totoal lack of sleep, etc.  Of course, with a disease that has the lowest quality of life of virtually all disease (not that there aren't worse disease  states out there but they are rare, recognized and treated, and not so inappropriately contentious.  In fact, one of the biggest problems for me has been trying to get the doctors to give me dosage that actually meets the full extent of the pain and the dose that they have allowed so far has only helped replace missing endorphins up to a certain point; so I still have a lot of what could be called "normal" pain and the meds have been just treating the hyperalgesia to some limited degree (the biggest problem is that fentanyl patch seems to be much weaker than it should be for a normal person but it continues working through the night which is the most important advantage for blocking the alpha,delta anomaly.)  I would be willing to bet that normal, healthy people given opiate blockers like Naltrexone would have a similar sensation to the fibro pain of primary FMS and secondary ME related FM (the descriptions I have heard are similar.)  Look up excitotoxicity in Wikipedia and the relationship to Traumatic Brain Injury (follow the references for the Wiki article). 

    In essence opiates and glutamate/NMDA antagonists (such Dextromethorphan which is clinically shown to be effective at reducing some symptoms of FM and cannabinoids which are anecdotally known to be effective to reduce Sx for ME/CFS and FM/FMS; see Goldsteins' bool "Betrayel by the Brain") are blocking the excitotoxic damage to the brain that is being caused by excess glutamate and is buffering the microseizure (DeMeirleir has talking about a form of "light epilepsy" being the problem with sleep and the cause of the alpha/delta anomaly; basically a microseizure.)  The problems with cognitive symptoms improving can be very well understood in the framework of the microseizure too.  Turning your brain off every few seconds is bound to affect long term potentiation of memory, focus, attention, and cause the innapropriate startle reflex that has been found with ME on the P300; i.e., no "pre pulse inhibition." (in the normal brain, a startle does not occurr if there is a "warning" within a certain number of seconds before the startle stimulus whereas in the M.E. brain, the microseizure occurring in between the "warning" and the stimulus, essentially makes one "forget" that the "warning" occurred and we startle when we should not.)

    This also explains how opiate medications can have such a beneficial effect for some subsets of M.E. (probably the viral CNS infected subset similar to the physiology of Post Polio Sequelae with decreased beta endorphins; often without the same side effects that would plague a person taking opiates who has their own normal complement of endorphins and is using opiates to handle the pain that the endogenous endorphins are not blocking) and that essentially, it is a form of "endorphin replacement therapy" for some subsets of these illnesses.  It has been confirmed that ME/CFS patients have decreased CNS beta endorphin and it has been confirmed that FMS patients have increased glutamate which supports this hypothesis (unfortunately one of the problems is that until these subsets of ME, other forms of CFS, and the crossovers between primary and secondary FMS are sorted out, there will confusion over many empirical testing studies.)

    My own further hypothesis is that those who do better with GABA agonists and are sensitive to opiates probably have primary FMS without the direct CNS dysfunction and cardiomyopathy and this is why they can exercise without negative effects.  My guess is that they have a primary toxemia (marine ciguatera, endogenously produced ciguatera-like compunds from infecting bacteria of various kinds, milder organophosphate or organochlorine poisonings [which have similar nitrosative and glutamatergic affects,] etc.) and this toxemia is having indirect affects on CNS glutamate systems through the NO/peroxynitrite systems and resulting glutamatergic effects along with channelopathy and tetany (similar to tetanus.)  Whereas ME viral illnesses include some level of direct CNS damage/dysfunction, and viral cardiomyopathy ALONG WITH the ciguatera-like bacterial toxemia that results from the peripheral low oxygen state produced by the initial cardiomyopathy (this could also explain acute onset from delayed acute onset forms; the illness doesn't completely form until the cardiomyopathy occurrs or is exacerbated.  It would also explain why the worst prognosis occurrs with those who try to exercise at first or too much since they are worsening the cardiomyopathy's effects.)  Either way, you get "lock jaw light" and hyperalgesia, but the toxemia is a peripheral process that occurrs independently of whether there is CNS damage/dysfunction or not.  When ciguatera was found with a study of "CFS" (which of course include ME and other subtypes of CFS and probably FMS) they found extermely high levels (high enough that it would have caused paralysis would it have been an acute marine poisoning) which probably indicates that it was produced in the organism over time and adapted to.  They also found lower levels in Hep C and kidney disease which further indicates that this may be a fairly common endogenous process and it's involvement with ME, CFS, FMS and other subsets of pain/fatigueing illnesses shouldn't be surprising.  This could also be why Lyme Disease is so similar too since it was found by a team in Boston that Borrela produces toxemia in a similar fashion and could explain why Lyme can be difficult to treat, killing the pathogen doesn't get rid of this persistent type of toxin.  Further, it may help explain why some patients (reputedly with "ME," "CFS," or "FMS" but may actually have Lyme or another similar pathogen) get worse with air travel since borrelia is a microaerophilic pathogen that grows well in the lower oxygen state caused by airtravel.

    I hope this makes sense and if you have any questions, let me know.  I can tell you that opiate medications saved my life.  Before I started getting help, I literally didn't sleep for 10 years, counted my comfortable moments in seconds (pure torture) and had tried just about everything that one can think of.  Now, I would like to find a way to get on the appropriate anti-microbials (Valcyte, Amantadine, etc.) to get rid of the viruses causing this and not be dependent on pain medications any more (see videos below.) 

    http://www.scivee.tv/node/7965/video

    http://www.youtube.com/watch?v=c_7ok7kFgG4&feature=related

    Thanks, Keir.

    child abuse and illnesses - sorell - Jul 19th 2009

     hello, I would like to know wether there have been studies about  the prevalence of child abuse in people who are suffering certain illnesses,and not just CFS, but for exemple cancer,depression,multiple sclerosis...?         personnally I have had a friend who suffered kidney disease,had dyalisis,then kidney transplant ,plus was contaminated with hepitatis, and this person had suffered physical abuse at home and sexual abuse from a neighboor as a child.

    I also met someone who suffered neglect and abuse as a child from an alcoholic mother and  was diagnosed with  multiple sclerosis.

    I also heard a few stories on the radio of people who were sexually abused as a child and  suffered cancer as an adult.

    does having suffered abuse in your childhood make  you more prone to suffer certain illnesses as an adult?

    or is it that child abuse is quite prevalent anyway and it is just coincidence if certain people who suffered abuse as a child unfortunately suffer an illness,wether psycological or physical, as an adult?

    or,even maybe more interesting:is there a correlation between the type of abuse sufferd in childhood and type of illness suffered later?

    Thank you  

     

     

    CFS and Child Abuse and Resistance - Allan N Schwartz - Feb 10th 2009

    Hello Hip,

    I believe you misunderstand the connection that may exist between some people with CFS and child abuse. It is not that child abuse directly causes CFS. Rather, we know that ongoing stress from many sources lowers the resistance of the body to many viruses and infections. Therefore, child abuse may very well lead to lowered resistance to viruses of many kinds and, in this case, CFS.

    Dr. Schwartz

    This Child Abuse Study Actually helps Support the Viral Etiology of CFS! - Hip - Feb 10th 2009

    As a CFS suffer myself, it makes me very angry to see that people are still trying to pin this condition on psychological causes. However, this child abuse story has raised my interest, because paradoxically it may help support the viral etiology and explanation of chronic fatigue syndrome! Having had a respiratory and neurological virus myself, and having seen this virus slowly spread to all my family members, and some friends too, I have noticed how it has caused mental state changes in nearly everybody that caught it, to some degree. However, only one person (myself) actually got full chronic fatigue syndrome from this virus. Most people got off much more lightly, but nevertheless did display some permanent mental state changes. So it is clear to me that such neurological viruses can cause subtle, subclinical mental state changes, as well as full CFS. Most of the subclinical mental state changes I have observed in my family and friends have made people act a little strangely. In short: the virus causes subclinical but sub-optimal mental states. Therefore, it is possible that as a virus slowly infects a whole family, some members will get CFS, but other members may experience these slightly abnormal mental states - and in very rare cases, it is these abnormal states that contributes to creating the abhorrent mind state that can go on to commit child abuse. In other words, in etiological terms, it is not the experience of having been abused as a child that later causes CFS, but rather it is a neurological virus that, having spread around the family, caused CFS in some members, and also kicked off the brain changes that, in susceptible people, then led to the extreme behavior of child abuse. Thus, read this way, rather than support the psychological causal theories of CFS, this data from Emory University on child abuse is more likely to support a viral etiology of CFS. In general, more research should be done on people that have one or more neurological viruses in their systems, even if they are apparently without overt symptoms. These neurological viruses may well be connected to all sort of subtle abnormal and subnormal behaviors and mental states, not just CFS. The connection between neurological pathogens and mental heath is very well established as regards to curable bugs like toxoplasma and syphilis, simply because mental state problems caused by these tend to resolve when the people are given the cure (antibiotics), thus proving the connection. Once effective antivirals are developed, the same will almost certainly be found true for CFS. In summary: although people with full CFS might be the worst off in terms of mental state changes, these same neurological viruses that cause CFS (which are very commonly found in the general population) may be responsible for many more mental state aberrations other than just those of chronic fatigue syndrome. For more details and examples on how a neurological virus can cause mental state changes, see my blog: http://chronicsorethroat.wordpress.com/

    Opiates - Allan N Schwartz - Jan 23rd 2009

    Hi Kelly,

    Initially those opiate pain killers do the very thngs you mention: energize, etc. However, that is fairly short lived. Soon, the opiate takes over and then the feelings of increased energy turn to sleepiness, a slowed down state of being, anger and irritability and, finally, addiction. I am not a medical doctor but I would venture to guess that opiates are best avoided unless someone is suffering acute pain from terminal cancer.

    I love Colorado, by the way.

    Dr. Schwartz

    Child Abuse/ CFS / Opiate meds / perimenopause - Kelly Harbolt - Jan 23rd 2009

    I have a unique situation that I’m sure MANY other women share. I am perimenopausal but I have the added challenge ofChronic Fatique Syndrome (‘88, remission w/birth of son in ’92, returned in ‘05) and Fibromyalgia (since ‘04). I’m stressed as a single mom of a Junior son with my own Rock band music teaching studio and I have been playing “home chemistry set” with my body since late 2004 because I have no insurance, limited income and get inconsistent child support.

    My problem is that the recommendations for hormone health are often counter-indicative to the advice for CFS/Fibro. I can’t afford the tests/doctor visits, so I’m trying to figure this out myself. I have done research with books, including Dr. Northrup’s book, and medical articles on the web. I can’t get this thing figured out! I have to pick and choose which rotating discomforts to live with.

    There is a further complication; I’m also a child sex abuse survivor. This is relevant because an Emory University study that came out just this month stated a theory that most people with CFS/Fibro come from a trauma background. As a result,cortisol and adrenal hormones are depleted thus contributing to the condition.

    I had an accidental discovery that when taking opiate-based pain relievers for the fibro that I regained energy AND my hot flashes, night sweats,dryness and insomnia almost completely disappeared! I did further research but my brain hurts. I found out opiate drugs affect adrenaline and cortisol levels.

    How the heck does this all fit together and make sense? I want to write a magazine article with the findings to help others with this problem! Who/where should I go to get the information on how the puzzle fits together? Endocrinologist,  pyschiatrist, OB/GYN, ? Please help me!

    Desperately hoping,
    Kelly Harbolt  Denver Colo. 

    abuse - Troy - Jan 13th 2009

    The issue of addressing and stoping abuse, and neglect falls into a wide range, cause many people are confussed or uneducated as to what abuse is.  The topic is to wide and difintion of what abuse is to widely given.  Example a person dening another of sex, is not abuse, all it takes is 1 person to say NO, and the answer should be NO.  But on the other hand any person that touches you without your permission is also not abuse, cause a child that is being disipline by spanking does not give the permission of the touch, and that would not be abuse. 

     

    I defind abuse as any action that is done in anger.  No child should ever be touch in anger, but also no child should be neglected.  Our society has estiblished ideas as to what we consider normal.  I would say any parent that does not take an interest into the well being, and education of their child is guility of abuse by neglect.  

     

    I am aware that many people that were abused will also abuse and neglect their children.  

     

    I also feel that a parent should not lose custody of their child unless they are convicted of abuse or neglect, that way in later years, there is no confussion on the parent or the child's part as to why they are not with that parent.  So the parent should be charged and convicted of the crime they are guility of.  I also feel that all children when they reach the age of morality, or maturety should be entittle to see any all DCF investigation envolving their childhool, by doing so, may give those children, an insight into the problems that they can be prone to contiune and therefore maybe able to help prevent those abusive tendicies that they grew up with.  Cause only by knowing can a person make a concienece effort about anything.  

     

    I admit that I was emotionally, mentally, phyisically and sexually abused as a child, I have always made a concience effort to not lose my control, and to not allow my emotions to control me, and to not act in anger when dealing with a child, or children.  I am not a touchy feelly type of person, infact, I do not like being touched by anybody, unless I give them permission to touch me.  If any person touches me, without my permission, I will look deadly at them and say take your hands off of me, if they do not, I might remove their hands from me.  Not in violance but in a sense to protect my space.  I admit to having trust issues with everybody, infact I do not trust anybody at face value, nor do I take anybody for their words.  I do look at what they say, and look for proof for or against it.  And with proof that might show they are trustworthy on that 1 issue that 1 time, but that does mean they are trustworthy on all issue at all times.   

     

    I did serve in the Marines.   And I am obossed to any and all abuse on children.  

    CFS and Cortisol - Allan N Schwartz - Jan 12th 2009

    Thank you for your comments but the issue here is not related to prevalence rates of CFS but to the connection between CFS and Child abuse. I have treated a number of patients over the years who were diagnosed with CFS and, you are correct, they were white, middle class women. Perhaps it was coincidence but I think not: they were either abused or neglected while growing up. I have always had a suspicion that there were more cases of CFS than were being recognized. My theory has always been that the failure to recognize and diagnose the illness had to do with prejudice against the diagnosis and an unwillingness to admit that it is a real disorder.

    Cortisol: No one should ever self medicate. If you suspect that you have PTSD then you should consult a psychiatrist and psychologist and start to get help for your situation. I would never recommend that anyone decide upon a certain medication for their self.

    Dr. Schwartz

    This sounds just like ME - - Jan 12th 2009
    I had a very difficult and emotionally abusive childhood. I became a very self destructive teen and continued in self abusing behaviors well into adulthood. I was abused in my first two relationships a period of time from age 20 to age 40. I have cfs and fibromyalgia. I can say that my life has changed drastically over the past ten years, this past year being the best year of my life. My symptoms are very problematic and often prevent me from enjoying life to the full. I can see the validity of your article and find this to be very true in my case.

    Study was done on new definition of CFS - John - Jan 11th 2009

    Hello,

    I am a CFS patient, and have been following CFS research for the past several years.

     The study by Emory researchers which proposed a link between childhood abuse and 'CFS' was done on patients fulfilling a new laxed definition of CFS, variously called the 2005, Reeves, or 'Empirical' definition. This 'Empirical' defintion increased CFS prevalence rates 10 fold from .24% or .42% found by different studies using the more common 1994 Fukuda criteria to 2.54%, and has been subject to much criticism by CFS patients and their advocates.

    It would be very interesting if you would do an article on whether or not it's ok for a single researcher or research group to re-define an illness so fundamentally that prevalence rates jump by this much to the point where it actually becomes questionable whether any of the patients in the study actually had the illness in question, and then compound this rather egregious act by hardly giving it any mention in the following papers they publish so that unless you specifically follow CFS research you wouldn't even be aware of it.

     http://www.iacfsme.org/IssueswithCDCEmpiricalCaseDefinitionandPrev/tabid/105/Default.aspx

    Do I need to increase Cortisol? - Cynthia C. South Florida - Jan 11th 2009

    I just read the article on child abuse and CFS.  I have been diagnosed with PTSD.  My childhood was very traumatic.  My relationships are suffering.  I am tired (I can & do marathon sleep), drepressed and have no life left in me.  I have wondered about cortisol before, but do not really know if I need to increase my levels and if so HOW?  My life is very stressful, most of which I have absolutely no control over.

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