2007 British Medical Journal Editorial on Chronic Fatigue Syndrome

[New Guidelines] for Chronic Fatigue 
Syndrome or Myalgic Encephalomyelitis
BMJ 2007; 335 doi: (Published 30 August 2007)   
Cite this as: BMJ 2007;335:411
[Herewith my 9/4/07 response to the "new guidelines for CFS"]
04 September 2007  
Helen Borel, RN,PhD  Psychoanalyst and Medical Writer NYC 10024

     [Published in the online issue of the British Medical Journal]

"CFS Guidelines" Irrelevant to Actual ME Disease 

by  Helen Borel, R.N.,Ph.D.   

I beg to differ with the "new" guidelines. 

In 1992, I wrote and published this book: 

Living with and Recovering from Chronic 

Fatigue Syndrome: DEBILITATING 

IMMUNOPATHIC RELAPSING 

ENCEPHALOMYELITIS.

(Note, this stands for DIRE.) I only used "CFS" in my
title because this was the faulty (and therefore
prejudicial) designation given this very serious disease
that it was widely known as. THIS IS NOT A DISEASE 
ABOUT THE NEED FOR GRADUAL EXERCISE OR 
FOR TREATING A PSYCHIATRIC ILLNESS!  This is a 
neuroimmune disorder and (just like Multiple 
Sclerosis and other multisystem diseases) you can't
exercise your way out of it, nor are you mentally ill 
because you have it.

It has been shown -- more than 15 years ago -- that
probably some viral or bacterial or toxic event
(most likely pesticide or other toxic chemical exposure)
has caused the immune system to overactivate 
and to have difficulty recovering from this 
overactivation.  Treatments must address this immune
system dysregulation and the negative effects this
immune chaos has on the brain and its neural branches.
My book delineates these, which I discovered and
detailed clearly.

Nowhere does "exercise" have anything to do with 
getting well from this DIRE illness. The treatments
are basic nursing and medical measures that seem 
to have been forgotten by physicians, maybe 
because they are not expensive.

Finally, it's also important to note that any "mental
illness" in people suffering with DIRE, such as
depression, ensues after months and years and often
decades of progressively severe debilitation with
pejorative diagnoses and insulting labelling. People
are not first depressed, then strangely develop DIRE.

How then would one account 
for all the chronic depressives 
worldwide who do not develop 
this neuroimmune disease?

Progressive inability to work due to DIRE and its
negative impact on finances, nutrition and socialization
contributes to any sad mood states physicians may
notice in these patients and to difficulty in recovering
some degree of the life these patients enjoyed before
being struck down with Debilitating Immunopathic
Relapsing Encephalomyelitis.

I hope this tired old "treatment" of "gradual exercise"
and that very wrong label of "psychiatric illness" is
finally dropped from characterizing these severely
suffering patients -- some with long-standing symptoms
akin to being endogenously chemotherapized, not for
hours or days, but for months and years.

[2015 addendum: Try telling a relapsed MS patient
or a cancer patient on nauseating Chemotherapy to
"Exercise" to overcome their "fatigue"...then run for
your safety if the DIRE victim happens to be a
former pugilist.]

(c) Copyright 2007-2015 Dr. Helen Borel.  
All rights reserved.

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