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NHS treatments for M.E. seem to focus on physical activity. Although I have limited physical stamina I also have limited mental stamina.

I have extreme difficulty in maintaining conversations for more than say 10mins. I can literally feel the energy draining out of me and my mind just sort of grinding to a halt. I have the same problem if I am in a noisey/bright/hectic type environment. I have difficulty filtering out sounds, so my brain gives up if say the TV is on and someone tries to speak to me. I find scanning shelves e.g. at the supermarket or library looking for one particular item exhausting. I've also found trying to do two things eg listen to instructions on a yoga tape & balance my body makes me feel quite ill as does concentrating where fine motor movements are needed i.e. doing up fiddly buttons. My poor brain. It's not just draining at the time, I aslo have PEM relating to both physical and mental activity if I over do it.

All this means that I no longer socialise in person or even ring people for a chat. I find it very hard being out anywhere 'normal' like a pub, restaurant, shops which are noisey & busy. It makes my life incredibly isolating.

Is there any help that can be offered for those of us suffering from this type of cognitive fatigue or anything I can do to help myself? I did try to gradually expose myself to places that were noisey etc to try and desensitise myself but it didn't help at all.

You may find it helpful to look at some of the other discussions that have been taking place to questions about brain fog/cognitive dysfuntion in ME/CFS

This is a reply I posted to one such question:


Along with fatigue and pain, cognitive dysfunction/brain fog (= problems with memory, concentration, information processing, word finding etc) is another very disabling feature of this illness.

At present we know very little about what causes cognitive dysfunction in ME/CFS. There are a number of theories - perhaps the most plausible being that it is related to problems with the autonomic nervous system and the way this part of the nervous system helps to control blood flow to certain parts of the brain.

But without a better understanding of what causes cognitive dysfunction it's very difficult to treat.

We have an MEA information leaflet that goes into more detail about both cause and management - but I would add that drugs and supplements are of no clear value at present

MEA website and pdf literature form: http://www.meassociation.org.uk

Blueskies wrote:.
Although I have limited physical stamina I also have limited mental stamina. ..
I can literally feel the energy draining out of me and my mind just sort of grinding to a halt...
I have the same problem if I am in a noisey/bright/hectic type environment...

Is there any help that can be offered for those of us suffering from this type of cognitive fatigue or anything I can do to help myself? I did try to gradually expose myself to places that were noisey etc to try and desensitise myself but it didn't help at all.

Your symptoms are familiar to me. Dammit.
My occupational therapist proposed as an analogy that our (reduced) energy budget basically comes out the same bucket, whether the "spend " is physical, mental or emotional, and by and large she seems to be right, in my experience. If I do brain-work until I hit "the block" I can't just switch to a physical activity under "a change is as good as a rest." My muscles will be almost be done for before I start.

My suggestions for "anything I can do to help myself?" are basic, and based on this.
to get the most out of mental working (note: it's not *lost* any more than a car without petrol is lost or wrecked.. ) it's going to mean getting rid of as much as possible which is also being "a drain on the bucket."
Any activities mental or physical which can be abandoned, made less frequent or made less stressful or demanding?
Best posture/ lighting/glasses (if needed, and that might be new.) for reading and computer work.
Tinted or sunglasses for glare.
Bigger font for computer or Kindle.
A quieter environment, at least at home. (most of my computing, even game playing is done with the sound off.)

Shopping on-line at least sometimes?

We vary, in situations, difficulties and priorities, so my adjustments may not be yours
(I'm typing from a near-prone position arranged to minimise all muscle and visual effort. Much less tiring than sitting at a desk or table.)

If we cannot, for now, improve ourselves then we can, usually, make some shifts to "improve the world" to better suit how we happen to be.

Best wishes, Chris.

Thank you Dr Shepherd for the link to the MEA literature and thanks also Chris for your helpful advice. From the research I've read I feel it is down at least to oxidative stress and after all the brain needs oxygen as much as our leg, heart muscles etc. The time I'm in real trouble is if I'm having a short walk within my capabilities and someone wants to talk to me as I walk.... a double whammy and my energy seems to drain in a nano second. Who was it who couldn't chew gum and walk at the same time? Well, I'm a bit like that. I can't 'talk or listen' and 'do' at the same time.

And that is such good things you say Chris
'If we cannot, for now, improve ourselves then we can, usually, make some shifts to "improve the world" to better suit how we happen to be.'

Best wishes xxx