David Jameson
First published October 2004
Revised and updated February 2015
Revised and updated April 2016
Revised and updated October 2023
There is no agreement on the etiology of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS), and the main theories (behavioural and viral/immune) do not satisfactorily explain the condition. A growing body of evidence suggests that ME/CFS may be caused by a dysfunction of the stress system — the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis in particular — as a result of chronic stress. ME/CFS shares many similarities to occupational burnout and overtraining syndrome, including similar symptoms, physiological abnormalities, and triggers.
After a brief review of the science of stress, burnout, overtraining, central fatigue, and ME/CFS, we propose a model of ME/CFS based on a state of persistent burnout that remains after the initial stressors have been removed. This persistence may be due to a combination of a dysregulation of the ANS and HPA axis, behavioural factors, and negative feedback from the illness itself.
Keywords: chronic fatigue syndrome, myalgic encephalomyelitis, ME/CFS, burnout, overtraining, fatigue, autonomic nervous system (ANS), parasympathetic nervous system (PNS), sympathetic nervous system (SNS), heart rate variability (HRV), hypothalamic-pituitary-adrenal (HPA) axis.
Please see the paper Persistent Burnout Theory of ME/CFS in PsyArXiv for the full text.
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