Ashok Gupta explains "glimpsing," when CFS symptoms briefly fade during engaging activities. He argues the amygdala's chronic overstimulation drives the condition's wide-ranging symptoms, and that retraining it could reverse the illness rather than treating permanent damage.
Have you ever noticed sometimes that if your mind is thrown 100% into something very stimulating or maybe something really important or enjoyable, that temporarily you can forget about the symptoms and almost feel normal? A lot of my patients report this phenomenon, and I call it glimpsing. It is a glimpse of what you may feel like when you are better. For some people, this often happens at a social event where they are talking to people and temporarily they forget that they are ill. To show this in action, let's have a look at a diagram from before. Basically, the amygdala is sending you worrisome thoughts on the right hand side. But if your conscious mind is engaged in something else, which you feel is more important, then the amygdala thinks, hang on, I can't seem to get this person's attention, therefore maybe the symptoms aren't that dangerous and I should switch this response off. The amygdala then calms down the sympathetic arousal, that stress response, which temporarily can make you feel better and make the body feel better. But then once the engaging activity finishes and you think about your body again, then the adrenaline cycles start once more. Now, this doesn't mean that you should ignore your body, because this strategy doesn't necessarily work either. Now, here is a quote From Professor Joseph LeDoux on this subject which sums up this process of glimpsing. Arousal locks you into whatever emotional state you are in when arousal occurs, unless something else occurs that is significant enough and arousing enough to shift the focus of arousal. Basically, Professor LeDoux is saying that your mind will stay fixated on whatever is troubling you the most at a particular point in time, or whatever is the most engaging at a particular point in time, and it will subconsciously stay locked until something more arousing occurs. I have noticed that many people do get better from CFS using different therapies, and they think that that therapy is the way to get better. Then later on they sometimes have a relapse, and when they try that therapy again, it doesn't seem to work anymore. I have seen this time and time again. Now, what is going on here? Well, I believe that when someone tries a new treatment initially, that treatment may well be helping to alleviate some symptoms. For example, changing diet can in some instances make positive changes. This makes a person feel really good, and they feel that they have found the answer to CFS through their diet. They feel so positive about getting better that neurologically what is probably happening is that the messages from the amygdala are no longer getting through to the conscious brain. Therefore, the amygdala gets gradually retrained that there's nothing wrong with the body or that a person is getting better. And therefore a person gets better and better towards full recovery. Because the amygdala is not getting responses, then, for whatever reason, they may have a relapse, maybe from overdoing it or feeling overwhelmed or stressing themselves out. Then they become disillusioned and negative about the therapy which they thought had worked. Then, of course, the amygdala's messages easily get through and the cycles begin again. Then the therapy no longer seems next. We will now talk about how such bad symptoms are created by an overactive sympathetic nervous system response, also known as the fight or flight response or stress response. I believe that most of the symptoms of CFS are caused by an unremitting stimulation of the stress response. As we mentioned, that's also called the overactive sympathetic arousal. Remember that the stress response was originally designed to protect us from physical dangers and was to be stimulated for short periods of time, say if you are running away from a wild animal. If this response is stimulated for long periods of time, then it can cause all kinds of debilitating symptoms in the body, of which chronic fatigue is simply one. It can affect everything from immune system function to mitochondria function to digestive system. If you speak to someone who has experienced a panic attack, for instance, a panic attack may last simply a couple of minutes. They will tell you how exhausted they can feel for up to hours afterwards. That can help us understand why overstimulation of the stress response can produce such dramatic symptoms in the body. Now you may ask, how is CFS different to anxiety or panic attacks? I would say that the conditions are very different, but there is a common underlying factor which is chronic overstimulation of the nervous system by the amygdala. The way the amygdala does this and the mix of symptoms produced will be different for each person. Furthermore, continuing stimulation from the amygdala may cause secondary illnesses unique to each person, which further aggravates the vicious circle. The amygdala has direct connections to many different brain structures and bodily systems. As in the diagram in your notes. It doesn't just link to the hypothalamus. This means the amygdala can put the whole body on high alert instantly. Researchers used to believe that the hypothalamus was the main organ in the brain that triggered this response. But latest research is showing that actually the culprit is the amygdala There is a diagram, as I mentioned in the accompanying notes for this session, which looks at how the amygdala stimulates the whole body. Please refer to that diagram if you are interested. CFS can be so puzzling because there can be so many different symptoms which seem to come and go. However, with this explanation it is easy to see how the symptoms develop and perpetuate. Most people stimulate the stress response occasionally through the day in response to stressful situations. However, CFS patients have to live through the stress of their symptoms constantly throughout the day and such chronic stimulation of the body leads to, you know, severe muscle tension, disturbed sleep, leading to sleep deprivation, stress hormone release throughout the body, a whole host of changes. It is already known that the stress response is itself toxic to the body and so such severe symptoms resulting from the stress response is not surprising. In fact, the stress response may be so severe that it leads to many secondary complications in the body and lead researchers to think that these secondary illnesses are the cause of cfs. Now, when I first started studying the CFS literature, I was amazed at how many different clinical observations were made about CFS patients and how these observations were very different from patient to patient. The sympathetic stress response affects every organ and every system in the body, so it is no wonder that there are so many wide ranging symptoms which differ amongst patients. Now the good news is I don't believe that there is any permanent irreversible damage in your body. It is simply a bodily system that has become trained to overreact to itself. The symptoms you suffer are simply temporary symptoms. However bad the symptoms may feel, there is unlikely to be any severe permanent damage done and the state you are in, I believe is definitely reversible. I hope that for you just knowing this in itself should release some of the fear associated with cfs. It is also easy to see how patients can have the illness for years without little change. Once the trauma has occurred in the amygdala, nothing will change until the amygdala is retrained.
