human bodies actively maintain an equilibrium that works pretty well for them.
sometimes you are knocked out of this equilibrium, but the all the maintenance mechanisms still work and you get back to normal. E.g. you get sick and feel like shit for a few days, but your body clears the virus and you recover 100%.
For issues like this, treatment is based on the first or root cause. if have strep throat you get antibiotics, if you broke your arm you need it set. Treating symptoms might be nice, but the issue will continue until the root cause is cleared.
sometimes you get knocked into a new equilbrium. You start out with externally caused anxiety, but that disrupts your sleep, which makes you anxious, which disrupts your sleep… And this is stable even if you remove the initial issue that made you anxious. You now have Bad Equilibrium Disease.
Original cause is almost irrelevant when treating Bad Equilibrium Disease. If anxiety gives you insomnia and insomnia gives you anxiety, treating either will shift you to a better equilibrium.
Most of medicine focuses on problems with root causes. Even if you go to alternative modalities, they usually sell themselves as being better at finding root causes. But sometimes there either is no root cause, or it’s not directly fixable, and you can still get tremendous gains by moving yourself to a better equilibrium.
This also sometimes implies that efforts to get out tend to suffer defeat in detail (https://en.wikipedia.org/wiki/Defeat_in_detail). If there’s 4 factors amphicausally propagating themselves, and you intervene on 1 (one) factor (strongly and in the right direction), the other 3 factors might be enough to maintain the bad equilibrium anyway.
This can lead to boondoggling: you correctly perceive that intervention X is somehow relevant, and is somehow directionally correct and has some effect. A bit of X gets a small temporary good effect. So you do X more. It doesn’t work. But maybe that’s just because you didn’t do X enough. So you invest even more in X. Since the bad equilibrium is confusing (no one root factor, in terms of factors you already understand) and out of sight, you don’t know why more X doesn’t work, so you don’t have an intuitive reason to not think more X might help… so you just keep doing more X even though it doesn’t get you out of the equilibrium.
this is more of a trap than BED, but: obesity makes exercise harder. Lack of exercise increases obesity. Past a certain point this downward spirals. Including if the lack of exercise was initially due to an injury or obesity to a medication side-effect.
example I just learned: inflammation increases hepcidin. Hepcidin reduces iron levels. Low iron makes it hard to exercise. Exercise would reduce inflammation, but you can’t. Exercise and for that matter oxygen help weight loss, which would also reduce inflammation, but you still can’t.
Chronic Fatigue Syndrome is, maybe—maybe—someth8ing of that kind.
Unfortunately, (a) the clinical trials of Cognitive Behavioral Therapy in this area, and as a result (b) we have a strong suspicion that it is ineffective as a treatment, and maybe is actually harmful relative to no treatment at all.
So, eg. does exercizing break you out of the bad equilibrium, or does it tighten the noose around your your neck tighter, making you more sick, disabled, and (potentially) closer to death?
What mutually reinforcing factors would be maintaining people in a chronic fatigue equilibrium? I’d be fascinated if some chronic fatigue could be explained this way.
CFS features elevated inflammation, and some people argue is fundamentally a disease of inflammation.
Inflammation can be a bad equilibrium disease all on its own (two simple mechanisms: cytokines attract more immune cells, which themselves produce cytokines. The immune cells may additionally damage healthy tissue, which will produce more inflammation markers).
Inflammation leads to a panic mode where your body underinvests in itself long term.
Inflammation reduces ability to digest nutrients and raises sensitivity/allergies, so feeding yourself becomes harder.
This isn’t strictly biological and I wouldn’t call it BED on its own, but in practice anything that causes fatigue will make it harder to do things that help you in the long term.
Best guess, CFS is spurred by an initial infection, but lingers long after.
Something something mitochondria or energy thermostat something something.
I have a model that:
human bodies actively maintain an equilibrium that works pretty well for them.
sometimes you are knocked out of this equilibrium, but the all the maintenance mechanisms still work and you get back to normal. E.g. you get sick and feel like shit for a few days, but your body clears the virus and you recover 100%.
For issues like this, treatment is based on the first or root cause. if have strep throat you get antibiotics, if you broke your arm you need it set. Treating symptoms might be nice, but the issue will continue until the root cause is cleared.
sometimes you get knocked into a new equilbrium. You start out with externally caused anxiety, but that disrupts your sleep, which makes you anxious, which disrupts your sleep… And this is stable even if you remove the initial issue that made you anxious. You now have Bad Equilibrium Disease.
Original cause is almost irrelevant when treating Bad Equilibrium Disease. If anxiety gives you insomnia and insomnia gives you anxiety, treating either will shift you to a better equilibrium.
Most of medicine focuses on problems with root causes. Even if you go to alternative modalities, they usually sell themselves as being better at finding root causes. But sometimes there either is no root cause, or it’s not directly fixable, and you can still get tremendous gains by moving yourself to a better equilibrium.
This also sometimes implies that efforts to get out tend to suffer defeat in detail (https://en.wikipedia.org/wiki/Defeat_in_detail). If there’s 4 factors amphicausally propagating themselves, and you intervene on 1 (one) factor (strongly and in the right direction), the other 3 factors might be enough to maintain the bad equilibrium anyway.
This can lead to boondoggling: you correctly perceive that intervention X is somehow relevant, and is somehow directionally correct and has some effect. A bit of X gets a small temporary good effect. So you do X more. It doesn’t work. But maybe that’s just because you didn’t do X enough. So you invest even more in X. Since the bad equilibrium is confusing (no one root factor, in terms of factors you already understand) and out of sight, you don’t know why more X doesn’t work, so you don’t have an intuitive reason to not think more X might help… so you just keep doing more X even though it doesn’t get you out of the equilibrium.
My post “The “mind-body vicious cycle” model of RSI & back pain” describes another (alleged) example of Bad Equilibrium Disease.
this is more of a trap than BED, but: obesity makes exercise harder. Lack of exercise increases obesity. Past a certain point this downward spirals. Including if the lack of exercise was initially due to an injury or obesity to a medication side-effect.
example I just learned: inflammation increases hepcidin. Hepcidin reduces iron levels. Low iron makes it hard to exercise. Exercise would reduce inflammation, but you can’t. Exercise and for that matter oxygen help weight loss, which would also reduce inflammation, but you still can’t.
Chronic Fatigue Syndrome is, maybe—maybe—someth8ing of that kind.
Unfortunately, (a) the clinical trials of Cognitive Behavioral Therapy in this area, and as a result (b) we have a strong suspicion that it is ineffective as a treatment, and maybe is actually harmful relative to no treatment at all.
So, eg. does exercizing break you out of the bad equilibrium, or does it tighten the noose around your your neck tighter, making you more sick, disabled, and (potentially) closer to death?
What mutually reinforcing factors would be maintaining people in a chronic fatigue equilibrium? I’d be fascinated if some chronic fatigue could be explained this way.
CFS features elevated inflammation, and some people argue is fundamentally a disease of inflammation.
Inflammation can be a bad equilibrium disease all on its own (two simple mechanisms: cytokines attract more immune cells, which themselves produce cytokines. The immune cells may additionally damage healthy tissue, which will produce more inflammation markers).
Inflammation leads to a panic mode where your body underinvests in itself long term.
Inflammation reduces ability to digest nutrients and raises sensitivity/allergies, so feeding yourself becomes harder.
This isn’t strictly biological and I wouldn’t call it BED on its own, but in practice anything that causes fatigue will make it harder to do things that help you in the long term.
Best guess, CFS is spurred by an initial infection, but lingers long after.
Something something mitochondria or energy thermostat something something.
There seems to be something missing here… Are you saying the trials went well, or poorly, or..?