ME/CFS Bank Account Analogy

• The ME/CFS Bank Account Analogy

TL;DR: Your health is like a bank account. Every type of exertion is a withdrawal. The lower your balance, the less income you have and the harder it is to recover. Overspending can lead to overdraft penalties (seemingly random delayed fees that can range from negligible to severe = PEM) or even an account freeze, which severely restricts exertion. Pacing is managing your account to stay solvent; while approaches that increase spending, regardless of your balance risk pushing you into a negative balance and penalties.

ME/CFS

• Your energy envelope/health is like a bank account, with a maximum balance limit, with a fee structure that changes frequently.

• How much income you receive is dependent on your current balance and can be reduced randomly.

• Everything has costs.  

  • Even just lying in bed existing has costs - those costs might be negligible for those with higher balances.

  • Costs can be charged for medical, environmental, emotional, physical, metabolic, cognitive, sensory, orthostatic, or any exertion

  • Cost Structures are not necessarily logical. It is not always obvious why one cost is much higher than another.

• Different balances have different perk levels:

  • High balances have reduced fees and costs but you still need to be aware of them to make sure all the fees/costs don't add up enough to drop your balance significantly  

• If you overdraft, you get penalties (which can vary randomly from negligible to very significant, at random times hours/days/weeks after the expense. You don't know how much they will cost, how many there will be, or when they will happen. AKA PEM) and a compounding interest rate which makes it harder to get back to a positive balance.

• Upcoming penalties can build up to a relatively consistent level so your balance remains at a lower perk level (AKA Rolling PEM).

• You can also be subject to an Account Freeze which severely restricts exertion.

✅Energy Management/PACING✅

• You are focusing on your balance, trying to stay solvent, and managing your expenditures. You are typically dealing with a backload of unknown fees and costs but, long-term, your balance may increase with careful management.

🚫Graded Exercise Therapy GET🚫

• You are increasing your spending regularly regardless of your balance or upcoming penalties which risks pushing you into a negative balance and penalties.

⚠️Cognitive Behavioral Therapy CBT⚠️

• If it is GET-based - you are increasing your spending regularly regardless of your balance or upcoming penalties which risks pushing you into a negative balance and penalties.

• If it isn't GET-based - you are still spending regularly and might overdraft, if you can keep the costs and fees within your budget, it might help with some issues but won't help improve your balance.