MECFS & Overachievers What's the link?

The Basics

Anyone can get MECFS. Not just overachievers. 

Overachievers are more likely to push through fatigue and post-exertional malaise which can lead to worsened MECFS. 

Anyone who fails to recover from MECFS will want to highlight the ways in which they were not lazy and achieved things before ME to push back against stigma.

The narrative of overachievers who get ME is particularly powerful as it has the most contrast between before and after. 

Because the stereotype of overachieving is useful the community actively propagates it.

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Disclaimer: I Am An Overachiever 

You can define overachiever in many ways but for the purposes of this post, I will say that it is someone who is gifted with talents, unsatisfied doing only what is expected of them and for these reasons is highly accomplished for their age. 

By this definition, I am a textbook overachiever. I started coding at 10, skipped a grade in math, performed all over the world, and was planning a dual degree with a total of 3 majors.

From having over 20 hours of rehearsal and performance with the SF Symphony while acing my AP tests to building a to scale model of the Triangle Shirtwaist Factory, recording a protest song, and staying up all night labeling 146 flowers commemorating each worker in place of a poster board, I was never satisfied to "just do the assignment." 

But while my personality definitely contributed to my rapid decline, it is not the reason I am severe. Even if I had paced perfectly from day 1, Behcets flares would have slowly caused me to progress to where I am today. It simply would have been less dramatic. 

That said, overachieving has certainly made my story more striking and I believe it has greatly contributed to my success as an advocate. As you will see, this is a trend and it is part of how the stereotype of overachievers with ME persists. 

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Being An Overachiever Makes Severe ME & Diagnosis More Likely

This is because overachieving is associated with behavior choices and life circumstances that increase your chance of pushing yourself into more severe illness and of being diagnosed. 

If you push through a viral illness you are more likely to get post-viral fatigue or not properly recover. Taking time off to rest and recover during post-viral fatigue is the best way to prevent MECFS. If you continue push through post-exertional malaise your MECFS will become more severe. 

Overachievers are more likely to be stressed, ignore illness, and push through fatigue and PEM. All of this can contribute to worsened MECFS or increased risk of MECFS. 

At the same time, overachievers are also more likely to push to get diagnosed and to seek multiple medical opinions. Thus their conditions become more severe and more likely to be diagnosed. Non-overachievers who are immediately severe or pushed into severity by circumstance are more likely to go undiagnosed or misdiagnosed. Lower confidence and academic ability may also make non-overachievers more susceptible to gaslighting. 

Financial bias also increases correlation between overachieving and diagnosis. It is much easier to be acknowledged as an "overachiever" if you are financially privileged as this gives access to opportunities at a younger age. It is also easier to be diagnosed if you are financially privileged. In contrast, pwME who do not have financial resources are much more likely to go undiagnosed or die on the street regardless of how overachieving or hardworking they may be. 

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The stereotype that MECFS patients are often "Type A" or "overachievers" is just that: a stereotype. 

So how do you explain why so many prominent Myalgic Encephalomyelitis advocates like @whitneydafoe@anilaboutme @agy.lena and many more are overachievers and fit this stereotype well? 

The answer is visibility bias. A common stereotype of people with ME or "Chronic Fatigue Syndrome" is that we are lazy. (Yes there is irony here) So if you were a massive overachiever its easy to negate this stereotype.

Additionally, if you are more pressured to overachieve you are more likely to not listen to Post Exertional Malaise and chronic fatigue. To push until you visibly collapse in public or become completely bedbound with severe ME. Plus you are more likely to push back against doctors and fight for a diagnosis. All of which makes a severe ME diagnosis more likely, and overachievers more visible. 

Finally, patient advocacy with such a severely disabling disease is almost by definition an act of overachieving. Part of the reason MECFS advocacy is so difficult is that it is severely dangerous to most persons with ME to participate in it. Overachievers are more likely to risk their health for visibility, for better or for worse. 

But the truth is that ME is not a product of overachieving any more than it is the product of laziness. This stereotype might be more positive, but it still perpetuates the biosocial model of ME disproven time and time again. pwME are not just tired, not just lazy, and it is not just burnout. We have a severe neuroimmunological disease that does not discriminate based on personality type. We deserve to receive compassion, respect, and treatment, of that disease. No personality type or past achievements necessary. 

PS: For those new to this page, I recommend also checking out my posts on the flaws of meritocracy and how ME advocacy is inherently anticapitalist which shed some more light on the toxicity of this stereotype. In short, by making pwME who overachieve out to be the proof of our value, we are inherently tying our value to capitalist productivity. Even if you are the sort of overachiever who benefits socially from this stereotype, it's still a very toxic mindset for anyone with ME to carry because it means you will never see yourself with the same value as you did when you were healthy. Instead, it is essential that we learn to value people for their choices and morals (what we choose to do). Not for their abilities and resources (what we are able to do).

Note: It is also a myth that overachievers must be destined to self-sabotage. While this is the most common occurrence due to poor information, as guidelines are changed and awareness increases more overachievers are likely to learn the truth about ME early in their illness. Overachievers often suffer most from GET because they follow the program exactly. In contrast, Ron Davis had a grad student who was well informed of ME and likely an overachiever. When she became ill with ME / post-viral fatigue she practiced extremely aggressive rest for an entire year and made a full recovery. This level of dedication is also consistent with overachievers who are more willing to take extreme actions to increase odds of success. So in a future where ME information is readily available, overachievers may be able to leverage their determination and ingenuity to find ways to quickly restructure their lives and pace aggressively, improving their chances of recovery.