How I Know I’ve Taken It Too Far: When PEM Crash Is About to Hit
How I Know When I’ve Taken It Too Far.
I have learned over time that my body gives me warnings long before I fully crash. I do not always want to listen, and sometimes I miss the early signs, but they are there. When I have taken things too far or done too much, post-exertional malaise does not arrive quietly. It announces itself in ways that are hard to ignore once I know what I am feeling.
One of the first signs for me is deep inner body shaking. These are not surface tremors or something visible from the outside. They feel internal, like my entire system is vibrating from the inside out. It can be unsettling, because there is no obvious trigger in that moment. I can be sitting or lying still, and yet my body feels like it is struggling to regulate itself. When this starts, I know something is wrong. It is a signal that my nervous system is overwhelmed and trying to cope.
Another early sign is the sore throat. It comes on suddenly and without warning. It does not feel like the beginning of a cold or flu. It is random and unpredictable. Sometimes it lasts only a couple of hours. Other times it stays with me for days. It can disappear as quickly as it arrived, leaving no clear explanation behind. Over time, I have learned to recognise this sore throat as part of my crash pattern rather than an infection.
My vision often changes next. Things become blurred, doubled, or difficult to focus on. It feels as though my eyes and brain are no longer working together properly. Reading becomes difficult. Looking at screens becomes exhausting. Even trying to focus on objects in the room can feel like too much. Alongside this comes breathlessness. Simple movements such as standing up or walking a few steps suddenly feel like exertion. My heart feels like it is working too hard for too little activity. The smallest actions leave me feeling winded and weak.
As this continues, my head becomes fuzzy. Brain fog settles in, and it becomes hard to think clearly. Words are harder to find. Thoughts slip away mid-sentence. Concentration disappears. I feel mentally slowed down, as though my mind is moving through thick fog. This can be frightening and frustrating, especially when I try to push through it or pretend I am functioning normally.
Then there is the weight. This is the symptom that is hardest to ignore. It feels like a heavy pressure bearing down on my entire body. It is not just tiredness. It is not something that can be pushed through with willpower. It is a deep, overwhelming heaviness that makes movement feel impossible. My limbs feel heavy. My chest feels weighed down. Even holding myself upright feels like too much.
When this weight hits, my body makes the decision for me. I have to lie down. I have to stop. Any attempt to push past it only makes everything worse. It is as though my body is forcing me into stillness in order to protect itself. I no longer have the option of ignoring what is happening. The crash is already in motion.
These symptoms do not always arrive all at once. Sometimes they unfold slowly over hours or even days. Sometimes they hit quickly and intensely. But when I look back, the pattern is clear. These are the signs that I have crossed a line, even if I did not realise it at the time. They are my body’s way of telling me that I have exceeded my limits.
Living with this means constantly negotiating with myself. It means learning to listen earlier, even when I want to do more. It means accepting that my limits are not fixed and can change from day to day. Most of all, it means respecting the signals my body sends, even when they interrupt plans, expectations, or the version of myself I wish I could still be.
Post-exertional malaise (PEM) is not just exhaustion. It is a full-body shutdown that affects every system. These signs are not subtle once I know them. They are loud, physical, and impossible to reason away. Recognising them has not cured anything, but it has helped me understand what is happening to me and why rest is not optional. It is necessary.
This is how I know when I have taken it too far.
About Me
I am a married mother of four children. One of those children, for whom we are legal guardians (SGO)/kinship carers. I run a small business, and I love to write, which is how this blog came to be. I write about family life, kinship care, and my experiences living with chronic illness and disability, including ME CFS, spinal stenosis, chronic pain, and fibromyalgia. I write to share my perspective, raise awareness, and connect with others navigating similar challenges. I am also very aware that I am doing all of this in my mid-forties, which still surprises me some days.
