The three episodes of ME/CFS that I have had were all caused by stress:
- In University days — Doing triple honors and a life threatening condition hit my father
- At Microsoft — Assigned to a bad boss that created endless non-productive stress (he was “asked” to leave shortly after I went off sick — co-workers also has issues)
- At Amazon — similar to the above, except no co-operation from fellow employees — everyone was trying to have other team members be who was cut on the next review cycle.
This week’s New Scientist article: We may finally know why psychological stress worsens gut inflammation (26 May 2023) which cited from The enteric nervous system relays psychological stress to intestinal inflammation (May 25, 2023) motivated me to cite my own experience.
Society and family often expects you to put up with stress. In some cases, it may be needing a job and stress is “just a normal aspect of that“. In other cases, there may be “drama queens”, “gas lighters” and other personality types that uses stress to manipulate people.
There have been many studies finding that ME/CFS is associated with prior stress. Some literature:
- Chronic fatigue syndrome: a stress disorder? 
- Stress-associated immune modulation: relevance to viral infections and chronic fatigue syndrome. 
- Cumulative life stress in chronic fatigue syndrome. 
- Associations of occupational stress, workplace violence, and organizational support on chronic fatigue syndrome among nurses.
- Self-critical perfectionism, stress generation, and stress sensitivity in patients with chronic fatigue syndrome: relationship with severity of depression. 
- Self-critical perfectionism predicts lower cortisol response to experimental stress in patients with chronic fatigue syndrome. 
- Stress management skills, cortisol awakening response, and post-exertional malaise in Chronic Fatigue Syndrome. 
- The comorbidity of self-reported chronic fatigue syndrome, post-traumatic stress disorder, and traumatic symptoms. 
- Premorbid personality in chronic fatigue syndrome as determined by the Temperament and Character Inventory 
One study is particularly interesting: Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients.  and likely applies to many people with microbiome dysfunctions. For many years, “Personality Type A are more prone to get ME/CFS” that is people with a pattern of behavior and personality associated with high achievement, competitiveness, and impatience. This study refines that paint brush more. Please read this study.
“Well, I can’t do anything about it”
Most people can do many things. For myself, I have (finally) accepted this simple rule: “If the stress cannot be resolved in X weeks, promptly exit stage left/abandon ship”. In terms of work, if I quit a job, take a financial hit for a while, and get a less stressful job — that is a better alternative than risking a ME/CFS relapse and being unable to work at all. In terms of family, decline contact with stressful members of the family. The latter often require a smoke screen so you agree to come to family gathering and then car troubles, work emergency, prevents you attending.
In other cases, it may take help from others to identify and unlearn habits/conditionings from childhood or prior relationships.
Society and friends can be a major source of stress. This can come from many sources “high expectations of you” to “keeping up with the Jones” to “you are not doing your duty”.
IMHO, your first duty is for your own health. How can you support and care for others when your health is blocking things.
Stress is a co-factor
Other factors are involved, diet, past virus, DNA. Stress is a significant factor and for many people it is the hardest to change because people often resign to their current stress level. For myself, I often surprise my wife by being hyper-reactive to issues. I avoid procrastination and attempt to deal with issues promptly — it is an effective way of reducing stress. Procrastination on the grounds of having to think thing over (or hoping things will resolve themselves) adds to your stress queue in small amounts. If you can’t do anything about it, then accept that reality and don’t worry about it.
Take a hard look at stress in your life and then resolve them. Your health is the cost of not resolving them.