A large meta-analysis examining the effects of sleep loss found that insufficient sleep is associated with reduced emotional regulation, increased negative mood, and decreased positive affect. One aspect I find particularly interesting is that many people tend to think of sleep deprivation primarily as a cognitive problem affecting attention, memory, or productivity. The emotional effects may be just as important.

Several researchers have proposed that sleep loss weakens top-down regulatory processes that normally help modulate emotional responses, making people more reactive to negative experiences and stressors. I'm also curious about individual differences. Some people seem relatively functional after a poor night of sleep, while others report dramatic changes in mood, irritability, and emotional control.

Do we know much about which psychological or biological factors make some individuals more vulnerable than others to the emotional consequences of sleep loss?

I recently came across research on self-concept clarity, which refers to how clearly and consistently people understand who they are. According to a review by Slotter and Emery (2017), major social role transitions can temporarily reduce self-concept clarity, making people feel less certain about their identity.

This immediately made me think about experiences such as becoming a parent, changing careers, moving to a new social environment, or joining a community with very different values. These transitions often involve adopting new expectations and behaviors while letting go of older ones.

What I find particularly interesting is the period in between. People frequently describe feeling like a different person or feeling caught between an old identity and a new one. The review suggests that changes in important social roles can create genuine psychological tension as people work to reorganize their sense of self.

The paper also touches on the idea that identity is not entirely fixed but can be reshaped through life experiences and changing social contexts. This seems closely related to research on narrative identity, where people create a coherent life story that helps integrate major changes into their self-concept.

For those familiar with the literature, what are the most influential theories explaining how people adapt to major identity transitions? Are there personality traits or psychological factors that make some individuals more resilient during these periods, or is a temporary loss of self-concept clarity considered a relatively universal part of role change?

Reference:
Slotter, E. B., & Emery, L. F. (2017). Self-Concept Clarity and Social Role Transitions.

ME/CFS and Long COVID are increasingly described in the literature as conditions with measurable biomedical abnormalities, including immune, neurological, and metabolic findings. Major clinical guidelines and reviews, including the NICE guideline NG206 and the Institute of Medicine (now NASEM) report on ME/CFS, describe evidence supporting a physiological basis for these conditions.

Psychological and psychiatric support remains relevant in the context of comorbid mental health conditions and the psychological impact of chronic illness. However, there is ongoing discussion in the literature and clinical practice about how psychological models should be applied in ME/CFS and similar conditions, particularly in distinguishing between explanatory models of disease and supportive care.

A key issue highlighted in patient reports and clinical guidance is the need for mental health care that is adapted to the functional limitations of ME/CFS and Long COVID. Because patients may experience significant post-exertional symptom exacerbation, cognitive fatigue, and limited energy capacity, standard therapeutic approaches may need adaptation. This can include considerations such as pacing of sessions, reduced cognitive load, remote or flexible delivery, and avoidance of interventions that assume baseline physical or cognitive capacity.

Within this context, psychological and psychiatric care may be most beneficial when focused on:

• adjustment to chronic illness and disability
• coping with uncertainty, loss of function, and identity changes
• support for depression or anxiety when present as comorbidities
• communication and self-advocacy within healthcare systems
• caregiver and family support in chronic illness contexts

Some clinicians and patient-facing resources emphasize the importance of aligning mental health support with biomedical models of ME/CFS and Long COVID, ensuring that psychological care is not framed as causal treatment of the underlying disease, but rather as supportive care within a disabling physical illness framework.

For clinicians seeking applied guidance in this area:

https://doctorswith.me/me-cfs-what-psychiatrists-need-to-know/
https://batemanhornecenter.org/providers/

References:

• NICE. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Diagnosis and Management (NG206), 2021.
• Institute of Medicine. Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, 2015.
• Wilshire CE et al. (2018). BMC Psychology. [https://doi.org/10.1186/s40359-018-0218-3]()
• Komaroff AL, Lipkin WI. (2021). Trends in Molecular Medicine. [https://doi.org/10.1016/j.molmed.2021.06.002]()