I'm often asked if a severe period of stress can either bring on CMT in a person who has not previously experienced symptoms or make CMT worse in a person who has mild symptoms.

Just recently, in a two-day period, I was asked if prolonged extensive forced exercise could bring on CMT; if silicone breast implants or if an industrial accident causing herniated discs could make CMT worse. People involved in automobile accidents often write to ask if the accident could have caused their CMT to worsen and I've also heard from a person who was dumped from a wheelchair while being carried downstairs, someone who fell off a ladder and a woman who tripped on a section of uneven sidewalk. Marital problems, looking after relatives, financial problems, divorce and lost employment also seem to be major stressors that exacerbate CMT.

To my knowledge there is no research being done or that has been done on the effects of major stressors on CMT and this is mainly because you can't measure stress. The people in question weren't in a program to measure how they were physically and mentally before their major life event so no one really knows what their CMT was like then. Only they know. Research is not based on your say, it is based on measurement. Telling a doctor you are much worse now than you were six months ago just doesn't do it.

As Dohrenwend and Dohrenwend (1979) said, if we could "measure the magnitude of life events with something approaching the incisiveness with which we measure the magnitude of electric shock or exposure to combat" the predicted relationship would emerge. But, we have what I call soft anecdotal evidence that a person who has CMT, whether it is evident or not, can see it either become evident or worsen when he/she experiences a major life stressor. It doesn't happen in everyone and, just as not everyone reacts the same way to drugs, not everyone reacts the same way to various stressors.

Holmes-Rahe scale of stress ratings.
Death of a Spouse - 100; divorce - 73; marital separation - 65; jail term - 83; death of a close family member - 63; personal injury or illness - 53; marriage - 50; fired at work - 47; marital reconciliation - 45; health change - family member - 44; change in sleeping habits – 16; change # of family get-togethers - 15; change in eating habits - 15; vacation - 13; Christmas - 12; minor violations of the law - 11.

Those are all Holmes and Rahe wrote. I won't attempt to rate the following as the Holmes and Rahe study is based on research, but I'll venture to say that they are just as important and carry just as much weight as any of the other items on the Holmes and Rahe scale. The H&R scale works with normal people not a population that is born with a chronic syndrome.

These are what I'd add to a scale for people with CMT. Coping with the side effects of a new drug; learning a new shoe; a change in mobility, e.g. from canes to walker or from walker to wheelchair; a change in how you see yourself; loss of independence; pregnancy; looking after a family especially with several young children; looking after sick parents or in-laws; being in pain all the time; a severe illness - pneumonia, shingles, heart, colitis, etc.; a severe personal injury, e.g. car accident or a bad fall; surgery for CMT; surgery of any kind; overwork; anxiety about a job; too much exercise; worry over CMT children; trying to do it all.

When you consider that life=stress, then life+CM=stress squared. Use the H&R scale listing stresses that have happened in the last 24 months. Add them up and if your total if over 300, according to some of the books I have on stress, you'll have a greater chance of illness at your weakest point in the near future. If you are a healthy individual but are predisposed to CMT it makes sense that major stressors could bring it on, does it not? If you experience CMT, it also makes sense that major stressors could make it worse. I can't prove this, no one can, but it seems like common sense if you think about it. Trying to prove it in a court of law is tough but we'll keep gathering information and case histories and perhaps someone will figure out a way to "measure" stress to satisfy those who want the numbers instead of our reasoning.