It is but normal for all of us to get tired, or feel depressed and run down during our hectic routine. But do you feel chronically tired and fatigued without any apparent cause or underlying disease condition? If so, you could be suffering from chronic fatigue syndrome/CFS.
CFS still remains a controversial topic among professionals and public alike. Even as diagnoses of the condition increases existence of CFS is doubted, and many consider it to be a psychological ailment. But research has confirmed that it is a physical illness; only that it is not fully understood. It is therefore important for you to remember that your fatigue is real, and that you can work with your doctor to improve your symptoms.
Chronic fatigue syndrome
Chronic fatigue syndrome/CFS is a devastating and complex disorder characterized by overwhelming fatigue that is not improved by bed rest, and may be worsened by physical or mental activity. There is no apparent or clinically evident underlying disease condition responsible for the symptoms. The condition is seen to affect individuals between the ages of 20 to 40 years. Females are seen to be affected more than males. These individuals most often function at a substantially lower level of activity than they are capable of before the onset of illness.
Definition of CFS includes the presence of severe chronic fatigue of six months or longer duration with exclusion of other known medical conditions, and presence of four or more of the symptoms (substantial impairment in short-term memory or concentration, sore throat, painful lymph nodes, muscle pain, pain in multiple joints without swelling or redness; headaches of a new type, pattern or severity; unrefreshing sleep; and post-exertional malaise lasting more than 24 hours).
Causes
Cause of CFS is unknown. A dysfunction of the immune and central nervous system has been implicated as one of the possibilities. Few risk factors that are being studied as reason for CFS are genetic predisposition, age, gender, prior illness, environment, and stress. Iron deficiency anemia, environmental allergies, sleep disorders, and low blood pressure are also suggested to have a role in CFS. Viruses such as Epstein Barr virus (EBV) are thought to cause CFS; however it has not been proved. Some experts opine that infection with the bacterium Chlamydia pneumonia may be a cause of CFS in some individuals.
Symptoms
Symptoms of CFS include overwhelming fatigue and weakness that are not alleviated by rest. The individual finds it difficult to perform daily tasks such as getting out of bed, dressing, and eating. Chronic fatigue is seen to affect school, work, and leisure activities. Symptoms may include forgetfulness/trouble concentrating, sore throat, muscle pain or multi-joint pain without swelling, headaches of a new type, pattern, or severity, unrefreshing sleep and vague feelings of illness or depression after exerting oneself. Other symptoms may be mild fever, blurry vision, chills, night sweats, diarrhea, and fluctuations in appetite and weight. Persons with CFS may have problems finding or saying a particular word during normal speech (verbal dyslexia).
Diagnosis
There is no single diagnostic test to identify CFS. Chronic fatigue syndrome is a hard to diagnose condition and is said to be a diagnosis of exclusion. Also, the condition may mimic other disorders such as viral infections, kidney disease, cardiac disease, depression, hormone disorders, and neurological illnesses. So first and foremost, the doctor will exclude other underlying disease conditions that could cause symptoms of fatigue by taking a detailed history and asking for blood and urine tests. A psychologist can help in the assessment of symptoms in relation to cognitive skills, concentration, memory, personality, and overall psychological state.
Physical examination of an individual may show evidence of fever, lymph node swelling and tenderness, and redness in the throat without drainage or pus. Brain MRI may show swelling in the brain or destruction of part of the nerve cells. There may be higher levels of specific white blood cells (CD4 T cells) compared with other types of white blood cells (CD8 T cells). Single-photon emission computed tomography and/or positron emission tomography scans may reveal presence of decreased blood flow in areas of the brain.
Treatment
There is currently no reliable or proven cure for CFS. Symptoms such as pain, discomfort, fever, anxiety, and depression can be eased by antidepressant medications, pain medications, anti-inflammatory drugs, and antiviral medications in some patients. Antibiotics are not seen to provide any benefit in CFS. Cognitive behavioural therapy, graded exercise, and sleep management techniques are some of the proposed treatments. Relaxation techniques such as biofeedback, deep breathing exercises, hypnosis, massage therapy, meditation, muscle relaxation techniques, and yoga are suggested to help alleviate symptoms.
Self help
Individuals with CFS should be encouraged to maintain active social lives. He/she should implement a regular regimen of mild physical exercise. He/she should avoid sudden bursts of exercise and should pace themselves while doing any physical activity. People with CFS should have a healthy diet and avoid heavy meals, alcohol, caffeine, and large quantities of junk food. They may try undergoing acupuncture, massage, stretching, yoga, and tai chi, to help with the symptoms of fatigue. Sessions with a licensed therapist or counselor can help the person cope with the limitations brought on by the illness, and to change negative or unrealistic thoughts or feelings into positive, realistic ones.
The person should try to find a level of activity that he/she can handle without getting fatigued. Activity management should involve avoiding doing too much on days when the person feels tired, balancing time between activity, rest, and sleep, breaking big tasks into smaller more manageable ones, and spreading out more challenging tasks throughout the week.
Fight the fatigue
Chronic fatigue syndrome is characterized by prolonged and severe tiredness or weariness that is not relieved by rest and is not directly caused by other conditions. Symptoms of CFS often develop suddenly, and come and go or remain for months. Managing chronic fatigue syndrome can be as complex as the illness itself as there is no cure yet for it. The key to managing CFS is to work with a team of doctors and other health care practitioners such as mental health professionals, rehabilitation specialist, and physical or exercise therapists, to create an individualized treatment program. Finally, the individuals with the best chance for improvement are those who remain as active as possible, and who seek some degree of control over the course of their illness.
