Understanding Chronic Fatigue Syndrome
Chronic Fatigue Syndrome (CFS) is a medical condition (ICD-9 Code 780.71) that is also referred to at times as myalgic encephalomyelitis (ME) or systemic exertion intolerance disease (SEID). CFS is a chronic disease — a biological condition, not a psychological disorder. The exact process of how the disease develops and progresses is not fully understood.
CFS can begin gradually or suddenly. It is a complex multisystem disease commonly defined by extreme fatigue, including cognitive dysfunction, sleep problems, and disruption of the nervous system that controls internal organs, muscles, and glands. It can also cause post-exertion physical discomfort, resulting in severe impairment of activities of daily living lasting for at least six months.
This pain and fatigue do not go away with bedrest and cannot be explained by any other medical condition.
CFS can affect anyone, even children, although it is most common among women between 40 and 60 years of age. Some studies have shown that it is fairly common for more than one member of a family to be affected. There is currently no cure. The goal of treatment is to reduce and relieve symptoms.
How CFS Affects Daily Life
People with CFS may not look sick but may be unable to do their normal activities. Some symptoms may become worse after physical or mental activity. After exertion, a person may need to stay in bed for an extended period of time. About one in four people with CFS are confined to bed at some point during their illness.
Diagnosis: Ruling Out Other Conditions
There is no specific test for CFS. Because other illnesses can cause similar symptoms, your physician will have to rule out other diseases before making a diagnosis of CFS. Your provider will perform a thorough medical examination and ask about your symptoms, including when they began, how severe they are, whether anything triggers them, and how they affect your daily life. They will also review your medical history, family history, and any current health conditions to help rule out other causes of your symptoms. This is the time to provide as much detail as possible.
Your care provider may also order tests to check for other medical conditions that could be causing your symptoms. This process is referred to as a “rule out” situation, meaning other conditions are being excluded as the cause of the present problem.
Common Symptoms of CFS
Symptoms of CFS can vary from person to person and often fluctuate from day to day. The most common symptoms include overwhelming fatigue that does not improve with rest, feeling worse after physical or mental activity, unrefreshing sleep, problems with memory or concentration, dizziness when standing, and muscle or joint pain. Some people also experience headaches, sore throats, tender lymph nodes in the neck or armpits, and increased sensitivity to light, sound, smells, foods, or medications.
Managing Symptoms
There is no approved “standard” treatment for CFS, so treatments focus on managing symptoms.
A. Know Your Limitations
Keep a diary that tracks your energy levels and note whether it was a “good” day or a “bad” day. The purpose is to identify patterns that contribute to how you feel and that affect your energy levels. Prioritize essential tasks, break them into smaller steps, and use your energy-level diary to help plan activities and schedule rest periods between them.
Getting adequate sleep is important. Establish a bedtime routine with a comfortable and relaxing bedroom environment. Avoid stimulation before bedtime, including alcohol, computers, television, and similar activities so you can properly wind down.
B. Keep a Symptom Diary
Keeping a diary of your symptoms, energy levels, and what you eat can help identify patterns that affect how you feel. People with CFS often also experience symptoms of irritable bowel syndrome, so tracking meals and symptoms may reveal foods that trigger digestive problems or worsen fatigue.
C. Pay Attention to Nutrition and Hydration
Whenever possible, avoid foods and drinks high in sugar, as rapid rises and falls in blood sugar can increase fatigue. Because people with CFS often do not feel hungry or may be too tired to eat, those struggling with regular meals or weight loss may benefit from eating smaller meals more frequently and adding snacks between meals. Staying hydrated is also important, as dehydration can aggravate fatigue, so drink plenty of fluids, especially water, and limit high-sugar beverages, energy drinks, and excessive caffeine intake.
D. Exercise in Moderation
Some exercise is good, but do not overdo it. Work toward a balance between exertion and rest. Relaxing activities such as slow walking, stretching, or gentle yoga may improve some symptoms.
E. Take Control
Sometimes you have to say no. Look at your priorities and decide which things you can remove from your plate. This may mean scaling back commitments such as volunteering or social obligations. Do not place unrealistic expectations on yourself that will exhaust you and increase your symptoms.
F. Protect Your Mental Health
Living with CFS can take a toll on your mental health as well as your physical health. Stress, depression, and anxiety often overlap when coping with a chronic condition such as CFS. Stress-reduction techniques such as acupuncture, breathing exercises, massage, yoga, and meditation may help improve coping and overall well-being while living with CFS. Seeking counseling for emotional health and developing coping mechanisms may also help you manage your condition.
Final Thoughts
Again, chronic fatigue syndrome (CFS) is a chronic biological medical condition, not a psychological disorder. However, it is important to take good care of both your physical and mental health in order to cope with this long-term condition.
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