What Is Chronic Fatigue Syndrome?
Characterized by extreme fatigue that is not resolved with rest, chronic fatigue syndrome is a debilitating condition that affects between 850,000 to 2.5 million Americans. Most estimates put the diagnosis rate at around 10% of cases, meaning the vast majority of people with CFS have not been identified.
Because it is a chronic condition, a diagnosis of CFS can mean a lifetime of debilitating illness. It affects an individual’s ability to perform routine activities and can drastically impact lifestyle.
1. Is CFS the Same as Myalgic Encephalomyelitis?
While most people have only heard it called chronic fatigue syndrome, the condition is also recognized by other names. The most widely used of these is myalgic encephalomyelitis. Many specialists refer to it as ME/CFS for this reason. Myalgic refers to long-term, persistent muscle pain, which is quite common among patients with chronic fatigue syndrome. Encephalomyelitis, on the other hand, is swelling of the spinal cord, brain or brain stem. It indicates the neurological involvement often associated with the condition.
Myalgic encephalomyelitis isn’t the only alternative label for CFS, however. It is also sometimes called systemic exertion intolerance disease.
2. What Causes Chronic Fatigue Syndrome?
Doctors are unsure about what leads to CFS. Many researchers feel that it is actually the end result of other infections. Roughly one in ten people who have a severe case of viral infection will go on to meet diagnostic criteria for chronic fatigue syndrome.
Not everyone diagnosed with CFS has experienced a severe infection. Other factors that may cause the condition include a compromised immune system, hormonal changes, and severe and prolonged stress that affects the body’s chemistry. There may also be a genetic component to the condition since there appears to be a family connection.
3. Who Is at Risk of Developing it?
CFS can affect anyone regardless of age, gender or ethnic background. However, it is much more prevalent among certain groups. Most cases are diagnosed in adults between the ages of 40 and 50. However, children and adolescents can also develop CFS.
Women are at a significantly increased risk of the disease compared to men. CFM is also more commonly diagnosed in whites than other ethnicities. That may be due to a high estimated prevalence of undiagnosed cases among minority populations, more so than the actual rates of disease.
4. What Are the Symptoms of CFS?
The most prevalent symptom of chronic fatigue syndrome is fatigue. It is pervasive and experienced by all patients with the condition. It can range from feeling drained to being unable to get out of bed in the morning. Activities that others find easy often seem impossible for people with CFS.
Besides pain, many CFS patients also experience confusion or memory issues, often described as a “brain fog.” Dizziness is common, especially when changing positions, sitting or standing, as is a nonspecific muscle or joint pain.
5. What Is Post-Exertional Malaise?
Although all CFS patients experience fatigue, some are more affected than others by activities that require even minor levels of exertion. This often results in a secondary diagnosis of post-exertional malaise. Patients with PEM suffer extreme exhaustion after even relatively minor physical, emotional or mental exertion.
A PEM episode will usually develop 12 to 24 hours after the period of exertion. It can last for anywhere from several days to weeks. Those who experience severe post-external malaise should learn what activities trigger episodes and how they can minimize their impact.
6. How Is Chronic Fatigue Syndrome Diagnosed?
Getting to a diagnosis of chronic fatigue syndrome can be a long and complicated process. It is currently based on a comprehensive medical history that eliminates other, more easily detected, conditions. Prolonged fatigue that lasts for more than six months is one of the current markers for diagnosis.
Work is being done to uncover a more accurate and quicker method, and researchers have recently started testing a blood test that could streamline the diagnostic process. It detects cellular consumption of ATP, a chemical used to produce energy. People with CFS appear to have a reduced ability to use ATP to regulate physical stress at the cellular level.
7. How Is CFS Treated?
Current treatment focuses on managing symptoms and improving the quality of life of patients living with CFS. The universal treatment is rest. For some, this means simply getting adequate sleep at night. For others, it means stopping to rest after performing activities. Individuals who find it difficult to fall asleep may benefit prescription sleep aids that do not contribute to drowsiness.
Pain associated with CFS can be managed with medications and other, non-pharmaceutical, pain management strategies. Stress, anxiety and depression can be addressed with counseling and anti-depressants.
8. Who Treats Patients with Chronic Fatigue Syndrome?
Your primary care doctor will be your main point of contact for all treatment. However, you may need to see specialists in order to manage specific symptoms. Occupation therapists can help you devise strategies for completing daily activities such as showering, getting dressed and maintaining your home that can pose serious challenges for CFS patients. Working with a physical therapist may also help improve muscle strength and minimize atrophy associated with a lack of activity.
Research hospitals are studying various treatments that may benefit CFS patients. The clinical trials they offer help uncover new therapies and diagnostic tests and can be an excellent way to gain access to cutting edge treatment options.
9. What Is the Prognosis After Diagnosis?
There is no uniform prognosis for CFS patients. The severity of symptoms will largely impact how individuals fare after being diagnosed with CFS. A minority of patients will have symptoms so severe that they will be unable to independently manage activities of daily living. They may become bedbound and require constant care.
The majority of people diagnosed with CFS will be able to function at a higher level. However, they will still need to make adaptations that allow them to get the proper amount of rest and to recover after activities. This may mean attending school through alternate means or working reduced hours at a job. For many, CFS can mean changing career aspirations in order to accommodate the disease.
10. Does CFS Cause Other Complications?
Unfortunately, the strain of chronic fatigue can lead to a host of other complications. Many of those are related to emotional well-being. For example, both depression and anxiety are common among CFS patients. Many people also report increased isolation as they struggle to maintain connections with others who are more active.
As the condition progresses, lifestyle adaptations may be required. This can include changes in transportation and housing needs. It can also be difficult to maintain a full work schedule, which can lead to financial strain and additional stress, further aggravating symptoms.
