What is chronic fatigue syndrome?

Chronic fatigue syndrome is a puzzling problem. There are many theories about it and few answers. And that only adds to the frustration and helpless feelings of the people with the condition. Because most symptoms are invisible, it is difficult for others to comprehend the array of debilitating symptoms that people diagnosed with chronic fatigue syndrome endure. (The difference between chronic fatigue syndrome and chronic fatigue is that the syndrome includes fatigue with other symptoms while chronic fatigue involves only fatigue.)

The symptoms of chronic fatigue syndrome don't fit neatly into categories. There is no definitive test like there is for diabetes. The symptoms may vary from person to person, fluctuate in severity, and be interpreted differently from physician to physician. "There is not one single condition that is responsible. It is a real grab bag of things," says Arthur Hartz, M.D., University of Iowa Health Care.

Symptoms can include profound exhaustion, low stamina, problems with concentration and short-term memory, pain in the joints and muscles, tender lymph nodes in the armpit or neck, sore throat, unrefreshing sleep, and headaches. Incapacitating fatigue, not relieved by rest and lasting more than six months, has become one of the few set criteria for the condition. "This level of fatigue forces people to reduce their level of activity by as much as 50 percent and change their way of life," says Hartz.

The diagnosis process is lengthy and frustrating. Chronic fatigue is often misdiagnosed because it resembles other disorders such as fibromyalgia, Lyme disease, mononucleosis, multiple sclerosis, lupus, and candida albicans. In most cases, chronic fatigue is diagnosed when other medical illnesses that cause fatigue have been ruled out and no other cause for the fatigue and accompanying symptoms can be found.

What can be done?

Communication between physician and patient is important to evaluate symptoms and discuss possible new treatments. Courses of treatment vary from person to person because of the nature of chronic fatigue. Most treatment is aimed at relieving the symptoms and improving the patient's quality of life.

A personal rehabilitation program

Hartz says it is important to recognize your limitations but not be limited by them. "The struggle with chronic fatigue entails more than dealing with the physical symptoms, contending with your emotions can be equally demanding. Cognitive therapy helps you understand and manage the disease. Exercise therapy helps you stay as active as you can without overdoing it," says Hartz.

• Learn to accept the bad days as well as the good ones.
• Journal to help you identify energy drains and speed up your learning curve of what to do and what to avoid.
• When you feel good, use that time no matter how short, to do something that energizes you without stressing or taxing your body.
• Ask the right questions. Don't waste time by asking questions like "Why me?" There is no answer. Instead ask questions like "What can I do? Where are my interests?" and then figure out how to incorporate the answers into your life.
• Don't become a recluse. When possible, get out and participate in activities with people you enjoy.
• When you venture out, you may find yourself being judged and incorrectly labeled. Try not to judge in return and certainly don't judge yourself for being ill.
• Rejoice in the love and support you have from family and friends.

Recovery?

The word recovery takes on a different meaning with chronic fatigue. Some patients recover completely with time. Most others recover well enough to resume work and other activities but may experience periodic symptoms, while others may grow progressively worse.

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• U.S. Centers for Disease Control and Prevention / National Center for Infectious Diseases
  Chronic Fatigue Syndrome: Support Groups
• Arthritis Foundation
  What's in a Name: Fibro vs. CFS

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