What Is Chronic Fatigue Syndrome?
We all get tired. Many of us have felt depressed at
times. But the mystery known as chronic fatigue syndrome (CFS) is not
like the normal ups and downs we experience in everyday life. The early
sign of this illness is a strong and noticeable fatigue that comes
on suddenly and often comes and goes or never stops. You sometimes
feel too tired to do normal activities or are easily exhausted with
no apparent reason. Unlike the mind fog of a serious hangover, to which
researchers have compared CFS, the profound weakness of CFS does not
go away with a few good nights of sleep. Instead, it slyly steals your
energy and vigor over months and sometimes years.
How Does CFS Begin?
For many people, CFS can begin after a bout with a minor illness such
as a cold, or an intestinal bug. Often, people say that their illnesses
started during a period of high stress. In others, CFS develops
more gradually, with no clear illness or other event starting it.
What Are The Symptoms?
Unlike influenza symptoms, which usually go away in a few days or weeks,
CFS symptoms either hang on or come and go frequently for more
than 6 months. Symptoms can include: headache, tender lymph nodes, fatigue
and weakness, muscle and joint aches, and the inability to concentrate.
Who Gets CFS?
CFS was once called "yuppie flu" because those who sought
help for and caused scientific interest in CFS in the early 1980s
were mainly well-educated, well-off women in their 30s and 40s. Since
then, doctors have seen the syndrome in people of all ages and social
and economic classes from several, mostly English-speaking, countries
around the world. Similar illnesses, known by different names, date
back at least to the late 1800s.
Still, for unknown reasons, CFS is diagnosed two to four times more
often in women than in men. In addition, some members of the medical
community and the public do not know about or are skeptical of the
syndrome.
How Many People Have CFS?
Because there is no specific laboratory test or clinical sign for
CFS, no one knows how many people are affected by this illness.
The Centers for Disease Control and Prevention (CDC) estimates,
however, that as many as 500,000 people in the United States have
CFS or a CFS-like condition.
What Causes CFS?
While no one knows what causes CFS, for more than a century, doctors
have reported seeing illnesses similar to it. In the 1860s, Dr.
George Beard named a similar or identical syndrome "neurasthenia" because
he thought it was a nervous disorder with weakness and fatigue.
In the mid-1980s, health
experts labeled the illness "chronic
EBV" infection when laboratory clues led scientists to wonder
whether the Epstein-Barr virus (EBV), one of the causes of infectious
mononucleosis, might be causing this group of symptoms. Evidence
soon cast doubt on this theory.
How Is CFS Diagnosed?
Health care providers find it difficult to diagnose CFS because
it has the same symptoms as many other diseases. When talking with
and examining you, your health care provider must first rule out
diseases that have similar symptoms. In follow-up visits, you and
your provider need to watch for any new cues or symptoms that might
show that the problem is something other than CFS.
When other diseases are ruled out and if your illness meets other
criteria as well, your health care provider can diagnose you with CFS.
How Can I Cope With And Manage
The Illness?
Learning how to manage your fatigue, in spite of your symptoms, may
help you improve the level at which you can function as well as
your quality of life. A rehabilitation medicine specialist can evaluate
you and teach you how to plan activities to take advantage of times
when you usually feel better.
The lack of any proven effective treatment can be frustrating to both
you and your health care providers. Scientists are currently conducting
studies to evaluate such treatments as cognitive-behavioral therapy
(a psychological therapy) and graduated exercise therapy. While early
results look promising, these therapies do not work for everyone, and
often induce improvement but not cure. If you have CFS, health experts
recommend that you try to maintain good health by: Eating a balanced
diet and getting adequate rest; Exercising regularly but without causing
more fatigue; Pacing yourself-physically, emotionally, and intellectually-because
too much stress can aggravate your symptoms.
The course of CFS varies from person to person. For most people, CFS
symptoms reach a certain level and become stable early in the course
of illness and thereafter come and go. Some people get better completely,
but it is not clear how frequently this happens. Emotional support
and counseling can help you and your loved ones cope with the uncertain
outlook and the ups and downs of this illness.
Treatment
Antidepressants sometimes help to improve sleep and relieve mild,
general pain in people with CFS. Because adequate doses of an antidepressant
often increase fatigue, health care providers may have to start
with a low dose and increase it very slowly or prescribe another
type of antidepressant. Some people with CFS benefit from medicines
used to treat acute anxiety as well as other nervous system problems
such as dizziness and extreme tenderness in the skin. You should
work closely with your health care provider to find a medicine,
or a combination of medicines, that works well for you and that
your body can tolerate.
Conclusion
CFS is a disease of unknown cause. Early results of new treatment
methods appear promising, but it is too soon to tell how well these
treatments will work, and for how many CFS patients. Because CFS
can be a serious illness that affects many aspects of daily living,
you should consult a qualified doctor who can evaluate you and
help you manage your illness.
This article was reprinted from the Office of Communications and Public
Liaison, National Institute of Allergy and Infectious Diseases, National
Institutes of Health, Bethesda, MD 20892. For more information news
releases, fact sheets and other NIAID-related materials are available
on the NIAID Web site at http://www.niaid.nih.gov.
