Chronic Fatigue Syndrome
Author: Dr George John
Chronic Fatigue Syndrome is not a new disease but there is now a better understanding of its symptoms.
Some distinguishing features of Chronic Fatigue Syndrome are:
- New onset of unexplained fatigue
- Lasts for over 6 months
- Not related to on-going exertion
- Not substantially alleviated by rest
- Associated with other symptoms
Chronic Fatigue Syndrome can affect either sex of any age and any social group, its severity and duration, even resulting in disability, may vary.
Many sufferers have profound ill-health, reduced physical and cognitive functions, and their daily living activities are reduced.
The exact cause is unknown but for many the onset is related to infection.
Relationship with Chronic Fatigue Syndrome & Depression
Both illnesses can have interactive symptoms. Patients with primary depression may have fatigue similar to Chronic Fatigue Syndrome, whereas patients with Chronic Fatigue Syndrome may also show symptoms of depression. Patients can develop secondary depression/anxiety especially if Chronic Fatigue Syndrome is denied or not diagnosed. Patients with a history of depression can later develop Chronic Fatigue Syndrome. However, clinical features suggest that they are distinct.
Diagnosis
Diagnosis of Chronic Fatigue Syndrome is made by getting to know the sufferer's history, there are no lab tests. Normally worsening of fatigue is delayed usually starting in a day or two after increased physical or mental activity and lasts for days or weeks.
Psychological stresses also precipitate setbacks like this. Worsening of tiredness can also occur the day after drinking alcohol. Physical and psychological symptoms can vary and may be present continuously or intermittently. Psychological symptoms include reduced concentration, short term memory loss, inability to cope, mood swings, panic attacks and depression. Sleep disturbances can occur such as- hypersomnia, insomnia, early morning wakening and waking up feeling unrefreshed.
Treatment of Chronic Fatigue Syndrome
The following treatments may help sufferers in the management of this condition:
- Activity levels need to be "managed" to avoid cycles of over and under-activity
- Cognitive therapy
- Behaviour modification
- CBT to assist adjustment and recovery
- Input from Physiotherapist, occupational therapist, dietician, social therapist, clinical psychologist.
