Chronic fatigue syndrome: More than just feeling tired

5/24/2018, 1:19 p.m.
Everybody feels tired sometimes, but feeling fatigued for six months or longer can be a sign of chronic fatigue syndrome.
Sleep Wikipedia

Everybody feels tired sometimes, but feeling fatigued for six months or longer can be a sign of chronic fatigue syndrome. Although the causes of CFS are still a mystery, CFS can be a serious illness that affects many aspects of daily living. If you suspect you have CFS, consult a physician who can evaluate and help manage your illness.

CFS was once called “yuppie flu” because in the early 1980s those seeking help for the symptoms of CFS were mainly well-educated, affluent 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, according to the National Institute of Allergy and Infectious Diseases. Still, for unknown reasons, CFS is diagnosed two to four times more often in women than in men.

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 estimates, however, that as many as 500,000 people in the United States have CFS or a CFS-like condition.

Two criteria for diagnosis

Although much remains to be discovered about CFS, in general, two criteria must be met to receive a diagnosis of chronic fatigue syndrome.

  1. Individual must have severe chronic fatigue for six months or longer with other known medical conditions excluded by clinical diagnosis, and
  2. Individual must concurrently have four or more of the following symptoms: substantial impairment in short-term memory or concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain without swelling or redness, headaches of a new type, pattern or severity, unrefreshing sleep and post-exertional malaise lasting more than 24 hours.

The CDC adds that the symptoms must have persisted or recurred during six or more consecutive months of illness and must not have predated the fatigue.

Coping with CFS and managing the illness

Learning how to manage your fatigue, despite your symptoms, might 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. Scientists are currently conducting studies to evaluate such treatments as cognitive-behavioral therapy (a psychological therapy) and graduated exercise therapy. Although 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 do ing the following:

Eating a balanced diet and get adequate.

Exercise 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 that happens. Emotional support and counseling can help you and your family and friends cope with the uncertain outlook and the ups and downs of this illness.

Antidepressants sometimes help to improve sleep and relieve mild, general pain in people with CFS. Because adequate doses of an antidepressant often increase fatigue, you might have to start with a low dose and increase it very slowly, or another type of antidepressant might be prescribed. 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 doctor to find a medicine, or a combination of medicines, that works well for you and that your body can tolerate.

For more information about CFS, visit the websites of the Centers for Disease Control and Prevention at and the National Institute of Allergy and Infectious Diseases at