We all experience fatigue. It can be work stress, family arguments or illness that is making us feel tired. For a small portion of the population, it’s chronic and wearing. It can be explained away with a medical diagnosis like anemia or arthritis. These people can be experiencing Chronic Fatigue Syndrome.
Exploring chronic fatigue characteristicsFor someone to have this, the fatigue has to be new, not lifelong and lasting since onset. The slowness will impact activity levels. In adults, the fatigue last at least 4 to 6 months before looking towards CFS as an explanation.
Specific features of chronic fatigueThere are a number of physical and other associated symptoms of chronic fatigue. For instance, headaches and muscles aches, nausea and lightheadedness, swollen glands and sore throats all connect to its Syndrome. Poor sleep, memory troubles and a worsening following exertion have also been noted. These are the symptoms people with Chronic Fatigue Syndrome present with. Unfortunately, the symptoms are not specific and could be a marker of a number of illnesses. Also, people experiencing chronic fatigue are likely to brush it aside or come up with alternate explanations.
- Irritable Bowel Syndrome
- Temporomandibular joint dysfunction
- Postural orthostatic tachycardia syndrome (POTS)
Neurological CausesMany of the problems experienced by people with its Syndrome are in fact neurological; headaches, memory loss and poor concentration to list some. Brain blood flow scans and neurotransmitter level changes suggest abnormalities. Addressing these, and whether doing so would result in functional improvements is yet unclear in research currently being undertaken. Autonomic dysfunction might be another contributor. Take for instance dizziness and feeling nauseated. Researchers wonder if this could be related to poor autonomic nervous system functioning.
Psychiatric causesThere is quite some overlap between Chronic Fatigue Syndrome and depression, generalized anxiety disorder and somatization. Of interest, the mood and anxiety symptoms usually started before the chronic fatigue symptoms arise. There are a couple of research papers that point to childhood trauma being associated with Chronic Fatigue Syndrome.
ImmunodeficienciesMultiple studies point to increases and decreases in certain immune cell gene expression. Thus far the research findings have been inconsistent and non-conclusive.
Infectious causesScientists and doctors have wondered if its Syndrome could be the result of infections such as EBV, Hepatitis C or Enterovirus. However, the research findings aren’t statistically conclusive. In addition, giving people with this Syndrome antiviral medication has not been proven helpful.
Psychological assessment for Chronic Fatigue SyndromeOften time depression is the key diagnostic overlap with this Syndrome. Whilst diagnosis and treatment of chronic fatigue can be challenging, managing depression is more straightforward. How we respond to chronic fatigue is driven partly by our personality, temperament and psychosocial factors. Assessing and understanding these should form the first step in treating chronic fatigue and other symptoms.
Medication benefits?Thus far there has been no conclusive evidence supporting the use of medication when treating its Syndrome. Researchers have trilled antivirals, immunological agents, hormones, antidepressants and steroids without finding strong supporting evidence.
TherapyTwo or more studies have shown 1) graduated exercise programs and 2) psychological therapies to be effective. It is thought that thinking and behaviour continue symptoms of chronic fatigue. Breaking this pattern with an exercise program that slowly builds physical resilience increases tolerance and self-efficacy. A graduated exercise program can lead to a reduction in fatigue, improvement in functional status and overall fitness. Experiencing chronic fatigue can be disempowering. Psychological therapies can make you feel more in control. Research has shown the benefits of such a program to last for years.
Likely due to a lack of established therapies; self-help groups form an important part of learning and support for people experiencing chronic fatigue. Frustration, fear to lead to yielding to chronic fatigue which reinforces the cycle of misery and ill-health. Here, being part of a self-help group or helping oneself can shift the tide with respect to chronic fatigue.
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At Epsychiatry our front desk team at aware of the disempowerment of chronic health conditions. The research evidence supports the use of psychological therapies to address its Syndrome. Given us a call or send us a webchat to learn more about how our clinicians can help.