Highlights
- CFS is a recognized, complex, multisystem biological illness. It is not caused by depression or anxiety, though these can occur alongside the condition.
- CFS makes work, study, and daily life very difficult.
- Women are more likely to have the condition, and most people with it have not been diagnosed.
- Seeking care early can help you get treatment and support, improving your quality of life.
Chronic fatigue syndrome (CFS) creates significant disability and distress. It causes persistent, overwhelming tiredness that is unexplained by your activities and not relieved by rest. If you are living with this condition, you are not alone. Understanding CFS can help you get the support and treatment you need and improve the quality of your life.
Chronic illnesses like ME/CFS can have an impact on mental health. Get support online in 24 hours.
What Is Chronic Fatigue Syndrome?
Around the world,
Scientists don’t fully understand what
Chronic Fatigue Syndrome Symptoms
The symptoms and severity of CFS can vary from person to person. The core symptoms include:
- Deep, unexplainable tiredness that doesn’t go away with rest: Tiredness from CFS is different from “regular” fatigue because it is overwhelming and persistent, often lasting six months or more.
- Feeling sick after exercise: CFS can also cause
extreme fatigue after physical[4] , emotional, or mental activities. This is called post-exertional malaise (PEM), and it can last more than 24 hours. - Unrefreshing sleep: Sleep refreshes and reinvigorates. But it might not feel that way if you have CFS. You
continue to feel tired even after getting enough sleep[5] - Memory and thinking difficulties: Memory loss, brain fog, or being unable to focus are
symptoms[6] you may experience. - Balance difficulties: You may feel lightheaded or dizzy when you sit or stand from a lying position.
- Pain: This may be in your muscles or joints and vary from slight to severe.
- Headaches: Headaches are common when you have CFS.
- Sensitivities: You may also be more sensitive to bright light and loud noises.
- Digestive Issues: These can include diarrhea, abdominal pain, feeling bloated, and indigestion.
- Frequent Sore Throats: CFS disrupts your immunity, and this could cause more frequent infections like sore throats.
CFS symptoms tend to fluctuate over time. Periods of extra stress, exertion, or illness can make them worse. And you may need bed rest during those times.
How Is Chronic Fatigue Diagnosed?
There is no single test to diagnose chronic fatigue syndrome. Some online quizzes can give you a hint that you may have CFS, but they won’t diagnose the condition.
To get a diagnosis, you need to see a healthcare provider who will make the diagnosis after reviewing your symptoms to see if they fit into the CFS diagnostic criteria. It’s also possible that you’ll have to see multiple specialists, such as a primary care physician, neurologist, a sleep specialist, etc. to have a comprehensive overview of your health.
The diagnostic criteria for CFS were developed by the Institute of Medicine in 2015. They state that, to be diagnosed with CFS, you need to experience three main symptoms at least 50% of time with moderate or greater severity and at least two additional symptoms for at least six months.
The main symptoms include:
- Fatigue that is new or has a clear onset, which does not go away with rest and is unrelated to exertion. The fatigue shouldn’t be traceable to a medical condition, and must make you unable to carry out pre-illness activities.
- Post-exertional malaise, which means worsening of symptoms (having flu-like symptoms) after exertion, prolonged recovery, etc.
- Unrefreshing sleep.
Other symptoms are:
- Problems with thinking or executing tasks, which get worse under pressure or with exertion.
- Orthostatic intolerance: Feeling dizzy, weak, or lightheaded, and having blurred vision when you sit or stand from a lying position.
Differential Diagnosis
While making a diagnosis of CFS, your healthcare provider recognizes that your symptoms might not be due to CFS. Other conditions can mimic symptoms of CFS, such as:
- Thyroid disorders
- Sleep apnea
Depression[8] - Fibromyalgia
- Lyme’s disease
- Mononucleosis
- Some autoimmune conditions
Your healthcare provider may ask you to do laboratory tests to rule these conditions out.
Diagnosing CFS can take time. You should get involved and keep an open mind. It helps to have a symptom diary where you write out any changes in your symptoms and share it with your doctor.
Causes of Chronic Fatigue Syndrome
CFS is a biological condition and not a psychological one. While its exact cause is unknown, experts have noticed these links:
- Biological Factors: CFS appears to run in families. Many people who have CFS have a relative with the condition, and
twin studies[9] show that if one twin has it, the other is more likely to have it too. - Infections: Approximately 1 in 10 people who get infected with the Epstein-Barr virus, or Ross River virus, or Coxiella burnetii eventually develop an illness like ME/CFS. This is more common if they had severe infections. But not all people with ME/CFS have had these infections. People have reported ME/CFS-like illness following the COVID-19 infections, called Long COVID. Altogether, this suggests viral infections
could play a role[10] . - Autoimmune Changes: In CFS, immune cells behave abnormally, and an
overactive immunity[11] has been suspected as a possible cause. However, immune cells in people with CFS do not typically kill other body cells. - Trauma: Physical and emotional trauma may contribute.
One study[12] found that the risk of developing CFS is six times higher if you experienced childhood trauma such as sexual abuse, emotional abuse, or emotional neglect. Many people with CFS report a recent traumatic event.
Chronic Fatigue Syndrome Treatment
The main goal of treating ME/CFS is to relieve symptoms and improve your quality of life. Proper treatment can help you sleep better, make you less depressed, help with pain, and address other problems. The most discomforting symptoms are usually treated first. The most
Pacing and Activity Management
This aims to help you maximize your energy without making your symptoms worse. Your healthcare provider might ask you to keep a journal, where you record your day-to-day energy levels. You may do this with a mobile app or a journal. Stay within your energy limit by:
- Prioritizing: Do what you have the greatest need for, and leave the rest for when you can.
- Avoiding Overexertion: Pay attention to your feelings and take a break before you feel too tired.
- Positioning: Assume a position that requires the least effort for tasks. For example, you can sit rather than stand or lie down rather than sit.
- Doing Only What Matters: While physical activity is highly encouraged, it’s important to not overstretch yourself because it can trigger post-exertional malaise. So,
plan your activity[14] and not push yourself too hard.
Cognitive-Behavioral Therapy
Cognitive-behavioral therapy (CBT)
Specific Symptom Management
Specific symptoms like pain, insomnia, digestive problems, and any other concerns can also be addressed.
Pain, sleep issues, and digestive symptoms may be addressed with individualized strategies, which can include lifestyle adjustments or medications when appropriate. For example, insomnia or sleep disturbances can be managed with proper sleep hygiene. A clinician should help guide these decisions.
The treatment of ME/CFS is personalized; what works for you might not work for someone else. For example, some people may require antidepressants for their mental health symptoms, while some may not. Stay in touch with your healthcare providers, letting them know any changes you notice.
Living With Chronic Fatigue Syndrome
ME/CFS can affect every area of your life, even your relationships and work. Some ways to cope with the condition are:
- Journaling: Journaling can help you understand your thoughts, symptoms, and feelings better. It can also give your healthcare providers insights into how best you should be managed.
- Use Memory Aids: Lists, apps, or timers can help you manage forgetfulness.
- Join a Support Group: Belonging to a support group can help you cope with ME/CFS through listening to people with similar experiences and sharing your fears and achievements with those who can understand that completely.
- Ask for Help: Let your family and friends know when you need assistance or accommodations. There is no need to “tough it out.”
- Request accommodations at work or disability benefits if you can’t work anymore.
Emotional and mental support is very important. While it can be challenging to live with ME/CFS, you are not alone. Use the support systems around you.
What to Expect With ME/CFS
ME/CFS symptoms tend to fluctuate. You may experience periods of improvement followed by a relapse. Full recovery is possible but rare, but getting a diagnosis and managing your symptoms will improve your quality of life.
When to See a Healthcare Provider
You should see a healthcare provider if:
- You have persistent, unexplained severe fatigue that has lasted more than six months.
- You can’t perform daily activities by yourself.
- You experience new or worsening symptoms, especially mental health concerns.
Show up to your appointments with:
- Your symptom diary, chronicling how you have felt at different times and days.
- Your medication list, including any supplements or home remedies you tried.
- Any questions you may have about your health.
Currently, MEDvidi doesn’t offer clinical services for diagnosing and treating ME/CFS. But if this chronic illness affects your mental health, you can get adjunctive treatment support, for example, for the symptoms of anxiety or depression.
Summing Up
ME/CFS is a long-term condition that makes people feel deeply fatigued for months at a stretch, despite having adequate rest. The condition interferes with daily life and should be managed by a medical team. If you live with ME/CFS, remember that you are not alone. Don’t blame yourself for your experiences or think that you are “lazy.” Consider journaling and joining a support group. Share any concerns with your care team and continue working with them to minimize symptoms.
