Too Much Work: Chronic Fatigue Syndrome


Chronic fatigue syndrome (CFS) is a disease that holds many mysteries. It is a long-term disability, and its causes remain largely unknown. Unfortunately, there is no simple treatment with the effectiveness that has been demonstrated. The diagnostic criteria also pose a problem. However, there is no doubt that the CFS is a real health burden - individual and common.

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No Biological Marker

The most common symptoms are persistent fatigue, muscle weakness, various problems more or less associated with memory and sleep disorders.Its prevalence is estimated, very globally, between 0.1 and 3% of the general population. The CFS has been recognized by the World Health Organization since 1992. However, no recognized biological marker can detect or diagnose it. Doctors state that the CFS (officially classified as a neurological disease) is close to the "fibromyalgia syndrome."

Chronic Fatigue Syndrome: Fibromyalgia Syndrome

CFS has a lot of similarity to fibromyalgia syndrome: firstly, its chronicity and low sensitivity to treatment. The main difference seems to be the first symptom put forward: fatigue in the CFS and pain in the fibromyalgia syndrome. It is interesting to note that in the US people claiming one or other of these syndromes have experienced both.

How to Treat It?

Led by Professor Andrew R. Pickles (Department of Biostatistics, King's College London), researchers wanted to know what therapies could be used in case of the CFS and how effectively. They analyze four possible treatments and ultimately advocate for the addition of "cognitive-behavioral" and progressive exercise-type therapies to help resume normal daily activities.The analysis looked at data from 641 CFS patients from six special clinics in the UK. Four therapeutic approaches were determined:

  • specialized medical care alone;
  • specialized medical care associated with adaptive stimulation therapy with alternating periods of activity and rest periods;
  • specialized medical care associated with cognitive-behavioral therapy;
  • specialized medical care associated with progressive exercise therapy.

Reduction of Symptoms

The analysis shows that in these last two groups we can observe a significant effect on the reduction of symptoms – with a reduction in avoidance behaviors and in situations that aggravate the symptoms. Compared to the first two groups, improvements can also be seen in physical function and fatigue reduction.

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Chronic Fatigue - Treating with Acceptance

One in six hundred people would be affected by chronic fatigue, a hard-to-detect disease that causes real suffering. It is treated well by physical activity and psychotherapy. How do people usually experience chronic fatigue syndrome? They do not have the energy to do anything. Their projects and actions are forgotten, as the fatigue they experience is intense. You also may have chronic fatigue.

What Do We Feel When We Suffer from Chronic Fatigue?

It is a terrible fatigue. A person is so tired that they cannot do their daily activities at all. Fortunately, such cases are rare: it is estimated that they affect one in a hundred people who consult a doctor for a problem of fatigue. The real fatigue syndrome is therefore infrequent, while people complaining of fatigue are very numerous (about 15% of general medical consultations).Above all, this state is different from that which would cause a depression. In chronic fatigue, the person has not lost the desire to do things. They also enjoy what they manage to accomplish. Unfortunately, the body does not follow in such a case.It is not excluded, however, that discouragement in the face of the disease will eventually cause depression, but this is the consequence and not the cause.

How to Determine That a Person Is Suffering from Chronic Fatigue?

Since when does fatigue start? And does rest have an effect? These two points are essential. We are indeed talking about chronic fatigue syndrome if the fatigue lasts for more than six months, not improved by sleep or rest. This condition is associated with other complaints such as joint pain, headaches, and difficulty concentrating.

There are many other ailments that need to be excluded before chronic fatigue can be discussed, such as a sleep disorder or night apneas that a sleep recording will highlight. Did depression or anxiety exist before the onset of fatigue? We must take it into account.

The doctor must also check if a patient is taking medications that he/she does not handle well and that makes them feel tired, or if a drug or alcohol consumption is to blame. Finally, doctors must also make sure that fatigue has no endocrine cause such as hypothyroidism.

Who Is More Likely to Have Chronic Fatigue Syndrome?

This disease affects more women than men and especially perfectionists. In general, specialists state that chronic fatigue syndrome appears as an inadequate response to a very significant stress. The individual does not have all the assets in hand to respond to it in the right way.This fragility can be explained by several factors: psychologically, it has been shown that people who have been abused in childhood are more likely to have chronic fatigue.

It is also known that any mistreatment can disrupt the expression of certain genes, in a way "etching" the trauma in the genetic code and, thus, adversely affecting the response to intense stress. It is also stated that some diseases make a person more vulnerable to fatigue, for example, mononucleosis, Lyme disease, brucellosis or Q fever.Fortunately, neither a psychological sensitivity nor a pre-existing illness causes chronic fatigue. These are just factors that can promote its appearance.

Chronic Fatigue, Can Doctors Treat It?

Doctors Treating

Doctors use two complementary pathways to treat chronic fatigue successfully. In terms of physical health, it is about getting an affected individual moving again, as gradually as possible to avoid an immediate failure. In these programs, doctors make their patients literally just walk around the block.

Step by step, the exercise will increase, but always gradually. Psychological therapy is also very important. People tend to have many negative thoughts that fuel the phenomenon. Doctors, therefore, offer them cognitive-behavioral therapies, focused on the action and management of these negative feelings. They allow them to get rid of negative thoughts and stress and get the activity back.

Results of This Therapy in Real Life

These strategies work well: in some studies, up to 60% of patients experience a marked improvement in their condition and even come back to normal functioning. Moreover, in cases where chronic fatigue caused depression, it is obviously necessary to treat it.The attitude towards the disease is finally serious. The best-performing patients are those who give up the idea of finding a cause for their disease. Instead, they must resolve to manage their symptoms; there is no miracle pill that will heal them. It is really about changing the perspective, and it is a long-term journey.

Fibromyalgia: What Is the Difference?

Fibromyalgia and chronic fatigue are two diseases that have common manifestations. These have many similarities, especially the presence of joint pain and concentration disorders. They have so much in common that 70% of people with fibromyalgia also experience chronic fatigue.

However, they have a different dominant symptom. In case of fibromyalgia, it is the pain that will force the patient to consult the doctor when, in chronic fatigue, it will be the fatigue itself.

Prevent Fatigue: Sleep Is Essential for Our Physical and Intellectual Health

Sleep occupies a third of our life, and we cannot live without it. Sleep may even be as important to health as food and exercises. A good night sleep first allows you to rest and "recharge your batteries." When you sleep, the body temperature drops and the energy expenditure decreases, allowing the body to rest and recover its strength.

Our metabolism does not remain inactive at this time as well. It takes advantage of our deep sleep to create hormones, starting with the growth hormone that makes children grow and develop the muscles, bones, and cartilage of adults.Moreover, it is no coincidence that, when we suffer from infections or inflammations, our body secretes substances that promote falling asleep. There is nothing better than sleep to strengthen our natural defenses and help the immune system to respond.

Sleep and Brain Activity

Sleeping Student

The biggest beneficiary of a good night's rest remains the brain. Day and night, it never stops working and uses sleep to strengthen our memory and encourage learning abilities. In a way, it encourages neuronal circuits to "repeat" what they have learned in the waking state in order to reinforce the mnemic trace. A simple test is convincing: learn a series of words and try to repeat it a few hours later. You will find that you will do a much better job the next morning.

Risk of Accidents and Obesity

Since sleep is a vital function, it is logical that its disturbances and disorders have a negative impact on our physical and mental health. After bad nights, we feel flaccid, deprived of energy, and experience drowsiness. This state of fatigue is a major cause of accidents – especially, on the road where, according to the experts, it is responsible for 10 to 20% of accidents.

Lack of sleep also increases the risk of hypertension, cardiovascular disease, diabetes and even promotes obesity. It actually disturbs the balance that is established naturally between three hormones involved in weight gain: it deprives us of the one that curbs the appetite (leptin), increases the secretion of another that stimulates the appetite (ghrelin) and leads to the production of a surplus of a third (orexin) that pushes us to eat for pleasure alone. Poor sleep encourages overeating and snacking between meals.But fatigue also affects our character: it makes us irritable and promotes mood disorders or even depression. This is all to prove how sleep is essential for us.

Fatigue of Teenagers Can Be Treated by the Internet

Often causing some diseases, the Internet can also have some therapeutic virtues. This was shown by a study that concerned chronic fatigue syndrome. For teenagers, this syndrome causes recurrent and prolonged school absences. Behavioral therapy in this field has proved its effectiveness, but its limitations are due to the lack of specialized practitioners. Hence the potential interest of developing consultations on the Internet. During the study, the doctors have taken care of a group of 135 teenagers suffering from this syndrome for at least two years.

Special Research

They formed two groups: in the first, tired adolescents received an individual and collective behavioral therapy usually offered in this situation. Those in the second group benefited from a new program – an original therapeutic program based on the Internet. It is based on existing cognitive-behavioral therapy protocols and has been specifically developed for adolescents with this syndrome and their parents. A specialized therapist provides support through regular consultations through an e-mail exchange. In both groups, specialists were using standardized questionnaires to assess fatigue, physical functioning, and self-perceived improvement in health status. At the same time, school attendance was objectively recorded.

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Surprising Results

After six months, it was found that the proportion of adolescents who had their symptoms going away noticeably was significantly higher in the second group than in the first group (85% versus 27%). Significant differences were also noted in terms of physical performance (78% vs. 20%). The same was true for improving the level of school attendance (75% versus 16%).These advances were still observed after twelve months. It, therefore, seems that the efficacy of the treatment is due to the use of the Internet therapy.

The definitive demonstration, the authors conclude, will be provided by the results of clinical trials conducted on larger scales. For Professors Peter Barts (Queen Mary University of London) and Trudy Chalder (King's College of London), these authors should be warmly congratulated for having demonstrated that it is possible to provide a traditional therapy that was already proven to be effective in other, much more flexible, ways. There is no longer any reason not to believe that this method can be successfully proposed for the treatment in any situation.

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