Chronic Fatigue Syndrome: Just What Is It?

ByMichelle Garrett

Do you constantly feel exhausted no matter how much rest you get? Does even minor activity like making dinner or taking a shower wipe you out for hours? If you experience extreme, prolonged fatigue that sleep does not relieve, you may have chronic fatigue syndrome (CFS).

CFS is a complex disorder characterized by incapacitating fatigue lasting at least 6 months that rest does not improve. The fatigue often worsens with physical or mental activity and an underlying medical condition does not explain it. CFS can be frustrating to deal with because it is difficult to diagnose and treat. However, recognizing the signs and symptoms can help you get the right diagnosis and find ways to better manage your energy.

What Are The Symptoms of CFS?

The primary symptom of CFS is severe fatigue lasting 6 months or longer, which substantially reduces your daily activities. The fatigue in CFS is often described as paralysis, exhaustion, or constantly feeling flu-ish. Sleep does not relieve this fatigue, and physical or mental exertion can worsen it.

In addition to fatigue, CFS has several other symptoms that can fluctuate in severity over time. Common symptoms include:

  • Problems with concentration, memory, and focus (“brain fog”)
  • Unrefreshing sleep and sleeping issues like insomnia or hypersomnia
  • Muscle and joint pain not caused by injury or overuse
  • Persistent sore throat and lymph nodes
  • Frequent or recurring headaches
  • Dizziness and balance issues
  • Sensitivity to light, sounds, chemicals and foods
  • Depression, anxiety and irritability
  • Stomach issues like nausea, bloating, and diarrhea

The combination of extreme fatigue plus some of these other symptoms sets CFS apart from regular tiredness. The fatigue substantially limits your ability to function in areas like work, social activities, and self-care. Even if you push through, the exhaustion continues.

Who Gets Chronic Fatigue Syndrome?

CFS impacts people of all ages, genders, races, and socioeconomic backgrounds. However, it is 2 to 4 times more common in women than men. The estimated prevalence of CFS in the United States is between 836,000 and 2.5 million cases. CFS often begins between 30 and 50 years old.

While the cause is unknown, several factors may trigger or worsen CFS:

  • Viral infections like mononucleosis or the flu
  • Immune system problems
  • Hormonal imbalances
  • High stress levels
  • Trauma or adverse experiences
  • Genetic predisposition

CFS can occur suddenly after a viral illness, or gradually over time. Many patients report progressively worsening fatigue until they are nearly homebound or bedridden.

The Diagnosis Process

Since there is no specific test for CFS, diagnosis can be challenging. Doctors identify CFS based on a thorough medical history, physical exam, and ruling out other fatiguing conditions.

The first step is to see your primary care physician. Be prepared to describe your fatigue in detail – when it started, how it feels, how it impacts your life, and any other symptoms. Your doctor will ask questions to rule out potential causes like thyroid disorders, sleep apnea, depression, medications, obesity, and more.

Blood work will likely check for conditions like anemia or diabetes as well as hormone and immune function. Mention any family history of autoimmune disorders. Your doctor will want to know if you have significant stress, anxiety, trauma, grief, or depression that could explain the fatigue. Mental health issues often coincide with CFS.

Chronic fatigue is a common symptom of sleep disorders, so a sleep study may be recommended if you have unrefreshing sleep or insomnia to rule out apnea and restless leg syndrome.

If all test results are normal, your doctor may refer you to a specialist, like an infectious disease doctor, rheumatologist, or neurologist, to evaluate the chronic fatigue itself. The specialist will review your history, conduct an exam, and likely repeat some blood tests.

To diagnose CFS, doctors look for:

  • Fatigue lasting over 6 months that rest does not relieve
  • Fatigue that significantly reduces activities
  • Fatigue that worsens with exertion
  • No other medical condition explaining the fatigue
  • Several CFS symptoms like muscle pain, headaches, brain fog, etc.

If your fatigue does not improve with rest, you do not overexert, and no other cause is found, you may be diagnosed with chronic fatigue syndrome.

Treating and Coping with Chronic Fatigue Syndrome

While there is currently no cure for CFS, treatment focuses on managing symptoms to improve quality of life. The goal is to pace activities to avoid post-exertional malaise – the extreme exhaustion after activity.

Your doctor may prescribe medications to help with sleep, pain, brain fog, and low energy. Discuss any side effects. Counseling is often recommended to address the emotional aspects of a chronic condition.

Lifestyle changes are key as well. Keep a regular sleep routine, add gentle stretching or yoga, eat healthy, address nutritional deficiencies, reduce stress, and relax. Support groups can help you feel less alone.

Listen to your body and learn to operate within your energy limits. Keep a diary to identify activities that deplete or increase your energy. Prioritize important tasks when you have more energy. Avoid over-doing it on good days which can lead to setbacks.

Patience and pacing are vital in managing CFS. You cannot push through the fatigue. Accept your stamina is limited for now and build in frequent rests. Give yourself permission to decline anything non-essential. It may feel like one step forward, two steps back at times.

While CFS can be frustrating and life-altering, diagnosis opens doors to accommodations and lifestyle changes. Recognition and support from family and employers can make a big difference. With proper pacing and activity limits, many people improve their CFS symptoms over time.