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Chronic Fatigue Syndrome

Everyone knows what it's like to get tired, but chronic fatigue is different from the sort of tiredness normally experienced. A small proportion of the population feels tired all of the time. Some physical illnesses, such as thyroid disease, anaemia and liver disease can cause fatigue. Sometimes people develop fatigue after common infections. It can be a symptom of emotional distress. However, in most cases, it is unlikely there will be a single specific explanation.

Diagnosis of Chronic Fatigue Syndrome

Contrary to popular belief, there is no definitive test for Chronic Fatigue Syndrome (CFS) but a number of other illnesses with similar symptoms must be ruled out before CFS is diagnosed. Sometimes the illness is referred to by other names. ME is a popular one, and the term PVFS is sometimes used if the fatigue appeared to start with a virus. The term CFS is probably the most helpful as it does not make any assumptions about the cause of the problem.


CFS is an illness characterised by a combination of symptoms that have lasted six months or longer. It affects both physical and mental functioning. It also fluctuates. Sometimes people will feel almost back to normal and will then relapse and feel fatigued again. This can be very disconcerting and demoralising.

Other physical symptoms which may accompany fatigue include headaches, dizziness, nausea, tingling in the fingers, shakiness, muscle and joint pain. Mental symptoms such as concentration difficulties, memory problems and not being able to find the right words are also commonly described by people with fatigue. Problems with sleep and mood are common.

Seeking Help

It is when fatigue is more severe then expected, or when it goes on for a long time that sufferers may seek help. Help may also be needed if the fatigue affects ability to work or to carry out normal everyday tasks. Usually the problem will have developed gradually over a period of time. Individuals often carry on trying to cope for some time, but eventually find it too difficult.


The cause of CFS is unknown. Usually there is more than one reason why fatigue problems develop. Below is a list of factors which could contribute:

  • Stress, busy lifestyle, little time for enjoyment or rest
  • Major upheavals or life events such as job change
  • High expectations of oneself coup[led with perfectionism
  • Emotional troubles such as anxiety and depression
  • Failure to get over a viral illness
  • Not being able to balance activity and rest

A person's response to the condition is important in determining its course. For example, completely denying the condition and over-exerting oneself, or in contrast, reacting with fear and severely limiting one's activities, can both be unhelpful.



Symptom relief can be obtained from medication. Anti-depressants can help with fatigue and muscle pain.

Exercise and Physical Therapy:

Exercise avoidance or over-strenuous aerobic exercise can both make symptoms worse. This can lead to a misunderstanding of one's body. For those reasons a supervised gradual approach to activity and exercise can be helpful.

Cognitive Behavioural Therapy (CBT):

CBT is a collaborative approach which aims to improve levels of disability and reduce symptoms associated with CFS.

Treatment components which should be individually programmed may include:

  • Record keeping in order to monitor the condition and understand it better
  • Gradually resuming activities which were previously too difficult
  • Establishing a sleep routine
  • Treating any associated anxiety or depression
  • Making lifestyle changes which may have contributed to the development of the condition
  • Monitoring thoughts and changing any unhelpful ideas which may be hampering progress with treatment


CFS is a recently defined condition, and both medical and psychological research is going on to help understand and treat it. However, multidisciplinary care that is overseen by one professional can help the person to cope and learn to decrease symptoms. There are now a number of controlled treatment trials showing that cognitive behaviour therapy can produce lasting improvements in disability and fatigue in sufferers of CFS.

View a case study on Chronic Fatigue Syndrome

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