This is the case when the recommendation "Pull yourself together, rag!" not only useless, but even dangerous.
Chronic fatigue syndrome (CFS) is a disease in which a person constantly feels a breakdown. Even if he is resting properly.
"Constantly" in this case is a literal term. The diagnosis of CFS is made only if extreme weakness haunts a person for at least six months. And all this time, the sick person feels as if a battery has been pulled out of him: it is difficult for him to go to work, it is almost impossible to go to the gym, to the store or for a walk. Even getting out of bed is a real challenge for many.
Anyone can get chronic fatigue syndrome, including young children. But most often it occurs in women aged 40 to 60 years.
Weakness is aggravated by the slightest physical or mental exertion. And it takes many hours, or even days, to recover and try again to take up work, study, social life.
Doctors consider chronic fatigue syndrome to be a complex, multi-systemic disease that affects many organs and systems of the human body. And they find it difficult to say what exactly is its cause.
Problems with establishing causes are obvious even because the disorder does not have a single, well-defined name. In evidence-based medicine, the term "chronic fatigue syndrome" is actively used. However, CFS is known to specialists under other names, each of which encodes the alleged cause and general meaning of the disease. Here are just a few of them:
The term CFS was first used in 1988, but physicians have been describing this disorder quite clearly since at least the middle of the 18th century. In those days, he also had alternative names: general malaise, neurasthenia, chronic brucellosis, neurocirculatory dystonia and others.
Many years of attempts to understand the causes of the disorder have so far led to little. It is assumed that chronic fatigue syndrome can be caused by an innate predisposition, as well as a combination of a number of factors.
Some people develop chronic fatigue syndrome after they have had a viral illness. Therefore, there is a version that the disorder is triggered by some viruses. Suspicious infections include Epstein-Barr viruses, human herpes type 6, and possibly the SARS-CoV-2 coronavirus that causes COVID-19.
The lingering effects of covid that some people suffer may be manifestations of chronic fatigue syndrome. But more research is needed on this.
Scientists believe that immunity in people who suffer from CFS is weakened. But it's not yet clear if that's enough to cause a breakdown.
It is not uncommon for people with CFS to have high or low levels of hormones produced by the hypothalamus, pituitary gland, or adrenal glands. But how these hormones trigger chronic fatigue syndrome is still unknown.
Such stresses affect the chemical processes within the body. It is assumed that they can cause neurosis of the autonomic nervous system. Because of this, the human brain is in constant tension - that is, it simply does not rest.
Chronic fatigue may be due to the fact that the cells of the body, for various reasons, do not receive enough energy or cannot use it.
Extreme weakness and inability to do daily activities for at least six months are not the only symptoms of chronic fatigue syndrome.
Although at least 25% of people believe they have experienced CFS, only about 0.5% have features that meet the criteria for the disorder.
Experts at Harvard Medical School list the symptoms needed to make a diagnosis. Sick people have at least four of them. And they last at least six months.
First of all, an accurate diagnosis must be made. Unfortunately, there are no analyzes or tests that could unambiguously confirm CFS. Therefore, the syndrome is diagnosed on the basis of symptoms, excluding other diseases that can cause them.
The first doctor to contact if you suspect chronic fatigue syndrome is a general practitioner. He will ask you about your well-being, conduct an examination, and give you a referral for basic tests: urine, blood. And will try to determine what is happening to your health.
Perhaps what you think of as chronic fatigue syndrome is actually a completely different disease. Here are a few conditions that have symptoms similar to CFS:
If the therapist suspects one of these diseases, he will refer you to a specialized specialist - a neurologist, endocrinologist, psychotherapist, hematologist.
Unfortunately, there is no cure. All that modern medicine can offer is to identify those symptoms that spoil your life the most and try to alleviate them.
For example, if there are problems with sleep, the doctor will start with them. You will be offered to slightly change your lifestyle in order to fall asleep better: go to bed and wake up at a strictly defined time, ventilate the room, give up gadgets and a hearty dinner in the evening. If that doesn't work, the therapist will prescribe insomnia medication. Or send you to a sleep specialist.
If the problem is related to headaches and muscle pain, the most effective and safe painkillers will be selected for you. Or they will be referred to physical therapy, which includes gentle stretching and massage.
Another option for symptomatic therapy is the creation of the so-called energy shell. Your doctor will suggest that you keep a diary to record the exercise and its effects. For example, like this: “I walked 100 meters. Fell helpless." “Walked 50 meters. I seem to be feeling pretty good."
Such a diary will help to establish those limits of physical and mental activity that do not leave you without strength. Next, you will need to plan business and leisure in such a way as to stay within these limits. And, perhaps, gradually increase the load. But only gradually!
Do not try new treatments on your own without consulting your doctor.
Those methods that have helped other people in a similar condition may turn out to be not only useless for you, but even dangerous. For example, the recommendation to move more really helps with many chronic diseases. But for people with chronic fatigue syndrome, extra physical activity is evil. She only makes things worse.
But there is also good news. Although the state of health in chronic fatigue syndrome worsens or does not change for a long time (1-2 years), after this period, most of the sick people still return to normal life.
No way. Since the exact causes of CFS are still not clear, there are no reliable ways to prevent this disease either. All that can be done is to try to exclude those factors that are likely to play a role in the development of the disorder.
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