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What is chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is a complex and still quite “invisible” condition that can dramatically affect a person’s long-term quality of life. Also known as myalgic encephalomyelitis (ME), it is chiefly characterised by at least six months of suffering from persistent, extreme fatigue. The debilitating tiredness cannot be relieved by rest. Onset often follows a viral infection or a physical or psychological trauma.

A hidden disease

There continues to be a great deal of misunderstanding around CFS. It is not a psychosomatic condition but has instead been confirmed as physiological in nature. The mental impact on a person dealing with the condition is massive, with their life often effectively “put on hold” due to the uncertainty over its duration and a lack of medical solutions.

How common is CFS?

There is little in the way of Irish statistics on the condition. UK research has found that as many as 1 in 250 people are affected, which would translate to approximately 20,000 Irish sufferers. However, only around 20% of people with CFS are actually diagnosed.

Who is likely to be affected?

Cases of CFS most commonly arise in people between the ages of 25 and 45. However, it can occur at any age, even in children. Women are more likely to develop CFS than men.

What are the symptoms?

More than just prolonged feelings of tiredness, CFS will force a person to decrease their everyday activity levels by at least 50%. Typical energy-boosting solutions will also have little effect. Someone with CFS will also have at least four of these symptoms present for at least half a year:

  • Difficulty concentrating or short-term memory loss
  • Pain in several joints without any visible signs
  • Muscle pain
  • Sore throat
  • Swollen glands in the neck or underarm area
  • Unusual or more severe headaches
  • Feelings of sickness after exercise or involved physical activity
  • Sleep not improving the situation

While roughly half of people with CFS will go on to develop depression, CFS is not a psychiatric illness.

What causes CFS?

Unfortunately, an exact cause has not been identified. However, CFS can follow infectious, flu-like illnesses, such as Lyme disease. Traumatic accidents and the death of a loved one have also been noted as trigger points. CFS begins suddenly in many people, but can also develop gradually.

Testing has shown that people with CFS can have abnormalities in areas of the brain, such as the hypothalamus and pituitary gland. Nervous system problems have also been detected. Most recently, mounting evidence points to it being an autoimmune condition, where the person’s immune system is attacking the body’s tissue.

Getting a diagnosis

With no clear-cut indicator for CFS as yet, your GP will look at similar conditions and work by a process of elimination. As a result, you may be asked about or tested for symptoms for other conditions such as hypothyroidism, adrenal insufficiency, hepatitis B and C, sleep apnea, cancer, heart disorders and certain psychiatric illnesses. Drug abuse (including alcohol), eating disorders and severe obesity must also be ruled out. Basic blood tests may follow.

Can it be cured?

No proven cure has been found as yet. CFS can persist for months or years and it rarely goes away completely. However, the first year or two is usually the most difficult, with people’s level of function gradually improving over time.

What are the treatment options?

While it is rare for someone with CFS to return to their fully-active old self, exercise and cognitive behavioural therapy (CBT) may be effective in improving people’s situations.  An individual treatment plan will be put in place in consultation with medical experts.  

Lifestyle changes will be required, with the affected person learning to reserve their energy for essential activities and cut back elsewhere. With the help of a physical therapist, a gradual exercise programme may be implemented if appropriate. CBT can help improve the person’s mental health. Experimental therapies, such as anti-viral therapies and high doses of omega-3 fatty acids, have been trialled as the search for answers and a brighter future for those with CFS continues.

If you are concerned about any of the symptoms of CFS, it is best to talk to your GP. This is particularly important if they are adversely affecting your capacity to be fully involved in everyday activities at home, work or while socialising.

To read more on clinical health, click here.