What Is Chronic Fatigue Syndrome?

Chronic fatigue syndrome (CFS) is a complicated disease for doctors to diagnose — and even fully understand.

CFS is a physical condition, but it can also affect a person psychologically. This means that someone with CFS may feel physical symptoms, such as being very tired and weak (extreme fatigue), headaches, or dizziness. But the person may also notice emotional symptoms, such as a loss of interest in favorite activities.

To make it even more complicated, different people with CFS can have different symptoms. And the symptoms of CFS often are similar those of other health conditions, like mono, Lyme disease, or depression. And the symptoms can vary over time, even in the same person.

This makes treating the illness complicated because no single medicine or treatment can address all the possible symptoms.

What Are the Signs & Symptoms of Chronic Fatigue Syndrome?

There's a long list of possible symptoms that someone with chronic fatigue syndrome can have. The most common ones include:

• severe fatigue, which can make it hard to get out of bed and do normal daily activities
• sleep problems, such as trouble falling or staying asleep, or not having a refreshing sleep
• symptoms getting worse after physical or mental effort (this is called post-exertional malaise)
• symptoms or dizziness that get worse after standing up or sitting upright from a lying down position
• problems with concentration and memory
• headaches and stomachaches

What Causes Chronic Fatigue Syndrome?

Scientists have been researching chronic fatigue syndrome for many years, but they still don't know for sure what causes it.

Many doctors believe that the way some conditions interact within the body and mind might leave some people at risk for CFS. For example, if someone has a virus and is under a lot of stress, the combination of these two things might make them more likely to develop CFS.

These things are believed to interact with each other in this way, putting some people at risk for CFS:

• infections. Experts have wondered if infections like measles or Epstein-Barr virus (the virus that causes mono) might increase the risk for CFS. The role Epstein-Barr plays in CFS is not clear because studies have not confirmed it as a cause.
• problems with the immune system or the nervous system
• hormone imbalances
• emotional stress
• low blood pressure

Who Gets Chronic Fatigue Syndrome?

Chronic fatigue syndrome can affect people of all ethnicities and ages, but is most common in people in their forties or fifties. It's very rare in kids. A few teens do get CFS, and it affects more girls than guys.

Sometimes different people in the same family get CFS. This may be because the tendency to develop CFS is genetic.

How Is Chronic Fatigue Syndrome Diagnosed?

Right now, there's no test to tell if someone has chronic fatigue syndrome. Doctors ask a lot of questions (about a person's medical history and the health of family members, medicines, allergies, smoking and drinking habits, etc.). They also will do a thorough physical exam.

Doctors also usually order blood, urine (pee), or other tests to check for conditions that cause similar symptoms. They may send a person to see other specialists (such as a sleep specialist or a neurologist) to help with the diagnosis.

A doctor may suggest meeting with a psychologist or a therapist who can see whether mental health disorders might contribute to or mask CFS.

How Is Chronic Fatigue Syndrome Treated?

There's no known cure for chronic fatigue syndrome. But experts say that these lifestyle changes can help:

• Include regular, carefully planned exercise in your daily routine. Exercise can increase energy and make a person feel better. People with CFS should pace themselves while doing any physical activity that requires exertion. Talk with a doctor what's right for you — you don't want to overdo it and get discouraged. Studies show that "graded exercise" (which means starting with small activities and slowly working up to a higher level of exercise) is very helpful in CFS recovery.
• Follow stress-management and stress-reduction techniques. A doctor or therapist can teach these — they're great ways to take control of some aspects of the illness.
• Ensure good sleep habits to overcome CFS-related sleep problems.
• Work on ways to keep track of important things, such as keeping lists and making notes, you have problems with concentration or memory.

Meeting regularly with a therapist or counselor can help in CFS treatment. (So can getting involved in a support group for people with CFS.) The main goals of therapy are to help people cope with the illness and to change negative or unrealistic thoughts or feelings into positive, realistic ones.

Having a positive feeling that you can get better is very helpful. Therapy and support groups can also help teens with CFS and their parents deal with the academic or social challenges brought on by the illness, such as missed school, falling grades, or withdrawal from friends and social situations.

Doctors may suggest over-the-counter or prescription medicines for some of these symptoms.

What Else Should I Know?

• Strong emotions can be a part of the illness, so it's important to recognize and express your feelings. Feelings like sadness, anger, and frustration are completely normal — and it's important to acknowledge how you feel and recognize that it's not your fault. Recognizing emotions (rather than suppressing them or pretending you're OK) can help you figure out what's behind your feelings and help you manage problems.
• It can help to keep a daily diary of feelings and energy highs and lows. This also can let you share information that might help your doctor. You can also track trends — for example, if your energy is high at one time of day and low at another — that will help you figure out when to exercise or do other activities.
• Give yourself more time to do things, especially activities that take concentration or physical exertion.
• Get support from family, teachers, and friends.
• Get information about CFS from reliable sources. There's a lot of misinformation and confusion about this disease. So it's important to know and trust your sources.

Most important, don't give up. Having chronic fatigue syndrome can be hard. But for most people, the symptoms are most severe in the beginning. Later, they may come and go. Teens with CFS generally get better faster and recover more completely than adults do. Most teens get partial or full recovery within 5 years after symptoms began.

It's important to keep a positive approach to getting well and to not look for the reason why you have CFS. People who take action and stay positive can have a good outcome.

Reviewed by: Elana Pearl Ben-Joseph, MD
Date Reviewed: 02-07-2018