Chronically fatigued?

A debilitating condition characterised by profound tiredness and an inability to perform daily tasks, myalgic encephalomyelitis could be a result of psychosocial factors, warns Dr Girishchandra

A study among Indian women by the British Medical Journal concluded that the strongest associations with chronic fatigue syndrome were psychosocial factors indicative of poor mental health and gender disadvantage.

What is Chronic Fatigue Syndrome (CFS)?

Chronic Fatigue Syndrome (CFS) is a complex and multi-faceted illness that can cause immense fatigue, cognitive issues, sleep disturbances, autonomic dysfunction, and severe post-exertional malaise, making it difficult for patients to perform even the most basic daily tasks.

Symptoms can continue for six months or more with no single definitive cause for the condition. Physicians have observed that physical or mental exertion exacerbates the fatigue experienced by those with CFS, while rest provides no relief. The medical community now also calls this condition Systemic Exertional Intolerance Disease (SEID).

CFS for years was regarded as a psychological disorder, with patients being placed in psychiatric care. However, today, the medical and health community has recognised the serious and long-term nature of the condition.

Possible causes of Chronic fatigue syndrome (CFS)

The cause of CFS has yet to be identified. Several possibilities have been proposed, including viral infections, weakened immune systems, stress, and hormone imbalance. Additionally, there is evidence to suggest that some individuals may be genetically predisposed to CFS.

There is no single virus or pathogen definitively linked to the disorder. The Centers for Disease Control and Prevention (CDC) suggested that CFS may be the result of multiple underlying conditions. It has been noted that approximately one in 10 people with Epstein-Barr Virus (EBV), Ross River virus, or Coxiella burnetii infections will develop a condition that meets the criteria for a CFS diagnosis, with those experiencing severe symptoms of any of these three infections being at a higher risk.

Who is at risk for chronic fatigue syndrome (CFS)?

CFS can affect individuals of any age, however, it is most prevalent among adults aged 40 to 60. Furthermore, women are more likely to be diagnosed with CFS than men. Unfortunately, many developing countries, including India, lack awareness of this condition among people, resulting in delayed diagnoses.

Symptoms of Chronic fatigue syndrome (CFS)

CFS symptoms can include:

 Severe fatigue  Sleep problems  Post-exertional malaise (PEM) where your symptoms get worse after any physical or mental activity  Problems with thinking and concentrating  Pain  Dizziness  Gastrointestinal problems  Sensitivity to light, touch, heat, or cold  Anxiety or panic attacks.

How is CFS diagnosed?

A diagnosis of CFS can be challenging due to a lack of medical tests to screen it. Symptoms of CFS are similar to many other medical conditions, making it difficult to pinpoint but the doctor can review your medical history and rule out any other potential causes of your fatigue to give an accurate diagnosis.

(The author is a senior consultant in psychiatry.)