Why are you tired all the time?
One morning, you’re sitting at your desk and feel like you could fall asleep right there. You figure that you didn’t get enough sleep the previous night. However, the next day, you feel the same way despite getting a good night’s sleep. This continues for several weeks. What’s causing you to feel so tired? How can you feel more rested?
Chronic fatigue syndrome (CFS), or myalgic encephalomyelitis (ME), is a condition where someone has extreme fatigue that lasts at least six months and isn’t explained by an underlying medical condition. Usually, physical or mental activity makes it worse and it doesn’t improve with rest. The exact cause is unknown, but certain things might trigger it, such as viral infections, immune system problems, hormonal imbalances, and physical/emotional trauma. Some viruses thought to be responsible are Epstein-Barr or human herpes virus 6; further study is needed to confirm this, though. People with CFS often have imbalances in hormones produced by the hypothalamus, pituitary glands, or adrenal glands. It’s unknown what role this plays in the condition. Some factors can increase your risk of developing the disorder, like being a woman and middle-aged.
Besides extreme fatigue, symptoms include problems with memory/focus/concentration, sore throat, headaches, enlarged lymph nodes in your neck/armpits, unexplained muscle/joint pain, unrefreshing sleep, dizziness that gets worse when moving from lying down/sitting to standing and extreme exhaustion after physical/mental activities (post-exertional malaise—it can last for days or weeks). Symptoms can vary from person to person. The severity can fluctuate daily. Due to the nature of symptoms, many people have complications, such as lifestyle restrictions, social isolation, depression, and increased absences from work.
According to the United States Institute of Medicine, to be diagnosed with CFS, the fatigue must be so severe that it interferes with the ability to engage in pre-illness activities, of new or definite onset, not substantially alleviated by rest, and worsened by physical, mental or emotional exertion. In addition, a person has to have difficulties with memory, focus and concentration or dizziness that worsens with moving from lying down/sitting to standing. The symptoms must last for at least six months and occur at moderate or severe intensity at least half the time.
There isn’t a cure for chronic fatigue syndrome. Instead, the goal is to relieve symptoms. Typically, the most disruptive ones are addressed first. For some of the symptoms, medication can be helpful. If you’re having issues when you change positions, your doctor might prescribe something to regulate your blood pressure or heart rhythm. If you’re experiencing depression, you’ll need to take antidepressants, which might also improve sleep. Over-the-counter pain relievers, like acetaminophen and ibuprofen, are good for relieving pain. However, if these don’t help, medications, like pregabalin, duloxetine, amitriptyline, or gabapentin, used to treat fibromyalgia might work.
Medications aren’t the only option. It’s important to focus on other elements, such as exercise and sleep. If you try to follow an aggressive exercise routine, your symptoms could get worse. It’s important to try to keep doing activities that you can to prevent a decline in your ability to function. If you do try a fitness program, start at a low-intensity and gradually increase it. As far as sleep goes, it’s essential to do your best to avoid sleep deprivation because this can considerably aggravate your symptoms. To avoid this, your doctor might suggest changing your bedtime routine and not consuming caffeine. Another item that can be beneficial is counseling because it can help you learn coping skills to deal with the limitations that come with the disorder, improve family dynamics, and manage depression.
You can’t prevent chronic fatigue syndrome from occurring. However, you can try to manage the condition to prevent it from controlling your life. One way to do this is by keeping a daily diary of your activities and symptoms. This will allow you to see what activity level makes your symptoms worse, which will aid you in not overdoing it. It’s also key to remember to not push yourself on days where you feel good because this often makes you feel much worse later.
Chronic fatigue syndrome can make living your life very challenging. By managing it to the best of your ability, you’ll be able to participate in the activities that you enjoy! If you have any questions or concerns about chronic fatigue syndrome, please speak with your doctor. If you would like more information, please visit MedlinePlus’ chronic fatigue syndrome page at https://medlineplus.gov/chronicfatiguesyndrome.html