Chronic Fatigue Syndrome (CFS) is a complex disorder about which little is known. The reasons for onset, etiology or cause of CFS are still largely unknown. In spite of the fact that more than one million individuals suffer from the disorder in the United States alone, physicians are still focused primarily on symptoms, rather than causality. There are no physical signs to alert an individual or your medical practitioner to the presence of CFS, nor are there any conclusive diagnostic laboratory tests designed to diagnose it. The only thing more difficult than diagnosing and treating chronic fatigue syndrome, is living with it!
The onset
Chronic Fatigue Syndrome differs from other chronic illnesses in that about three-fourths of occurrences come with what can only be described as an abrupt onset, often presenting suddenly and, seemingly, out of nowhere. Other instances of chronic fatigue spring up after a long period of mild symptoms, generally triggered by a traumatic event or stress. While suggestive, the link between stress and chronic fatigue remains only that...suggestive.
Etiology or Cause
The research into CFS has been extensive, published virtually around the world and in every scientific journal and magazine you can think of, the interest is intense as the disorder reaches epidemic levels. Every organization, from the National Science Foundation (NSF), to the National Institutes of Health (NIH), and the Center for Disease Control (CDC) have researched this complex and puzzling phenomenon, but to no avail. There are a number of powerful hypotheses but as of yet no solid data to support any of them. While anecdotal, it seems that the disorder only recently, in fact over the past three and one-half decades, has burst onto the scene, peaking the interest of scientists, researchers, and the medical community as a whole.
Transmission
No solid conclusions have been drawn pertaining to transmission of chronic fatigue. In fact there is no evidence at all to support the proposition that CFS may be contagious. Nevertheless, multiple cases of the disorder have been diagnosed in the same family. There does seem to be powerful suggestive evidence that chronic fatigue may indeed have a genetic component, however, the jury is still out. More research is needed to prove or disprove the suggestion that CFS is or is not genetic.
Symptomology
Chronic Fatigue Syndrome is categorized by incapacitating, debilitating, and even totally disabling fatigue. CFS presents with a myriad of symptoms, many resembling other illnesses. Symptoms of CFS mimic those of several other disorders, making it extremely difficult to properly diagnose. Chronic fatigue symptoms are similar to those of Fibromyalgia Syndrome, Myofascial Pain Syndrome, multiple sclerosis, mononucleosis, and even Lyme disease. The symptoms are widespread, and are usually broken down into three categories, they are listed below.
General or physical symptoms:
Many sufferers of CFS find it nearly impossible to perform any sort of physical exertion. When engaged in physical activity, such as exercise or any sort of physical labor, the CFS sufferer may experience shortness of breath, light-headedness, and even blackouts. While some individuals are able to conquer the work week, usually exerting tremendous effort to do so, many more are bedridden, forced to rely solely on others, totally disabled. Problems compound in the ear, nose and throat area, appearing to be endocrine driven symptoms (glands and hormones). Sore throats and swollen lymph nodes occur, perhaps suggestive of an infection (antigen/antibody reaction), as when the body attempts to fight off a foreign body or when the body is undergoing an extreme stress reaction. While allergies develop and symptoms become more severe, fevers often present as a symptom as well. Additionally, CFS sufferers will experience night sweats, weight change with little or no apparent change in dietary habits, and they will often suffer from irritable bowel syndrome and bladder dysfunction. Interestingly, many of the conditions listed above are often present during periods of exaggerated stress.
Neurological symptoms:
Sleep disorders are a common symptom of CFS and it has been suggested that increased pain sensitivity may contribute to the restlessness and sleeplessness many experience. Chronic fatigue sufferers often experience difficulty with their senses, mainly in the form of vision changes and sensitivity to bright light, olfactory changes (odor perception) and sensitivity to certain chemicals have been documented. Disorientation may also occur with CFS, while some suffer with problems of balance and spatial perception. Trouble with concentration and memory have also been reported, seeming to present along with impaired word usage during a phenomenon called "brain fog." Some living with CFS are even subject to seizure-like episodes and unusual and disturbing nightmares.
Emotional problems:
Depression is often connected with chronic fatigue syndrome. Along with depression, CFS sufferers experience suicidal ideation, anxiety (with or without panic attacks), anger and rage issues, and mood swings ranging from pronounced manic episodes to suicidal depression. The depression experienced alongside CFS may be chemically induced, due to a serotonin and norepinephrine imbalance, as well as a consequence of external events, such as severe pain, disability, and hopelessness due to lack of treatment options.
CFS varies in degree and expression, type and severity, from one patient to the next. In the same individual, chronic fatigue may wax and wane from one day to the next, even hour to hour. Chronic Fatigue Syndrome symptoms may be mild to acute, fleeting to chronic, in the same individual and from day-to-day.
Chronic Fatigue Syndrome crosses all barriers and touches individuals from all walks of life. There are no clear ethnic, socioeconomic or age-related factors...anyone may be affected. However, there does seem to be a gender issue, with twice as many women as men presenting with the disorder, particularly women between 30 and 50 years of age. Of the known cases of CFS, those with verifiable diagnoses, at least twice as many women have the disease as men. It also appears to affect pregnant women at a much higher rate than the rest of the population. The reason or reasons for the gender discrepancy, like the difficulty with the initial diagnosis, is problematic and requires more research. The complexity of the disorder, combined with a lack of any sort of diagnostic standard, results in a medical community that is reactive, required to treat symptoms, with little or no real idea of etiology (cause). The impact of chronic fatigue on the lives of those suffering from this debilitating and disabling disorder is unfathomable to those who aren't living it on a daily basis. Like Chronic Pain Syndrome, Chronic Fatigue Syndrome creates a constellation of secondary and tertiary consequences, some as bad if not worse than the original condition. Until etiology (cause) is established, CFS sufferers deal with, on a daily basis, one of the most debilitating of all disorders. While their load may be lightened with an individually designed and implemented treatment strategy, the ultimate treatment, a cure, still appears elusive.
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