Do you feel tired? We mean really tired, slogging-through-quicksand tired. The kind of tiredness that sleep doesn’t seem to help, and that has been going on for months or years. Tiredness that’s severe enough to impact your life and maybe even keep you from being able to work or to enjoy life. You have chronic fatigue.

Are you really sick?

You may wonder whether you are really sick; perhaps you’re just imagining it, or being lazy. After all, you look fine. Doctors can’t find anything wrong – no blood test, scan, or monitor can detect chronic fatigue. It’s easy to dismiss. Those closest to you are starting to think you should just snap out of it already, or learn to live with it and move on, or maybe get counseling even though you know the problem is physical.

We have two messages for you:

  • Yes, chronic fatigue is real and physical
  • And, yes, there’s hope and help for recovery

What exactly is chronic fatigue?

Chronic fatigue, by definition, is excessive tiredness (fatigue) that has been going on for at least a few months (chronic), with no obvious external cause. The medical world has tried to turn this disabling symptom into a diagnosis by stipulating that a certain number of nodes, or spots on the body, be tender; or that there also be a low-grade fever or a sore throat. These symptoms are found in some but not all of those with chronic fatigue, sometimes called chronic fatigue syndrome, or CFS; a syndrome is a collection of symptoms that tend to occur together.

How does chronic fatigue start?

The onset of chronic fatigue can vary by individual. In some cases there is a clear event preceding it: a concussion, whiplash, dental work, or flu, even if the connection isn’t obvious right away. The person might be fine in the morning and sick by the afternoon, and just never gets better. In other cases the onset of chronic fatigue is so gradual that it’s difficult to pinpoint a year of onset, likely because of cumulative exposure to the triggering factors.

What does chronic fatigue feel like?

Although everyone with chronic fatigue has, by definition, severe and unexplained tiredness that is unrelieved by sleep, there can be wide variations in individual experience. Some people simply feel bone-crushing tiredness without other symptoms, while others might feel sick and flu-ish as well. Some people feel generally tired regardless of activity, while others might feel fine until they try to do something mildly strenuous or stressful, after which they can take hours or even days to recover. Still others might feel more or less okay, and then with no provocation they might suddenly have to sit down and rest now. Some people may be tired every day, and others have energy ups and downs.

What other symptoms are often found with CFS?

As mentioned, tender nodes, or body points, are sometimes found in CFS, as are sore throats and low-grade fevers. Fibromyalgia, or overall pain without an identifiable cause, is often found in those with CFS. Chemical sensitivity is common as well, and not surprisingly; an overload of chemicals can cause both ailments. Brain fog, the feeling that your mind isn’t nearly as sharp as it used to be and your concentration and memory are shot, is common, and its severity on a given day usually correlates to how severe the fatigue is. Muscle weakness can be part of the experience; you may feel as if you can barely climb up a flight of stairs without pushing yourself and/or resting halfway up.

Depression is common with CFS. Part of the reason for this is simply that you have a disease that is sapping the enjoyment and ability out of your life, doctors don’t seem to know what to do about it and may not take it seriously, and you may wonder whether life will ever be normal again. As with any chronic illness, this situation would depress almost anyone. There’s more to it, though; depression and fatigue tend to occur together even if the primary diagnosis is clinical depression.

Motivation to get better

Something strange might seem to be happening with your motivation. You may want more than anything to get well, and you may have found a doctor or clinic that has a list of things you’ll need to do. But strangely, you might find yourself not doing these things. What’s going on? The simple answer is this: motivation is mental energy, and it may be as hard to come by or sustain as physical energy. It may be as hard to grit your teeth and slog through what you have to do as it would be to play a couple of games of tennis: you just physically can’t. This lack of sustained motivation can affect other areas of your life as well.

How does chronic fatigue end or progress?

Sometimes the fatigue just starts to get better as mysteriously as it came on. Sometimes it comes and goes, or it may steadily worsen. The course your case of chronic fatigue is likely to take depends on the cause and whether that cause is ongoing.

What can you do?

There’s a lot that you can do other than just waiting and hoping. Chronic fatigue is something that the practitioners at CAM see frequently and have had considerable success in dealing with. The key is to identify the cause or causes in each individual’s case, and to address these causes. What are the likely causes and associated treatments? These are discussed in the next article in this series.

But meanwhile, there’s an excellent book on the subject, Ending Fatigue, Pain, and Reactivity, written by Dr. Andrea S. Dworkin and Dr. Bill Kellas. This book is available at CAM and through this website. Dr. Kellas has had decades of experience in helping those with chronic fatigue and other chronic illnesses, and Dr. Dworkin has herself experienced severe ongoing fatigue over twenty years ago, regaining her health through following the protocols used at CAM and detailed in this book.

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