Chronic Fatigue Syndrome: Understanding Your Symptoms
Chronic fatigue syndrome (CFS) is a complex condition characterised by incapacitating, unshakeable exhaustion that isn’t relieved with rest. The exact cause of the illness is largely still a mystery. Some theories propose it may stem from psychological stress, viral and bacterial infection, hormonal imbalances, or a compromised immune system.
The condition, and its associated fatigue, can have a very debilitating impact on everyday life. For many people living with the condition, small, mundane chores demand an excessive amount of energy. This fatigue can affect emotional and mental health, too. Needless to say, living with CFS can be incredibly difficult, particularly if you do not understand the condition or how best to control it.
Unfortunately, there is no cure for CFS, but here we explain more about the condition in general and what you can do to help manage it.
What are the symptoms of chronic fatigue syndrome?
CFS can affect people in a multitude of ways and everyone will experience it differently. Although anyone can be affected by the condition — regardless of age, gender, or race — it is more prevalent in women and tends to develop between your 20s to 40s.i
CFS is notoriously hard to diagnose. Since there isn’t a specific test to determine whether someone has the condition, it has to be diagnosed based on the symptoms alone.
The overarching indicator of CFS is inexplicable fatigue that’s severe enough to affect your daily activities. For CFS to be diagnosed, the fatigue must be chronic — it will last more than six months — and cannot be counteracted by any amount of rest. Beyond this, you may also experience the following symptoms: ii
The most common symptoms of chronic fatigue syndrome include:
Post-exertion malaise: experiencing intense lethargy after too much physical or mental activity. A person experiencing this may describe it as having their ‘internal batteries’ drained.
Sleep disorders: experiencing unrefreshing sleep, insomnia (trouble falling asleep), hypersomnia (oversleeping), fragmented sleep (frequently waking and falling back asleep), or nightmares that disrupt sleep.
Cognitive impairment: experiencing problems with memory, following films or books, problem-solving.
Orthostatic intolerance: feeling lightheaded, dizzy, or faint when moving from lying down on your back to sitting or standing.
Pain: discomfort that ranges from severe headaches to cramps, muscle and joint aches. Those who experience CFS often describe the pain as shooting, burning, tingling, throbbing, or stabbing.
How to manage chronic fatigue syndrome
Listen to your body
Fatigue will vary in degree of severity depending on the day. Some days you’ll feel utterly depleted and others, you’ll feel better. But even on your good days, you need to find a healthy balance between activity and rest.
Make a concerted effort not to exhaust yourself on the days you feel well. Overexerting yourself will only tire your body and mind and trigger your symptoms. It’s important to be intuitive and listen to your body. As soon as you detect the first signs of pain, discomfort, or fatigue, you should stop and rest.
Fine-tuning your nutrition is another important component of managing CFS. With the correct dietary changes, you can improve your energy levels, address any nutrient deficiencies, and feel better overall.
You should aim for foods that deliver a steady supply of long-lasting energy and have a healthy balance of fats and antioxidants. These types of foods can reduce inflammation in the body. Research suggests that patients with CFS exhibit higher levels of two types of cytokines — compounds that promote inflammation in the body.iii
With this in mind, it’s generally agreed that following the guidelines outlined below can help:iv
Best foods for CFS:
Leafy-green and orange-coloured vegetables
Whole grains, beans and legumes
Oily fish and seafood
White soy foods (tempeh and tofu)
To keep your energy levels stable, aim to eat three nourishing meals a day. If you get hungry between mealtimes, you should graze on healthy snacks, like a handful of nuts or a bowl of Greek yoghurt. Be mindful that everything you eat should be balanced and include a variety of food groups — fruits, vegetables, protein, healthy fats, and some complex carbohydrates. Doing this will keep you energised and full until your next meal.
You may also want to add magnesium and vitamin B12 supplements to your diet as these nutrients support energy production in the body. Lastly, stay hydrated, as dehydration exacerbates fatigue.
Despite feeling exhausted, it’s essential to keep exercising. There’s robust evidence to suggest physical activity keeps you strong and active, as well as supporting your mental health and preparing the body for rest at night.v Just remember to pace yourself; overdoing it can make you feel worse. Exercise must be moderate and within your limits.
Generally, it’s advised to start with very small amounts of exertion and work up to a level that’s suitable for you. You could start off with a few yoga poses, a gentle walk, or picking up and grasping objects. Over time, you may progress to light aerobic exercises, such as walking, swimming, and dancing.
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy can be another effective way to help manage CFS. CBT is a short-term psychological treatment that aims to change your thoughts and behaviours towards certain things. It’s employed to treat both physiological and psychological conditions, providing the necessary mechanisms to break bad habits that perpetuate symptoms.
A team of researchers at Queen Mary, University of London, conducted a large-scale five-year study on the potential treatments for CFS.vi They discovered that a combination of CBT and exercise therapy lead to sizeable improvements in the symptoms of CFS. In fact, 22% of patients ‘recovered’ from CFS in this trial.
Although the results couldn’t predict whether the participants’ symptoms will re-appear, this was a promising outcome for the future of CFS treatment.
For more guidance on improving your sleep hygiene, explore the articles on our sleep health hub.
NHS.UK. Chronic fatigue syndrome (CFS/ME).. (2019). Available online: https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs
Ammes.org. Symptoms of ME/CFS – American ME and CFS Society.. (2019). Available online: https://ammes.org/symptoms-of-mecfs
Maes. M., Twisk. F. & Johnson. C. (2012). Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS), and Chronic Fatigue (CF) are distinguished accurately: Results of supervised learning techniques applied on clinical and inflammatory data. Psychiatry Research. 200(2-3), 754-760.>
Knight. S., Scheinberg. A. & Harvey. A. (2013). Interventions in Pediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Systematic Review. Journal of Adolescent Health. 53(2), 154-165.
Larun. L., Brurberg. K.G., Odgaard-Jensen. J. & Price. J.R. (2017). Exercise therapy for chronic fatigue syndrome. The Cochrane database of systematic reviews. (2010 Apr-Jun). 4(4), CD003200.
PhD. C. (2019). Chronic Fatigue Treatments Lead To Recovery In Trial. Medical News Today. Available online: https://www.medicalnewstoday.com/articles/255720.php
Olivia Salter has always been an avid health nut. After graduating from the University of Bristol, she began working for a nutritional consultancy where she discovered her passion for all things wellness-related. There, she executed much of the company’s content marketing strategy and found her niche in health writing, publishing articles in Women’s Health, Mind Body Green, Thrive and Psychologies.