CFS  - Is it in Your Head

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Imagine feeling exhausted after walking one block or carrying a light bag of groceries or walking up the stairs in your home.

Imagine feeling totally exausted after having slept over 10 hours the night before.  Imagine having your brain feeling constantly hung over - you can't think straight, you can't process information, you can't understand the simpliest of tasks. Imagine having constant chronic sore throats and muscle and joint pain. Imagine that when you try to read that the words don't sink in, they float off the page and you must continually start over. Imagine being totally exhausted and unable to sleep. Imagine that a simple trip to a grocery store could put you in bed for days because your brain has to process all the sights, sounds, lights

Now imagine these symptoms go on and on for years. This is how CFS (Chronic Fatigue Syndrome) feels.

These are some of the symptoms of Chronic Fatigue Syndrome, also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS,) or Myalgic Encephalomyelitis, a serious and disabling illness that is now one of the most common chronic illnesses of our time. It is also one of the most misunderstood.

People with Chronic Fatigue Syndrome have symptoms similar to a concussion: brain fog, confusion, memory loss and difficulty processing sensory input. A simple trip to the grocery store can be exhausting as the brain struggles to process all the light, noise and movement.

In 2002, the U.S. diagnostic code for chronic fatigue syndrome will be moved from "general symptoms-malaise and fatigue" to "other disorders of the brain."

The CDC estimates in the early 1990s, based on people receiving medical treatment, projected the number of people with chronic fatigue syndrome to be 10 per 100,000. The 1999 prevalence study, which evaluated a large random sample of people in metropolitan Chicago, reveals rates of 422 people per 100,000. When a whole community was studied, not just people under a doctor's care, the numbers increased significantly. The new numbers reveal 800,000 adults in the United States have chronic fatigue syndrome, twice the number of people with multiple sclerosis.

Other myths new research is debunking:

Myth: People with Chronic Fatigue Syndrome are "merely tired," perhaps from overwork or stress.

Fact: People with the illness have a complex, multi-system illness, showing abnormalities in the immune, neurological, endocrine and other systems. The profound exhaustion of a person with Chronic Fatigue Syndrome bears no relation to the fatigue a healthy person feels as the result of a busy life. People severely ill with Chronic Fatigue Syndrome have a functional level that is significantly lower than that of someone with cancer undergoing chemotherapy, someone with heart disease or multiple sclerosis.

Myth: People who claim to have Chronic Fatigue Syndrome are really de- pressed. It's "all in the head."

Fact: In the 1999 study, 60 percent of those diagnosed with Chronic Fatigue Syndrome had never experienced a psychiatric illness, such as depression, before the onset of the illness. People with depression generally feel better after exercise; people with Chronic Fatigue Syndrome feel worse after exercise. People with depression typically have enlarged adrenal glands; people with Chronic Fatigue Syndrome often have small, low- functioning adrenals.

New research also reinforces the understanding that the illness can involve significant transient (as opposed to permanent) brain damage. Brain scans have revealed lesions in people with the illness, as well as a decreased blood flow to the cerebrum and midbrain.

A diagnosis is made when a person meets the Centers for Disease Control definition: clinically evaluated, unexplained, persistent fatigue that is of new onset, is not alleviated by rest, lasts over six months and results in substantial reduction in previous levels of activity. In addition, four or more of the following symptoms must be present for over six months: impaired memory or concentration, sore throat, tender cervical or axial lymph nodes, muscle pain, multi-joint pain, new headaches, unrefreshing sleep and post-exertion malaise lasting more than 24 hours.

Chronic fatigue syndrome disrupts work and family life for hundreds of thousands of people. This has important implications for public health and policy. Our new understandings about the illness should galvanize support from legislators, the research community and the general public for increased research and education about this major public health concern.

Most facts here are taken from author Dorothy Wall who is a writer and writing consultant in Berkeley, California.