OVERCOMING CHRONIC FATIGUE SYNDROME
1. What is Chronic Fatigue Syndrome?
Chronic fatigue syndrome is also known as myalgic encephalomyelitis (ME) or post-viral fatigue syndrome (PVFS). The main symptom of CFS is overwhelming persistent fatigue – unlike normal tiredness. Other symptoms include pain in muscles and joints, pins and needles, headaches, sore throat, dizziness, sensitivity to noise and light. CFS sufferers have reported impaired thinking and short-term memory loss, poor concentration, problems sleeping and digestive disturbances such as loss of appetite, nausea, and intolerance to some foods or beverages.
People with CFS may have to give up work or study, reduce social and leisure activities, and restrict what they can do with their family. The exhaustion they feel often means they stay in bed for most of the day. Some may be able to manage work or home but little else.
CFS can occur any time in adulthood and is more common in women.
There is no single cause of CFS but triggers include:
An initial illness such as a viral infection.
A too busy stressful lifestyle.
Life changes such as getting married, bereavement or changing jobs.
Striving very hard to achieve in everything and too little time spent relaxing.
Factors that maintain CFS include:
Resuming your usual level of activity before you have fully recovered.
Too much rest makes it difficult to become active again and increases CFS.
Confusing advice about CFS and treatment.
Alternating between overactivity (when you have some energy) and longer periods of rest from being even more fatigued by your exertions.
Lack of adequate and regular sleep pattern.
Making symptoms worse by focusing on them.
CFS sufferers feel pain after any activity and may worry that activity will exacerbate the illness.
You may have reduced activity and be sleeping for long periods – but too much rest can cause problems.
CFS can cause stress and anxiety due to changes in lifestyle such as giving up work, a changed less responsible role within the family and isolation due to reduced socializing.
Long periods of inactivity as in CFS can have the following effects on the body:
CFS patients have fewer active mitochondria and their enzymes in their muscles compared with healthy active people. This can cause lack of energy in the muscles. The muscles become less efficient with reduced activity and can produce a feeling of weakness followed by pain when they contract.
Prolonged rest can de-condition the cardiovascular system and cause breathlessness or dizziness when exercising.
Disrupted body temperature regulation resulting in feeling hot and/or cold with too much, out of place sweating.
Problems in seeing and hearing.
Prolonged inactivity can generally de-condition the body making it harder to be active.
The nervous system may change, reducing coordination, resulting in difficulty moving precisely.
Continued rest can impair concentration and memory.
Some studies have shown that CFS is linked to a disturbed circadian rhythm (biological clock responsible for regulating such functions as hunger, sleep patterns, body temperature). This may start as an infection making daily functions such as sleeping and waking times irregular and then the biological clock loses control.
Research indicates that CFS patients have low cortisol levels and having less than normal of this hormone can explain the feeling of tiredness in CFS.
Disturbed sleeping which is reversible.
CFS can cause stress and anxiety which can result in:
A racing pulse, palpitations, or tightness in the chest.
High blood pressure.
Reduced blood flow to parts of the body such as the skin when blood is redirected to muscles to prepare for action.
Increased muscle tension.
Increased sweating to compensate for heat loss.
Altered mental functioning such as disturbed mood, poor concentration and restlessness.
As you continue with this program you will be shown coping strategies to overcome your CFS.
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2. Learning to Cope
Monitoring Activity and Sleep:
Keep an activity diary for what you do (including rest periods) each day of the week from waking to going to sleep. Also, monitor your sleep by keeping a sleep diary. After keeping these diaries for a week or two you may notice patterns such as a high activity level in the mornings or waking frequently at night. From analyzing these diaries you can construct an Activity Schedule to give you the right measure of activity and rest each day. Continue with these diaries to see if the coping strategies you implement are productive.
See Program 1: Coping Strategies Counselling Advice – Nutrition, Exercise, Managing Your Time and Sleep Management.
Setting SMART Goals:
Make sure your goals are specific, measurable, achievable, realistic, and time bound. Break down your targets into small manageable steps. When setting goals consider all areas of your life (e.g. work, leisure, socializing, study, exercise, household chores, sleep). Address a mixture of these in your targets, to keep your life in balance.
Changing Your Activity Level:
You may need to gradually increase or decrease your activity level.
See Program 1: Coping Strategies Counselling Advice – Planning an Activity Schedule.
Dealing with Unhelpful Thoughts:
Identify and challenge negative thinking; strengthen your new beliefs.
See Program 1: Coping Strategies Counselling Advice – Modifying Maladaptive Thinking.
Obstacles To Recovery:
Perhaps you fear that increased activity will make you feel worse. Note that a temporary increase in symptoms with increased activity is expected but lasts only a short time.
Develop a positive body image.
See Program 1: Coping Strategies Counselling Advice – Criticism, Countering Self-Criticism, Coping with the Need for Approval and Improving Your Self-Image and Combating Self-Harm.
To deal with any losses you have experienced:
See Program 1: Coping Strategies Counselling Advice – Troublesome Emotions, Forgiveness, Program 6: Overcoming Anger and Program 15: Overcoming Grief And Bereavement.
Perfectionism is unrealistic. It can cause frustration and distress when you cannot meet your exceptionally high standards.
See Program 1: Coping Strategies Counselling Advice – Competitiveness and Perfectionism, Frustration, Procrastination and Persistence.
If you are receiving state benefits you may worry about losing it if you work and are unable to manage your job. You could resume full-time work in a graded way, starting with a study course or voluntary work, then negotiating a few hours a week with your employer and eventually increasing the time you work. Alternatively, you may no longer want to work – in this case research the support available.
Other illnesses can exacerbate your CFS. It may be that those close to you have reservations about this program – reassure them that you are confident it will be helpful. If you lack social support try requesting help from a neighbour occasionally and find a local support group.
See Program 1: Coping Strategies Counselling Advice – Social Skills Training, Communication Training, Negotiation Training and Program 13: Overcoming Destructive Relationships.
Any sort of stress can make progress difficult. Two approaches to deal with stress are:
See Program 1: Coping Strategies Counselling Advice – Problem-Solving.
Exposure to anxiety provoking situations.
See Program 1: Coping Strategies Counselling Advice – Controlled Breathing and Relaxation Techniques, Eye Movement Technique (EMT), Mood Induction Procedure, Rational Emotive Imagery (REI), Imago Graded Exposure and In Vivo Graded Exposure
Learn to deal effectively with life stresses.
See Program 8: Overcoming Anxiety, Program 22: Overcoming Stress and Program 23: Overcoming Stress At Work.
Perhaps you have stopped doing things and now lack confidence in your ability to deal with them. Make a hierarchy list of things you used to do and starting with the easiest try to include one or two items weekly in your schedule.
See Program 1: Coping Strategies Counselling Advice – Assertiveness Training, Neuro-Linguistic Programming (NLP), Building Confidence I, Building Confidence II, Building Confidence III, Building Confidence IV and Program 16: Overcoming Low Self-Esteem.
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To sustain the improvement in your health and lifestyle and make further changes, continue to set targets that stretch you. Make sure there is a balance between activity and rest in your lifestyle. Ensure that you get regular sleep and exercise, eat a healthy diet, take short breaks when working and include at least one pleasurable activity daily. If you feel there is too much to do then prioritize your activities.
Learn to deal with harsh comments from others and your own inner critic. You may grieve for the losses you have experienced due to CFS. Consider situations that could trigger a setback and plan what action is needed to deal with them positively. Learn from setbacks to be able to cope better in future.
See Program 1: Coping Strategies Counselling Advice – Relapse Prevention.
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