Chronic Fatigue Syndrome: Real Illness, Misleading Name

In the 1970's and 1980's, publicist Howard Bloom was a mover and shaker in the American music industry. Head of publicity for ABC Records and then publicity director for Gulf + Western, Bloom was responsible for "discovering" John Mellencamp, KISS, Hall and Oates, AC/DC, and Run DMC. Running his own publicity agency, he represented Billy Joel, Michael Jackson, Cyndi Lauper, Talking Heads, Lionel Richey, ZZ Top,  Bette Midler, AC/DC, and Simon & Garfunkel.

Howard Bloom is hardly someone who could be accused of faking an illness because he couldn't hack leading a successful life. Nonetheless, in 1988 Bloom developed chronic fatigue syndrome. He was essentially confined to bed for the next 10 years. Bloom was still vitally interested in life. He even tried to get a marriage license without traveling to the New York City clerk for a license, impossible because he could not leave his home. Bloom eventually recovered and resumed a high-profile career as an author and commentator, but not until after enduring years of disability due to this poorly understood disease.

What Is Chronic Fatigue Syndrome?

People who have chronic fatigue syndrome usually pose a challenge to their doctors. They may complain of severe fatigue after minimal physical exertion. They may complain of "brain fog," or flu-like symptoms that just won't go away.

People who have chronic fatigue syndrome are often told they are malingerers, or that they have a psychosomatic illness and need psychiatric treatment, or simply to go away. There is a growing consensus, however, that their disease is just as real as diabetes, or heart disease, or a broken bone. Doctors in different parts of the English-speaking world, use different terms to describe similar symptoms.

Different Definitions In Different Countries

In the UK, Canada, and Australia, people who have symptoms of being chronically fatigued may be diagnosed as having myalgic encephalomyelitis. In these Commonwealth countries, a diagnosis of myalgic encephalomyelitis requires a muscle component (myalgia), some kind of weakness of the skeletal muscles, and a brain (cephalic) component, some degree of depression or impaired mental functioning.

In the United States, doctors use a looser definition of the disease to diagnose chronic fatigue syndrome. To get a diagnosis of chronic fatigue syndrome, a patient must (1) have suffered severe chronic fatigue for at least six months, (2) not suffer any other known disease that would account for the fatigue, such as multiple chemical sensitivity syndrome, fibromyalgia, complex migraine, or depression, and (3) display at least four of the following symptoms:

• Impaired memory or short-term concentration.
• Sore throat.
• Muscle pain.
• Tender lymph nodes.
• Failure to be refreshed by sleep.
• Pain in more than one joint without swelling or redness
• Headaches of a pattern and duration not experienced before the onset of fatigue.
• Fatigue for more than 24 hours after exercise.

See Also: Tired Of Extreme Fatigue, Sleeplessness And Muscle Pain? Beat Your Catabolic State

The disease is more common in women than in men, and in younger people than in older people. It is often called "yuppie flu," but it is more common in non-whites than in whites and in poor people than in middle class or wealthy people.

How Can You Know for Sure Whether You Have Chronic Fatigue Syndrome?

Chronic fatigue syndrome can cause many other symptoms, including orthostatic tachycardia (racing pulse when moving from a seated position to a standing position), heat intolerance, cold intolerance, and chronic digestive problems. The presence of chronic fatigue syndrome does not preclude also having fibromyalgia, irritable bowel syndrome, excessive joint flexibility, or chronic inflammation. Scientists no longer believe that chronic fatigue syndrome is triggered only by Epstein-Barr Virus infection; any of a number of viral infections may trigger an overactive immune system response that probably causes symptoms.

• MRIs of people who have chronic fatigue syndrome have found unusual thinning of white matter and unusual thickening of gray matter, as if "circuits were crossed." Only a few patients have been examined, not enough to establish a trend.
• People who have chronic fatigue syndrome are only twice as likely to test positive for the herpes-6 virus (HPV-6) as people who do not. However, only 2 percent of people who have chronic fatigue syndrome have the virus.
• About 80 percent of people who have chronic fatigue syndrome test positive for exposure to enteroviruses, compared to just 20 percent of the general population. However, over 95 precent of people who test positive for the virus do not have chronic fatigue syndrome, and 20 percent of people who do have chronic fatigue syndrome do not show signs of infection with the virus.
• People who have chronic fatigue syndrome are more likely to have antibodies for Epstein-Barr Virus, Ross River virus, or certain strains of herpes. No single virus, however, always accounts for the disease.

Scientists believe that chronic fatigue syndrome may be caused by any or all of a variety of infections, which affect not only the immune system but a variety of structures in the brain. For diagnosing the disease, however, this means that doctors have to go back to the established system of evaluating symptoms, not relying on a single set of laboratory tests.

What this means is that people who have this condition should not waste time on doctors who are unsympathetic to their condition. A survey of chronic fatigue sufferers found that 36 percent waited one to five years before they got the correct diagnosis. Another 21 percent waited five to ten years before they found a doctor who understood their disease. Another 12 percent of people who have chronic fatigue syndrome saw doctors for more than 10 years before they got the treatment they needed.

See Also: 6 Ways To Beat Tiredness

There is a single, simple way to determine whether you are likely to have chronic fatigue syndrome or some other chronic, debilitating disease. If you can point to a specific time your symptoms started, usually after you had a flu-like infection, you are more likely to have chronic fatigue syndrome than depression, migraine, rheumatoid arthritis, or a psychiatric condition.