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Too tired to do anything

Chronic Fatigue Syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits your ability to do ordinary daily activities.

health and fitness Updated: Dec 05, 2009 20:56 IST
Seema Hingor Rany

Chronic Fatigue Syndrome (CFS) is a disorder that causes extreme fatigue. This fatigue is not the kind of tired feeling that goes away after you rest. Instead, it lasts a long time and limits your ability to do ordinary daily activities. The hallmark symptoms of CFS are overwhelming fatigue and weakness that make it extremely difficult to perform daily, routine tasks, like getting out of bed, dressing, and eating. The fatigue does not get better with bed rest. The illness can severely affect, work and leisure activities, and cause physical and emotional symptoms that can last for months or even years.

In order to be diagnosed with CFS a person must have both:
1) Severe, chronic fatigue for at least six months or longer, unalleviated by rest, with other known medical conditions having been excluded by a doctor’s diagnosis
2) Four or more of the following symptoms:
Forgetfulness or difficulty concentrating
Sore throat
Tender lymph nodes in the neck or armpit
Muscle pain or multi-joint pain without swelling
Headaches of a new type, pattern, or severity
Unrefreshing sleep and vague feelings of illness or depression after exerting oneself, lasting more than 24 hours following exertion
Tiredness that lasts longer than 24 hours
Mood swings, anxiety, depression, and irritability
Odd tingling sensations in the skin
Decreased interest in sex
Digestive distress

Combination of physiological constitution and psychological factors can cause CFS. No primary cause has been found that explains all cases of CFS, and no blood tests or brain scans can definitively diagnose the condition.
Iron deficiency anemia
Mild, chronic low blood pressure (hypotension)
Dysfunction in the immune system
Depression /anxiety disorder
Prolonged exposure to stress/ faulty lifestyle, lack of sleep, bad eating habits
Low blood sugar (hypoglycemia)
History of allergies: Some studies have reported that a majority of CFS patients have allergies to foods, pollen, metals (such as nickel or mercury), or other substances. One theory is that allergens, like viral infections, may trigger a cascade of immune abnormalities leading to CFS. However, most allergic people do not have CFS.
Virus infection. Because most of the features of CFS resemble those of a lingering viral illness, many researchers have focused on the possibility that a virus or some other infectious agent causes the syndrome in some cases.
Changes in the levels of hormones produced in the hypothalamus, pituitary glands or adrenal glands.
Emotionally disturbed childhood or sexual abuse.

Lifestyle adaptations are key to the effective management of chronic fatigue syndrome symptoms. Making positive lifestyle changes lays a good foundation upon which other treatment plans can be built. Recommended lifestyle changes include:
Getting more rest. (If possible, however, avoid complete bed rest, which will lead to deconditioned muscles and increased fatigue.)
Following a regular, manageable daily routine.
Reducing physical and emotional stress.
Improving nutrition. (Avoid alcohol, caffeine, sugar and food additives. Many CFS patients have found eating more organic foods to be very effective).
Getting mild to moderate exercise regularly, but only with the doctor’s approval (for example, gentle stretching, simple water exercise).
Cognitive behavior therapy. This treatment, often used in combination with graduated exercise, has also been found to improve the symptoms of chronic fatigue syndrome. In cognitive behavior therapy, you work with your psychologist to identify negative beliefs and behaviors that might be delaying your recovery and replace them with healthy, positive ones. It’s based on the premise that how you interpret your experiences in life determines the way you feel and behave. If you have depression, for instance, you might see yourself and your experiences in negative ways, which worsens the symptoms of depression.
Get enough sleep. Getting sufficient sleep is essential. Allot enough time for sleep, practice good sleep habits, such as going to bed and getting up at the same time each day and limiting daytime napping. Sleep helps produce good hormones (especially melatonin) during a good night’s rest.

Seema Hingorrany is a clinical psychologist. You can mail her at