One of the theories regarding the causation of CFS, more often known as myalgic encephalomyelitis, is that is caused by a number of pathogens and or a combination of pathogens/toxins. Or possibly an uncommon reaction to a common pathogen.
Although the name chronic fatigue syndrome sounds trivial, the cardinal symptom of post exertional malaise (PEM) lasting 24 hours or more unrelieved by rest and upon minimal exertion such as walking the dog or doing the dishes is not your every day fatigue.
You do not mention substantial memory or concentration problem which would be in combination with PEM as part of the unique pattern of signs and symptoms of ME.
You also mention depression, but this is not part of ME or CFS. Being very sick is depressing, but it isn't a symptom of any disease - it's a psychiatric disorder called situational depression. It can co-occur with any disease including ME and CFS.
There is no cure. Patients usually use pacing to stay within their very limited energy envelope. If activities produce a flare in symptoms you are pushing too hard. Drugs can be used to control some symptoms and CBT can help you cope.
Here is how clinician diagnose ME and CFS after ruling out other disorders and diseases.
The 2003 Canadian Clinical Case Definition is summarized as follows and symptoms from all of the categories are required for a clinical diagnosis of CFS.
1. POST-EXERTIONAL EXHAUSTION: There is a loss of physical and mental stamina, rapid muscular and cognitive fatigability, post-exertional fatigue, malaise and/or pain, and a tendency for other symptoms to worsen. A pathologically slow recovery period (it takes more than 24 hours to recover). Symptoms exacerbated by stress of any kind. Patient must have a marked degree of new onset, unexplained, persistent, or recurrent physical and mental fatigue that substantially reduces activity level.
3. PAIN: Arthralgia and/or myalgia without clinical evidence of inflammatory responses of joint swelling or redness. Pain can be experienced in the muscles, joints, or neck and is sometimes migratory in nature. Often, there are significant headaches of new type, pattern, or severity. Neuropathic pain is also a common symptom
4. NEUROLOGICAL/COGNITIVE MANIFESTATIONS: Two or more of the following difficulties should be present: Confusion, impairment of concentration and short-term memory consolidation, difficulty with information processing, categorizing, and word retrieval, intermittent dyslexia, perceptual/sensory disturbances, disorientation, and ataxia. There may be overload phenomena: Informational, cognitive, and sensory overload -- e.g., photophobia and hypersensitivity to noise -- and/or emotional overload which may lead to relapses and/or anxiety.
5. AT LEAST ONE SYMPTOM OUT OF TWO OF THE FOLLOWING CATEGORIES:
A. AUTONOMIC MANIFESTATIONS: Orthostatic Intolerance: E.g., neurally mediated hypotension (NMH), postural orthostatic tachycardia syndrome (POTS), delayed postural hypotension, vertigo, light-headedness, extreme pallor, intestinal or bladder disturbances with or without irritable bowel syndrome (IBS) or bladder dysfunction, palpitations with or without cardiac arrhythmia, vasomotor instability, and respiratory irregularities.
B. NEUROENDOCRINE MANIFESTATIONS: Loss of thermostatic stability, heat/cold intolerance, anorexia or abnormal appetite, marked weight change, hypoglycemia, loss of adaptability and tolerance for stress, worsening of symptoms with stress and slow recovery, and emotional lability.
C. IMMUNE MANIFESTATIONS: Tender lymph nodes, sore throat, flu-like symptoms, general malaise, development of new allergies or changes in status of old ones, and hypersensitivity to medications and/or chemicals.
6. The illness persists for at least 6 months. It usually has an acute onset, but onset also may be gradual. Preliminary diagnosis may be possible earlier. The disturbances generally form symptom clusters that are often unique to a particular patient. The manifestations may fluctuate and change over time. Symptoms exacerbate with exertion or stress.
Carruthers BM, Jain AK, De Meirleir KL, Peterson DL, Klimas NG, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, Sherkey JA, van de Sande MI. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols. J CFS 2002;11(1):7 – 116
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