DO you feel tired even after a full night's sleep or exhausted all the time and no amount of coffee helps you stay alert?

Situations such as these are common for those with chronic fatigue syndrome or CFS and sufferers are often mistakenly labelled as lazy.

CFS is a debilitating condition that defies conventional diagnostic efforts as there are no specific tests or symptoms that can definitively identify the condition.

As a result, CFS remains shrouded in mystery and those affected are often left to figure things out on their own.

There is little data on CFS in Malaysia, not because it does not exist here but because there is low awareness among the general public, says IMU University clinical psychologist and head of department at the school of medicine, Dr Serena In.

Few people seek treatment for it, leading to CFS being under-reported and poorly understood, she adds.

Medically known as myalgic encephalomyelitis, experts are uncertain what causes CFS. It can sometimes develop after viral infections such as Covid-19, though it is not associated with any specific infection.

Other related factors – though not necessarily causal in nature – include inflammatory diseases such as arthritis, psychological conditions such as

depression, and hormonal changes such as menopause.

CFS can only be diagnosed based on a combination of symptoms, alongside a series of tests to rule out other possible causes.

However, before jumping to CFS as an answer, we should first "listen to our body".

"Address the basic needs first – get sufficient rest and eat a balanced diet. If you get the basics right, you should feel better in a few weeks. However, if you have tried this with no relief, then you may need medical advice."

A family physician can help to identify and rule out other possible health issues, from autoimmune conditions like lupus, to burnout, depression or other health problems. This may involve blood tests, journal-keeping to track symptoms, and weeks or even months of observation.

Where relevant, your doctor may also refer you to one or more specialists for further insights.

Fatigue that is not relieved with rest or sleep is a common symptom of CFS.
Fatigue that is not relieved with rest or sleep is a common symptom of CFS.

LIVING WITH CFS

"CFS is different for everyone. It is a multifaceted condition, and while its severity can vary from person to person, being constantly fatigued, in pain or feeling unwell on a daily basis can be debilitating," says In.

Some patients also report not being well understood by their own physician, employers, or loved ones when describing their symptoms. This can be particularly difficult for those who are used to being active and social, who are now forced to cut back on certain responsibilities, physical activities or social gatherings.

There is no specific treatment or cure for CFS, though pain management can play an important role in relieving symptoms, alongside lifestyle adjustments.

In addition, patients should consider seeing a clinical psychologist or counsellor for support in processing the vast changes to their lives.

"For some, the process of adjusting to life with CFS can feel like grief, as it may mean losing the healthier version of themselves."

Therapists can help patients address their fears for the future as many patients may also feel a sense of hopelessness.

"It is possible to work through acceptance and still lead a meaningful and fulfilling life after having learnt to effectively manage these symptoms on a daily basis," explains In.

It is important not to give up hope. CFS is challenging to diagnose and there is no quick fix, but it is important to persist in your efforts to find an answer.

Engaging a supportive team of medical specialists to manage your symptoms along with a therapist to process the unpredictable challenges, could greatly enhance your quality of life.

For some, the process of adjusting to life with CFS can feel like grief, as it may mean losing the healthier version of themselves, says IMU University clinical psychologist and head of department at the school of medicine, Dr Serena In.
For some, the process of adjusting to life with CFS can feel like grief, as it may mean losing the healthier version of themselves, says IMU University clinical psychologist and head of department at the school of medicine, Dr Serena In.

MAKING SENSE OF CFS

SYMPTOMS may come and go, and vary greatly from person to person, but most patients report symptoms such as:

*Fatigue that is not relieved with rest or sleep

*Difficulty concentrating

* Muscle weakness

*Hypersensitivity to smells, chemicals, light or noise

*Digestive problems like irritable bowel syndrome

*Joint and muscle pain without exertion, swelling or redness