I am really tired right now. What I mean by “right now” is pretty much my entire life. Every morning when I wake up my first thought is “I wonder when I can take a nap”. Even while I’m thinking it I realize the futility in this thought; I haven’t actually taken a “nap” in months.

So last week while I was doing my usual work day multi-tasking; eating lunch and working on a paper for one of my master’s degree classes, I got sucked-in to the to the break room TV, which is perpetually on CNN, and caught a bit they were doing on Chronic Fatigue Syndrome, CFS. As I watched, I began to wonder; what constitutes chronic fatigue? Do I have it? Is it really a viable disorder? What’s the difference between chronic fatigue and chronic laziness?

It’s been said that the pharmaceutical companies invent illnesses to get consumers to purchase their drugs. Anyone who watches TV at least a couple of times a week can attest to the barrage of pharmaceutical commercials which assault viewers, offering solutions to new categories of illnesses, illnesses which seem to be devised on a daily basis. Sometimes it makes me feel like screaming; “I’m just trying to watch ‘The Office’, lay-off Pfizer!!!” (My current favorite invention is “PMDD”, but I’ll save that one for another post) Is CFS another one of these illnesses invented to help drug makers increase their bottom line?

On emedicinehealth.com, I found the following explanation about what CFS is;

Chronic fatigue syndrome (also called CFS) is a disorder without a known cause, although CFS may be related to a previous infection. CFS is a state of chronic fatigue that exists without other explanation for 6 months or more and is accompanied by cognitive difficulties (problems with short-term memory or concentration).

Emedicinehealth.com goes on to say that if you have symptoms such as; sore throat, tender lymph nodes, muscle pain in multiple joints, headaches and problems with concentration or short term memory, you may be a candidate for Chronic Fatigue, which the website touts effects “tens of thousands” of people. Since the syndrome is based on a wide variety of subjective symptoms, there is no laboratory test which can prove the existence of CFS in a patient. In addition in order to accurately diagnose an individual with CFS a number of other possible problems have to be ruled out. For example, a lot of the symptoms which characterize CFS are synonymous with depression.

In other words we don’t know what causes CFS, we can’t test for it and it may be confused with other problems. CFS is beginning to look like the perfect illness to fake right? Come on, how many people haven’t thought about faking a medical condition, claiming total disability to hold a real job so that they can sit around their house all day watching the game show network, eating Mac and Cheese straight out of the pan and folding thousands of pieces of origami into the wee hours of the night by the hazy blue glow of the TV? Okay, so maybe the origami folding is just me, but seriously I was beginning to believe CFS was the perfect scapegoat to living a work-free life.

That was until I saw this article; Plunge in Blood Pressure Tied to Chronic Fatigue which was originally published in Johns Hopkins Magazine. Research by Peter Rowe and others at Johns Hopkins has shown a link between the symptoms of CFS and neurally mediated hypotension. Neurally mediated hypotension is a nervous system disorder which is characterized by abnormal communication between the heart and brain. An exert from the article describes what happens when a person is afflicted with this disorder;

Normally, when a patient sits or stands, the brain sends a message to the heart telling it to pump more blood throughout the body. But in patients with neurally mediated hypotension, the reverse occurs. Blood pools in the feet, and blood pressure drops precariously low. Patients often faint. “Some can’t even stand in line at the grocery store, or sit and type,” Rowe says. Following an episode, patients are often extremely fatigued – - just as occurs in chronic fatigue syndrome – - which suggested to Rowe and his colleagues that perhaps there was a connection.

In the Rowe study, Rowe and his colleagues used the traditional “tilt table test” which is often used to test for Neuurally mediated hypotension, in order to assess whether or not patients diagnosed with Chronic Fatigue exhibited the same blood pressure plunges. In the tilt-table test patients are asked to lie down on a table for a period of a few minutes, then they are strapped in and the table is titled to a 70 degree upright angle, which is sustained for about fifteen minutes. Rowe’s study exhibited that some of the patients diagnosed with CFS felt light headed and a few passed out and all patients had an extreme blood pressure drop averaging 105/64 to 65/40. These results showed the same effect on the CFS patients as it has on Neurally Medicated Hypotension patients. Rowe goes on to say he doesn’t believe that Neurally Mediated Hypotension is the cause of Chronic Fatigue Syndrome, but that it is a cause of its’ symptoms. The article goes on to say that seven of the patients diagnosed with CFS and exhibiting dizziness or fainting on the tilt table experienced a reduction in CFS symptoms after maintaining a diet rich in salt and taking medications which expand blood volume.

I guess we won’t be getting out of work so easily folks. CFS is likely a completely legitimate disorder, with objective means to diagnose. Although I have been accused of being a bit of a hypochondriac, it’s entirely possible that I do have CFS. However, I think I’ll try and get a bit more sleep before I get strapped to the tilt table.

 


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    Last reviewed: By John M. Grohol, Psy.D. on 31 Jul 2011
    Published on PsychCentral.com. All rights reserved.

APA Reference
Bechdel, J. (2006). Chronic Fatigue or Chronic Laziness?. Psych Central. Retrieved on November 23, 2014, from http://psychcentral.com/blog/archives/2006/12/06/chronic-fatigue-or-chronic-laziness/

 

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