Chronic Fatigue Syndrome Isn’t Just in Your Head

By
Man Rubbing His Eyes --- Image by ? Oliver Eltinger/Corbis
Photo: Oliver Eltinger/© Corbis. All Rights Reserved.

Chronic fatigue syndrome — a condition marked by persistent daytime sleepiness and cognitive impairment — is something that many people, including medical experts, have long dismissed as a psychological or even imagined illness. But today, a new report from an Institute of Medicine committee argues that the syndrome is a real, physical disorder, with a particular set of diagnostic criteria. The committee members also propose a new name: systemic exertion intolerance disease, which, they say, highlights the extreme exhaustion sufferers experience after minimal physical, mental, or emotional effort. 

If, right about now, you’re feeling a little skeptical of the idea of “exertion intolerance” — well, that’s exactly the kind of opinion the IOM committee is attempting to reverse with its new report. “We just needed to put to rest, once and for all, the idea that this is just psychosomatic or that people were making this up, or that they were just lazy,” Ellen Wright Clayton of Vanderbilt University, who chaired the committee, told the Washington Post earlier today. After reviewing the existing scientific literature and patient reports, they write that they identified “objective measures supporting a link between particular symptoms and a [chronic fatigue syndrome] diagnosis.” 

Up to 2.5 million Americans likely suffer from chronic fatigue syndrome, according to the report, though the figure may be even higher than that, as it’s often misdiagnosed, sometimes as depression or another psychological illness. That’s not surprising, the authors of the report write, as less than half of medical textbooks include any reference to the condition, suggesting that most doctors may not recognize it when they see it. With that in mind, the report includes some diagnostic criteria for the condition.

These are the three main symptoms: 

  1. Fatigue that impacts your ability to do the social, educational, or occupational things you used to do, which lasts for more than six months.
  2. The exhaustion worsens after you exert physical, mental, or emotional effort.
  3. You wake up after a full night’s sleep and still don’t feel refreshed. 

Plus, according to the new report, at least one of these two additional symptoms:

  1. You regularly experience signs of mild cognitive impairment — for example, misplacing things like your keys or forgetting about scheduled appointments or get-togethers with friends. 
  2. You experience something called “orthostatic intolerance” — meaning that all of these symptoms get a little bit worse when you’re standing upright, and the fatigue doesn’t improve until you’re lying down again. 

You can read the entire report at the IOM’s website