After a strenuous week at work or a boisterous party, everyone is exhausted and worn out at some point. Even a severe infection or a major physical challenge can temporarily weaken our performance. But what if physical and mental weakness constantly occurs for no reason and the inner battery cannot be recharged by sleep or rest?
In Germany, around 250,000 people suffer from myalgic encephalomyelitis/chronic fatigue syndrome, also known as ME/CFS. This complex neurological disease often occurs after a viral infection such as influenza or glandular fever.
How do you recognize chronic fatigue syndrome?
In ME/CFS, the body is no longer able to provide sufficient energy for physical or cognitive activities. Many sufferers then find it increasingly difficult to perform their everyday tasks, feeling permanently knocked out. Even simple activities, such as clearing the table or going to the bakery, often become insurmountable obstacles.
Moreover, the symptoms worsen massively after even minor physical or mental exertion. Experts call this leading symptom "Post-Exertional Malaise (PEM)".
Other typical complaints include:
- Flu-like symptoms such as sore throat, fever and swollen lymph nodes with extreme fatigue.
- Cardiovascular symptoms such as palpitations, dizziness and fluctuations in blood pressure
- Speech, concentration and memory problems
- Muscle, joint and limb pain
- Severe sleep disturbances, sleep does not improve symptoms
What are the causes?
Although ME/CFS was classified as a neurological disease as early as 1969, its exact causes are still unknown. Experts suspect that infections, immunodeficiencies and disturbances of the energy metabolism are among the triggers. Currently, COVID-19 is also suspected of triggering ME/CFS, as many patients still suffer from symptoms such as PEM six months after their COVID infection.
Good to know
Very often, the older literature still refers to "chronic fatigue syndrome" or "chronic fatigue syndrome". However, since this physical and mental weakness is not triggered by a lack of rest or activity, experts today reject this term for describing ME/CFS. In addition, they say it trivializes the severity of the disease.
Diagnosis and therapy
During the consultation, your doctor will ask you what symptoms you are suffering from. He will then examine you physically, if necessary. He will first rule out various causes for your chronic weakness, for example tumor diseases or chronic inflammatory diseases such as multiple sclerosis. Diabetes mellitus, liver diseases or mental illnesses such as depression can also trigger severe exhaustion and fatigue.
If you suffer from nocturnal breathing pauses (sleep apnea), this can be the cause of a lack of rest. Since certain medications can also make you extremely tired, your doctor may review your medication schedule.
Once your doctor has ruled out other causes, he or she may use the Canadian Consensus Criteria (CCC), for example, and standardized questionnaires to confirm the diagnosis of ME/CFS. Among other things, he checks whether the following criteria apply to you:
- The symptoms have been present for at least six months.
- You find it increasingly difficult to perform everyday private and professional tasks due to physical and mental weakness.
- Sleep does not lead to rest for you.
- You feel extremely exhausted after even light physical or mental activity (PEM).
Currently, there is no therapy that has been proven to help against ME/CFS. Therefore, the main goal is to treat the symptoms and thus improve your quality of life. For example, your doctor may prescribe medications to relieve pain or stabilize your circulation.
How is ME/CFS different from depression?
Both conditions are associated with severe fatigue, memory problems, loss of libido and sleep disturbances. ME/CFS starts suddenly in many cases and is also accompanied by flu-like symptoms (headache, sore throat, painful lymph nodes, feverishness). Depression, on the other hand, usually develops insidiously.
While the symptoms of depression improve noticeably with regular physical or mental activity, this makes them progressively worse in ME/CFS. People with depression tend to withdraw and resign, whereas people with ME/CFS usually actively seek help.
What can you do if you are affected yourself?
Even if it is very difficult: Accept that you are less able to cope with stress, because exertion can actually worsen your symptoms. Review your lifestyle and daily routine. In doing so, re-evaluate your own performance limits and adjust your daily workload accordingly.
Possible measures:
A regular daily routine with set meals and periods for activity and rest often relieves symptoms. Even if rest and sleep do not improve the symptoms, many sufferers find a clear daily structure beneficial.
Relaxation techniques are often helpful. Exercise and sport, on the other hand, can even intensify the symptoms.
Join a self-help organization. Fatigatio e. V., the German Association for ME/CFS, and the German Society for ME/CFS e. V. offer information and self-help groups for affected persons and their relatives.
