Chronic fatigue syndrome (CFS) is not a new disorder. In the 19th century it was called nervous exhaustion. In the 1930s through the 1950s outbreaks of disease marked by prolonged fatigue were reported in the United States and many other countries.

Fatigue that lasts for more than six months, impairs normal activities and has no identifiable medical or psychological problems to account for, is referred to as unexplained chronic fatigue. This condition, however, is not considered to be chronic fatigue syndrome unless it meets certain criteria.

Criteria for Chronic Fatigue Syndrome
1. Four or more of the following symptoms should be present for longer than six months:
* Short-term memory loss or a severe inability to concentrate that affects work, school, or other normal activities.
* Sore throat.
* Swollen lymph nodes in the neck or armpits.
* Muscle pain.
* Pain without redness or swelling in a number of joints.
* Intense or changing patterns of headaches.
* Unrefreshing sleep.
* After any exertion, weariness that lasts for more than a day.

2. The fatigue must be severe as indicated by the following:
* Sleep or rest does not relieve it.
* The fatigue is not the result of excessive work or exercise.
* The fatigue substantially impairs a person’s ability to function normally at home, at work, and in social occasions.
* Even mild exercise often makes the symptoms, especially fatigue, much worse.

3. The fatigue must be a new, not lifelong, condition with a definite time of onset. Often, the condition first appears as a viral upper respiratory tract infection marked by some combination of fever, headache, muscle aches, sore throat, earache, congestion, runny nose, cough, diarrhoea, and fatigue. Typically, the initial illness is no more severe than any cold or flu.

4. The symptoms must persist. In ordinary infections, symptoms go away after a few days, but in CFS, fatigue and other symptoms recur or continue for months to years.
If it does not meet these criteria, then the condition is referred to as idiopathic chronic fatigue. (Idiopathic simply means that the cause is not known.)

Risk Factors
According to a large 1999 US study, the highest rates of CFS were found among women in general, and people with lower levels of education and occupational status. Chronic fatigue is most often experienced by individuals 40 to 50 years old; it is least prevalent in people under 29 or over 60. This disorder, however, occurs in both sexes and at all ages and in all racial and ethnic groups.

Women: Although CFS occurs much more commonly in women, they do not appear to have more severe symptoms than men with the disorder.

Stress-Related Occupations: One study of nurses found that those who were exposed to poor working conditions and threats of accidents faced a higher risk of developing CFS symptoms than those without these experiences. This finding suggests, perhaps, that stressful work puts people at higher risk for CFS.

Children: Children and adolescents are not immune to its effects. Most studies indicate that girls are more apt to develop CFS than boys, although one found the incidence of the syndrome to be equal. According to a 1999 study, half of the children and adolescents with CFS also suffer psychiatric disorders, primarily anxiety, but also depression.

Personality and Psychological Factors: Some researchers suggest that people who are over-achievers may be more susceptible to chronic fatigue because they set impossibly high standards for themselves and CFS allows them to escape from them. Personality and psychological factors do not appear to be a direct cause of CFS but may increase a person’s susceptibility to the syndrome after exposure to mental or physical stresses, such as viral infections.

Lets consider it medically:
Primary Symptoms: In addition to the fatigue, the International Chronic Fatigue Syndrome Study Group identified the following primary symptoms:
* Headache of a new type, pattern or severity
* Sleep disturbance
* Extreme exhaustion after normal exercise

Treatment:
There is no specific treatment that has proven to be effective in treating chronic fatigue syndrome (CFS). Because CFS has no known cure and its cause remains uncertain, any treatment plan focuses primarily on treating the symptoms in an effort to improve the patient’s quality of life. Patients often find they experience the most improvement when following a multi-faceted treatment plan incorporating prescription medication, alternative therapies and lifestyle adaptations.

Alternative Therapies: Many CFS patients find various alternative treatments to be effective in managing their symptoms. These include:
* Acupuncture
* Aquatic therapy
* Massage
* Chiropractice
* Therapeutic touch
* Stretching
* Tai chi
* Yoga
*l Nutritional supplementation

Lifestyle Adaptations: Lifestyle changes are necessary and may be among the most effective means of managing CFS symptoms. Recommended lifestyle changes include:
* Following a regular, yet manageable, daily routine.
* Getting more rest (avoiding complete bed rest which leads to deconditioned muscles and increased fatigue). Massage may be tried.
* Reducing physical and emotional stress
* Improving diet (avoiding caffeine, sugar and food additives).
* Getting mild to moderate regular exercise (i.e., gentle stretching, mild water exercises).