In the introductory article, “The Mystery of Chronic Fatigue Syndrome”, we learned that fatigue is more than being tired. The kind of fatigue experienced by chronic fatigue syndrome (CFS) patients goes deeper than that. It is an unrelenting lack of energy sometimes crippling and debilitating enough to render a person bedridden for days, weeks, even months.
But fatigue is not the only symptom. Since the body commonly fatigues when fighting other physical or psychological battles, it is important to consider other physical manifestation of this imbalance.
Neurological and Other Related Symptoms
Other symptoms that occur after the onset of severe fatigue include:
1) Sleep Difficulties: falling asleep, staying asleep, and waking refreshed.
2) Pain: arthritic or muscle pain without confirming diagnosis of joint inflammation or fibromyalgia.
3) Neurological/cognitive symptoms (two or more of the following difficulties): “confusion, impairment of concentration and short-term memory consolidation, difficulty with information processing, categorizing, and word retrieval, intermittent dyslexia, perceptual/sensory disturbances, disorientation, and ataxia [loss of coordination of the muscles especially in the extremities]” (Carruthers/van de Sande). Patients may also experience informational, cognitive, and sensory overload (hypersensitivity to light or noise).
Autonomic, Hormonal, and Immune Symptoms
4) One symptom each from two of the following categories:
a. Autonomic symptoms: inability to stand for long periods of time requiring medication to ward off episodes of low blood pressure (neural medicated hypotension – NMH), or resulting in an abnormally large increase in heart rate (postural orthostatic tachycardia syndrome - POTS); light-headedness; nausea and irritable bowel syndrome; frequent urination and other bladder dysfunctions; palpitations with or without disturbance of cardiac rhythm (arrhythmia); and difficult or labored breathing with physical exertion.