Chronic Fatigue Syndrome

Does your teenager appear extremely tired even after a good night sleep ?

Then your teen might be dealing with chronic fatigue Syndrome.. Chronic fatigue is a condition characterized by continued tiredness that is not relieved by rest, can be worsened by exertion and is not directly caused by any other medical conditions. The exact cause of chronic fatigue is unknown.

 There are a variety of reasons for chronic fatigue, and medical conditions that need to be ruled out including but not confined to anemia, hypothyroidism, infections, malnutrition and depression.

Once primary medical conditions have been excluded a common factor contributing to unexplained, chronic fatigue is physical and cognitive deconditioning; not going to school, not being on a regular schedule, sleeping too much, decreasing the amount of physical activity or not getting any physical activity. This ends up worsening the fatigue.

Chronic fatigue can occur at any age. There have been a variety infections that have been known to cause tiredness, however there is not one specific viral or infectious agent that causes chronic fatigue, commonly caused by Epstein – Barr virus (the virus that commonly causes infectious mononucleosis) infection.

The teenager can be fatigued for weeks and sometimes longer as part of the normal recovery process. However, it’s important for the physician and the family to help get the teen back on a schedule as soon as possible after an infection so as not to prolong the recovery longer than indicated.

The main symptom of chronic fatigue is extreme tiredness which has been going on for much longer than can be medically explained (weeks to months).This is also called as “systemic exertional intolerance disease” (SEID). This captures the fact that exertion of any sort – physical, cognitive, emotional- can adversely affect these patients in many organ systems and aspects of their lives. Other associated symptoms can include one or more of the following:

  • Feeling extremely tired for more than 24 hours after exercise that would normally be considered easy
  • Feeling unrefreshed after sleeping for a proper amount of time
  • Forgetfulness
  • Concentration problems
  • Confusion
  • Dizziness, nausea in the upright position
  • Joint pain but no swelling or redness
  • Headaches that differ from those you have had in the past
  • Irritability
  • Mild fever
  • Muscle aches (myalgias)
  • Muscle weakness, all over or multiple locations, not explained by any known disorder
  • Sore throat
  • Sore lymph nodes in the neck or under the arms
  • School absenteeism is common
  • significant impairment of school work / schedule/ recreation and interpersonal relationships

However, what is known is that the fatigue can be improved by reversing the deconditioning process by making sure they are getting enough physical activity, attending school and improving their sleep schedule. These interventions can be done gradually, for example over the course of weeks.

Patients with chronic fatigue are encouraged to maintain active social lives and do regular physical exercise. A specific aerobic conditioning program, starting slowly and building each week, is reasonable. Counseling can also play a role in coping with the illness and can involve the individual and the family.

Incidence 4/1000

Screening of patients required

Cognitive behavior therapy with graded exercise therapy. Return to school should be initiated gradually and systematically to resume normal attendance and socialization.