Cracking The Conundrum Of Chronic Fatigue Syndrome
Monday, 09/05/11 6:00am - Morning Edition
Patti Neighmond
Nearly three decades have passed since the debate began about a series
of symptoms that have come to be known as chronic fatigue syndrome.
It's cause is still unknown, but over the years, researchers have
identified various brain, immune system and energy metabolism
irregularities involved. Some patients describe the syndrome as
feeling like an "unrelenting, unremitting flu."
Doctors say some treatments can help. Arthur Barsky, a psychiatrist at
Brigham and Women's Hospital in Boston and a professor at Harvard
Medical School, says patients need to change how they experience
symptoms =97 typically pain, insomnia and anxiety. When patients adopt a
more positive attitude, Barsky points out, it often translates into
greater confidence and more energy.
A study published this year in The Lancet found that a form of talk
therapy, as well as exercise, offered relief for some patients.
Researchers from the United Kingdom looked at cognitive behavior
therapy, or CBT.
In the study, over 600 patients with chronic fatigue syndrome were
assigned to different treatments. All of them received medical care
for symptoms like pain, insomnia or anxiety.
One group got counseled about how to pace activities. Another took
part in an exercise program. And a third received the cognitive
behavioral talk therapy. The therapy and the exercise group improved
the most, reporting less fatigue, insomnia and anxiety.
Barsky says his patients do best when cognitive behavior therapy is
also combined with gradually increased exercise. "People need to begin
to push themselves in the face of their fatigue, because if you don't,
you become deconditioned and you get caught in a cycle which ... makes
fatigue worse," says Barsky.
But he cautions against overdoing it. People should start with mild,
gentle exercise like clearing the table, doing the dishes, or taking
the dog for a short walk. Then, slowly build up to longer and more
frequent walks, he says.
Lucinda Bateman is a doctor at the Fatigue Consultation Clinic in Salt
Lake City who specializes in chronic fatigue syndrome.
She's skeptical about the Lancet study, pointing out that patients
improved only moderately, and not much more than those who were
counseled about pacing themselves. Bateman suggests her patients pace
themselves, and try to do only as many activities as they can manage.
She says some patients get caught in a "push and crash" cycle. When
symptoms abate and they feel better, they may go all out, exercising,
doing errands and socializing. But soon that level of activity often
comes to a crashing end and patients can relapse dramatically, even
becoming bedridden for several days or longer.
Bateman takes also issue with CBT's implication that chronic fatigue
syndrome is psychosomatic. We still don't know what exactly causes the
syndrome. And, like most professionals who treat patients, Bateman
eagerly awaits the day when science can finally pinpoint its cause.
With additional reporting from Joanne Silberner
---------------------------------------------
Send posts to CO-CURE@listserv.nodak.edu
Unsubscribe at http://www.co-cure.org/unsub.htm
Select list topic options at http://www.co-cure.org/topics.htm
---------------------------------------------
Co-Cure's purpose is to provide information from across the spectrum of
opinion concerning medical, research and political aspects of ME/CFS and/or
FMS. We take no position on the validity of any specific scientific or
political opinion expressed in Co-Cure posts, and we urge readers to
research the various opinions available before assuming any one
interpretation is definitive. The Co-Cure website <www.co-cure.org> has a
link to our complete archive of posts as well as articles of central
importance to the issues of our community.
---------------------------------------------
