Good Mental Health May
Help Ease Chronic Fatigue

People who have good mental health and refrain from using sedatives tend to fare better with chronic fatigue syndrome than others, new research shows.

People with the condition who avoided blaming their symptoms of crushing fatigue on a physical illness like a virus also tended to improve faster than other chronic fatigue patients.

Chronic fatigue syndrome (CFS) is characterized by a range of symptoms including profound tiredness that lasts at least six months, headache, sleep problems, muscle pain and difficulty concentrating. CFS often strikes suddenly and may be accompanied by a low-grade fever and swollen lymph nodes. The cause is unknown, and there is no laboratory test that can diagnose the illness.

Although patients with CFS often improve over time, very few ever fully recover from the condition, according to the report, which appears in the journal Psychosomatic Medicine.

To determine which factors might influence how well people fare with the debilitating condition, the researchers followed 100 patients for 18 months, noting their characteristics and who improved over time.

The investigators, led by Dr. Karen B. Schmaling of the University of Texas in El Paso, found that after 18 months, around one-fifth of participants appeared to have improved enough to no longer warrant a diagnosis of chronic fatigue syndrome.

People who tended to attribute their symptoms to a physical illness were less likely to improve than people who believed their condition was primarily due to non-physical or emotional problems, such as stress.

Chronic fatigue patients fared worse if they were unemployed, older or depressed.

Taking sedatives such as benzodiazepines and muscle relaxants - something CFS patients may do to alleviate the pain from headaches, sore throat and tender lymph nodes - was also associated with a worse outcome.

In an interview, Schmaling explained that, in general, having good mental health through chronic fatigue may be a sign people are adapting to their illness, a practice that may ultimately help them recover. In this instance, when CFS prevents people from doing something they once loved, those who adapt well may be more likely to avoid depression by seeking out other activities they enjoy just as much, she noted.

"People who cope well, cope flexibly," Schmaling told Reuters Health. "There are things that people do that can maintain or enhance their mental health."

In contrast, blaming symptoms on a physical problem may cause people to harp on the fact that something is "wrong" with their body, and they have to wait for doctors to cure it, Schmaling said.

However, if people believe the root of their problem is more emotional in nature, they may feel somewhat empowered - if they sought help from a therapist or another expert, for instance, they could improve, she noted. This empowerment may help them recover, Schmaling added.

Psychosomatic Medicine, November/December 2003.

Reference Source 89

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