Diane E. Judge, APN/CNP, contributing editor, NEJM Journal Watch, June 15, 2015:
Dispelling the myth that CFS is “all in your head”
Chronic fatigue syndrome (CFS) is a devastating illness that can interfere with all facets of life.
You might also see CFS called by an older name, myalgic encephalomyelitis (ME), or a combination of the two names (ME/CFS).
Yes, It's “Real”
When we first began hearing about CFS decades ago, many clinicians (doctors, nurse practitioners, physician assistants), and even friends and relatives of people with CFS questioned whether it was a “real disease” or “just a mental health condition” or a “figment of the imagination.” They had a hard time believing that a condition that couldn't be diagnosed with a blood test, x-ray, or physical examination could be real. Diagnosis depended (and still depends) solely on what the patient reports.
Recently the Institute of Medicine (IOM) and the National Institutes of Health took a strong stand on CFS. Based on more than 9000 research studies, these organizations concluded that CFS has a biological basis (occurs because of one or more body malfunctions), declaring it “a serious, chronic, complex systemic disease that can profoundly affect the lives of patients.” They also stated that CFS is not “a psychological problem.”
The studies identified many differences between people with CFS and healthy people or those with other conditions that cause severe fatigue (such as depression or multiple sclerosis). Differences were identified in the brain and nervous system, the immune system (which defends the body against infection), and the endocrine system (which regulates body function through glands and hormones).
There is still no cure, or even any reliably effective treatment, for CFS. But the IOM report should dispel the myth that CFS is “all in your head.” With more research, more clinician education, and more support for those who have CFS, this illness should receive the validation and attention it deserves."
NEJM Journal Watch is produced by NEJM Group, a division of the Massachusetts Medical Society.