There are people for whom the tendency to tire easily becomes the main problem, those who suffer from so -called chronic effort.
Certainly most of us would be placed in this group, at least considering certain phases of our life. In reality, for people suffering from this disorder, the problem is much more serious.
Symptoms of chronic effort syndrome
THE symptoms They are manifold and heterogeneous:
- intense malaise after even minimal physical exercises
- flu -like symptoms
- non -restaurateur sleep
- feeling of mental cloud
- a constellation of non -specific symptoms
The picture would not seem so rare if we consider that only in the United States the disorder involves about a million people, including adults and children.
It often concerns people belonging to ethnic or racial minorities or of low socio-economic level.
Correctly identify the syndrome
Standard laboratory exams almost always not detect anomalies and this explains why it happens that sometimes people suffering from this framework can be considered simulators, depressed or “psychosomatic” subjects.
Differential diagnosis with a depressive disorder It could be done by asking the subject: “What would you do if you were not sick?”. In depressive disorders usually the person would not know what to answer. Unlike subjects with chronic fatigue which instead list multiple activities that they consider pleasant and they would like to carry out.
In the scientific community there are scholars who consider the specific, autonomous, clear framework in its manifestations, thus giving it a dignity of existence. Others believe that there are no sufficient elements to talk about one Chronic effort syndrome Chiara and well defined, also denying its existence.
People with these symptoms on average are visited by at least 4 doctors before receiving specific diagnosis. The diagnosis can be formulated even after a period of time ranging from 1 to 10 years from the debut.
The history of diagnosis
The name of Chronic effort syndrome He began to be employed in the late 1980s in the USA; In Great Britain, Canada and other countries for the same symptomatic procession the wording was preferred “Encephalomielite myalgical“(Me).
Many patients do not welcome that their disorder is defined as “Chronic effort syndrome“. This is because they believe that the expression itself trivializes a picture that can also be very serious and disabling, certainly much more than a simple hyper-effectiveness.
In the scientific community we tried to find a compromise in giving a name to this disorder, using the term me/cfs. This would also pay attention to the biological component and not only on chronic thickening.
The diagnostic criteria for this disorder will soon be updated and the diagnostic label will also be changed, precisely in light of the new data from organic research.
The causes of chronic fatigue
In fact, it seems that the disorder derives from one abnormal response of the immune system to a large number of environmental or infectious agents. This would determine a state of chronic inflammationan discomfort of the autonomous nervous system, a dysfunction of the hypothalamic-pituitary-legal system with consequent neuroendocrine dysfunction.
A reduced cytotoxic activity of natural killer cells and an increase in pro-inflammatory cytokines levels has been observed.
A genetic predisposition would be the basis of the excessive activation of inflammatory responses to minimum environmental stimuli.
Other investigations carried out at an intracranial level would indicate atrophy of the white substance, bilaterally, at the level of some brain areas.
Unfortunately all these data do not allow the time to formulate certain diagnosis or to identify the disorder in the early stages so that they can implement a prophylaxis.
Therapies available to treat chronic fatigue
As at the moment There are no specific therapies: The inflammatory hypothesis prompted to use anti -inflammatory drugs. Sometimes antidepressants are used because they would raise the pain threshold.
Improvements have also been observed with Cognitive-behavioral psychotherapy and with the performance of physical exercises to be carried out gradually. Although many times patients reject this type of approach because they do not believe that the problem can derive from psychological aspects or can improve with psychotherapy.
I believe that this disturbance is paradigmatic of the split, in my opinion incorrect, which still remains between mind and soma; As if the human being can only be caught in one of the two components.
Clinicians who read the disorder as a problem exclusively on a psychogenic basis think, the patients who reject any hypothesis that the psychic state can influence the physical component think so.
Actually body and brain work as one and influence each other. It makes no sense to continue with splitting the result of a Cartesian thought that has had its great importance in western history but which in the light of our present should be revised.
Probably the psychoneuroendocrinology, in being able to better grasp the “mind-body” union better than other disciplines, will be able to provide us with some further elements of reflection.
At least I wish me.
