Chronic fatigue syndrome

Chronic fatigue syndrome is a medical condition characterized by long-term fatigue and other persistent symptoms that limit a person’s ability to carry out ordinary daily activities. It is caused by prolonged or major stress without adequate recovery. Typical symptoms are lack of energy, sleeping problems, problems with concentration and memory difficulties. The treatment is focused on recovery and rehabilitation. In the case of severe chronic fatigue syndrome, sick leave with a gradual return to work is often necessary.

General information

Previously, this type of stress-related problem was called “burnout” or “hitting the wall”. Chronic fatigue syndrome has been a medical diagnosis since 2005. It is both a physical and mental disorder that persists for more than 6 months and is accompanied by profound fatigue. Recovery usually takes a long time. The symptoms may eventually disappear completely, but most people need to change their daily lives, with a focus on a better balance between work and leisure, regular sleep and recovery time.


Chronic fatigue syndrome produces both physical and mental symptoms. In early stages, it can be difficult to diagnose – many people seek medical care for repeated infections, gastrointestinal problems, headaches, sleep disorders and depression.


Eventually, the lack of physical energy becomes evident along with memory problems and concentration difficulties. For example, it can be difficult to read books and capture the essence of thoughts and conversations. You feel constantly tired, easily irritated or sad, and it becomes difficult to handle everyday tasks and activities. Chronic fatigue syndrome can also lead to a feeling of hopelessness and depression. (“Fatigue depression” is a term that is sometimes used, but in medical speak, you talk about fatigue syndrome with or without depression.)


If your stressors do not subside, the disease can become acute – resulting in dizzy spells, panic attacks, chest pains and difficulty orienting yourself.


Signs of fatigue:


  • fatigue and lack of energy
  • sleep disorders
  • impaired stress resistance
  • concentration and memory difficulties
  • difficulties in making decisions and implement tasks
  • being close to crying / anger
  • anxiety and depression
  • hypersensitivity to sound, light and impressions.


Common physical symptoms:


  • nausea and dizziness
  • palpitations and chest pain 
  • headache and muscle pain
  • gastrointestinal problems.

Other possible explanations

You should know that prolonged fatigue, difficulty sleeping and other symptoms may not always be the signs of chronic fatigue syndrome. Other causes may include vitamin deficiencies, thyroid problems, fibromyalgia or more serious illnesses. Therefore, it is good to turn to a doctor to ascertain the cause of your symptoms.


The cause of CFS is unknown. Genetic, physiological and psychological factors are thought to work together to precipitate and perpetuate the condition. Sometimes it can be caused by prolonged exposure to stress without sufficient opportunities to recover. The body has probably signaled for a long time that the stress load is too high.


When the body becomes chronically exhausted in this way, with too high a workload or a difficult situation at work in combination with, for example, relationship problems and financial pressure, chronic fatigue syndrome can result. Sometimes, powerlessness over one’s own situation and a feeling that it cannot be changed can lie behind the problem. Caring for a sick relative while at the same time trying to live up to all the demands of everyday life, can also lead to fatigue. Sometimes, the expectation that one always has to succeed and perform to perfection, both in work and relationships, can put unmanageable pressure on the body, leading to stress breakdown and the diagnosis of chronic fatigue syndrome.

Prevention and protection

It is important to listen to your body’s signals – signs of long-term stress and lack of energy should be taken seriously. Try to find time for recovery.


When you suffer from chronic fatigue syndrome, or preferably far earlier, you will need to make changes to your everyday life to find a balance that will help you regain your strength. Is there anything you can change to reduce your mental strain? Maybe you can talk to your employer and make changes at work, or find some kind of relief in a difficult, private situation.


Remember to be careful with your food and sleep habits. Physical activity, as long as it is not too strenuous, is also important to prioritize – walking or just staying out in the park usually makes a big difference.


Try to reduce your mental strain:


  • create routines for food and sleep
  • walk or exercise at a reasonable level
  • Try relaxation techniques, like yoga or mindfulness
  • Don’t put too high demands on yourself
  • Align your commitments with what you can handle
  • try to find ways to unwind and regain energy.


To diagnose fatigue syndrome, medical examinations and conversations with a psychologist are required. Often there are so-called self-assessment tests that show how you are feeling – and how your mood changes over time. Symptoms such as muscle pain and gastrointestinal problems may require special treatment in the form of physiotherapy or adapted diet. Sleeping problems, anxiety and depression can sometimes be partially treated with medication. Otherwise, treatment of fatigue syndrome is largely about recovery and rehabilitation, as well as acceptance and insight into the disease.


The treatment often consists of a combination of doctor’s visits, CBT or conversation therapy, physical therapy and support from occupational therapists, so that you can function normally again. Finding a balance in everyday life with physical activity and good eating and sleeping habits is fundamental. Stress management is also an important part.


In the case of more severe chronic fatigue syndrome, full or part-time sick leave is usually required to be able to return to work in the long term. Often you need to make changes in your own life situation to avoid any relapse in the future.


Recovery generally takes at least six months and sometimes considerably longer. It is common to have setbacks, but one’s strength usually returns gradually. As the body recovers physically and mentally, most symptoms tend to subside. In severe fatigue syndrome, some problems can remain for a long time – a hypersensitivity to stress can be something you must learn to live with long term, and adapt your everyday life accordingly.

When to consult a doctor

If you have mental stress and think that you have symptoms of chronic fatigue syndrome, you should seek medical help.
If you experience acute chest pain, you should seek emergency care.

How APPOTEK can help

You can contact us at APPOTEK for help with stress-related problems. A nurse, doctor or psychologist can make an individual assessment based on your symptoms during the initial consultation. You may then be prescribed treatment or referred for further treatment. In case of chronic fatigue syndrome, we can also offer continuous follow-up and visits with psychologists and doctors.


Valeria Chernikova, Neurologist, M.D.