"Although the whole stress response system should be reserved for emergency situations, there is today a low grade constant arousal which may result in us constantly bathing in our own stress hormones".
|
|
|
|
Theories abound about the causes of Chronic Fatigue Syndrome, (also known as ME) from infectious agents to environmental chemicals to psychological disturbance, there is no general agreement about what causes the vast array of symptoms C.F.S. sufferers report. In some cases an infectious agent can bfse found at the onset, others report the illness beginning after physical or emotional trauma. For others, things are less clear and it has been suggested that C.F.S. is really nothing more than an umbrella term for several disorders that share the same characteristic features. In my own opinion and from my own experiences the underlying cause of C.F.S. is long term unremitting stress, when the stress has reduced the vitality of the body and the last stressor, the one blamed for the illness, is 'the straw that breaks the camel's back.'
|
|
Such was my own case, when after years of chronic unremitting stress including working too hard, poor eating habits, too much alcohol, smoking, financial stress, relationship stress, the continuous need to relocate, and several traumatic incidents, I began to experience chronic tiredness, irritable bowel and weakness in my muscles. My doctor said he thought it might be stress related, to which I replied 'I don't suffer from stress' and continued with my unhealthy lifestyle. |
|
The final straw came after I went to the dentist one day for what I thought was a routine appointment to have a crown fitted. The adrenalin in the anaesthetic speeded up my heartbeat to such an extent that I became concerned, not only that but it did not have the desired anaesthetic effect and I underwent treatment feeling every prod and poke from the dentist. On the walk home my legs felt weak and I was shaking from head to foot. The following day we moved house and at the end of that long arduous day I hit the bed in a state of exhaustion and could hardly leave it for the next three weeks. I spent the next two years hardly able to leave my home, unable to work or function effectively with severe unremitting symptoms that appeared to affect every system in my body and a diagnosis of ME/CFS. |
|
CFS is also sometimes referred to as chronic fatigue immune system dysfunction syndrome as some studies have found many irregularities of the immune system in which some components seem to be over reactive whilst others have impaired function. A number of chronic immune abnormalities have been found but no consistent abnormality that indicates a primary cause and many CFS sufferers report multiple allergies as well as the swollen glands and flu like symptoms typical of the disorder. There is also a high incidence of irritable bowel syndrome, reactive arthritis and fibromyalgia in CFS sufferers. |
|
Other studies have reported a higher incidence of experiences of victimisation from physical and emotional abuse in CFS patients suggesting that post traumatic stress or chronic stress can play a strong role in the development of this disorder. There is evidence that post traumatic stress actually results in changes in the brain due to long term exposure to stress hormones. Peter Levine in 'Waking the Tiger' suggests that energy, which we have been unable to release at the time, literally gets locked into the physical body as a result of the freeze response during the fight or flight mechanism. His work with somatic re-experiencing in which the traumatic memory is reworked in order to unlock this energy has yielded good results |
|
A detailed consultation with CFS sufferers can often reveal a history of physically or emotionally abusive relationships, bullying at home, school or work. Often these people have a passive nature and have spent years putting others before themselves and literally given all their energy away to others. Typical Type A personality behaviour is prevalent and it is no coincidence that before the onset of this illness many suffers admit that they used to work hard and play hard and are somewhat driven. Counselling often reveals the maladaptive thinking processes behind these behaviours. Others may admit to being something of an adrenalin junkie and have a history of partaking in dangerous or challenging activities. |
|
The severity of CFS varies. In its extreme patients are bedridden, some can undertake part time work, most admit that they find it impossible to juggle work and home commitments. Recovery varies enormously, some people seem to become worse, others recover over time after making serious lifestyle changes. Before looking at the lifestyle changes needed in order to recover from this disabling condition let's look at how sufferers found themselves with this condition in the first place. |
|
How is it possible for an infection to cause the same symptoms as emotional or physical trauma? How can we find a connection between those who relate to a virus as the beginning of their illness and those whose onset seems to have been preceded by years of Type A behaviour? Scientific evidence indicates that the ability of the body to adapt to potentially harmful stimuli or stressors has a fundamental effect upon our health. Hans Selye says "many common diseases are largely due to errors in our adaptive response to stress rather than to direct damage by germs, poisons, or life experience." (The Stress Of Life, 1978) |
|
Selye describes the General Adaptation Syndrome (GAS) as the process in which we adapt to different stressors. It has three stages, The Alarm Stage, The Adaptation Stage, and the Stage of Exhaustion. All stressors, if they are significant enough, will produce physiological changes and upon exposure to a |
|
Continual exposure to a stressor results in the second stage, the Stage of Resistance, during which adaptation occurs. Selye says "this is characterised by increased resistance to the particular agent to which the body is exposed and a decreased resistance to other stressors." Even though specific adaptation has been acquired there is a limit to how long this adaptive response can be maintained resulting in a loss of adaptive capacity. The final stage, the Stage of Exhaustion, occurs when the amount of adaptive energy available becomes depleted. |
|
GAS is characterised by numerous physiological changes, changes in blood volume and pressure, circulation, blood sugar levels, metabolism, thyroid changes, kidney function, enlarged adrenal glands and dysfunctional immune system. |
|
According to Hanley and Deville 'burnout' the final stage of adrenal exhaustion, causes symptoms ranging from anxiety, insomnia, recurrent infections, autoimmune diseases, heart disease and CFS. (Tired Of Being |
|
Murray and Pizzorno give symptoms of adrenal exhaustion as feeling stressed out, tired, prone to allergies. (Encyclopaedia of Natural Medicine, 1990) |
|
Cabot states that adrenal burnout causes morning fatigue and depression, general achiness, poor resistance to infections, inability to cope with stress, low blood pressure, low blood sugar, allergies, inflammatory |
|
If you compare a list of all the symptoms attributed to poor adrenal function with one from a CFS/ME sufferer they are remarkably similar. |
|
Poesnecker in his volume on CFS, 'Chronic Fatigue Unmasked', refers to a chart by Hans Selye illustrating the various stages of the adaptive process and says "this classic chart outlines the various stages of CFS dramatically, thus giving evidence to our contention that CFS is nothing more or less than the body's biological reaction to long-term unremitting stress." He goes on to say, "every patient with this condition resides somewhere on the chart of Dr. Selye. If they do not, they don't have CFS." |
|
CFS patients diagnosed during the first stages of GAS can, with correct treatment, expect a reasonably rapid recovery. Those who are not diagnosed until the second stage which is unfortunately the majority, will experience a slower recovery rate. Those who have burned out have the hardest recovery of all. Why is CFS/ME so prevalent today? According to Landis, although the whole stress response system should be reserved for emergency situations, there is today a 'low grade constant arousal' which may result in us constantly 'bathing in our own stress hormones' (Herbal Defence 1997). Modern life unfortunately has a tendency to keep our fight or flight response on constant low level alert. |
|
In treating clients with CFS we need to take a multifaceted and holistic approach to the problem rather than the symptomatic approach favoured by conventional medicine. Clients should be viewed as a whole person and all aspects of their being attended to, physical, mental, emotional and spiritual. Where to approach the problem from at the outset of treatment is not always clear as it can be difficult to see the wood for the trees and there is no one way of treating this condition that works for everyone. However holistic stress management gives us many of the tools needed to assist these clients to recovery. |
|
A detailed consultation at the outset is important and can tell us a great deal about the client's history. It is also important to check that the client has had any necessary medical tests to exclude other possibilities which may require conventional medical treatment. Due to the fact that CFS can have such a complex array of symptoms and can also present alongside other conditions, we may find ourselves working alongside other practitioners both from the orthodox and complementary medical professions. Facilitating the client's awareness of how stress impacts on them may be the first logical step to take. |
|
Diet can play an important role in the recovery process of CFS. Many sufferers report digestive disturbances and food intolerance. Wheat and dairy products seem to be the two main culprits here and clients should be encouraged to remove these from the diet one at a time to see if there is any improvement. A diet of whole, unprocessed foods is recommended. For those with low blood sugar, eating little and often is sometimes required, many find that eating a large breakfast, a substantial lunch and then eating less in the evening helps with bowel disturbances. |
|
There is no one correct diet for everyone and clients should be encouraged to seek specialist help in this area if it seems warranted. Drinking sufficient fluid appears to be especially important for sufferers of this condition and clients should be encouraged to drink at least 2 litres each day. Some CFS sufferers seem to have problems with Candida Albicans overgrowth and this can be rectified with a natural dietary and supplement approach as recommended by Trowbridge and Walker in 'The Yeast Syndrome'. Some additional nutritional supplementation appears helpful in any case. In 'Steps to Fight Chronic Fatigue Syndrome', Anthony Martin suggests Evening Primrose Oil, Magnesium, CoQ10, NADH, and Pycnogenal. The use of olive oil and garlic have also proved helpful for many. |
|
One of the biggest difficulties for CFS suffers is exercise intolerance and recommendations need to be given with great care as over extending capacity in this area can cause relapse. Gentle exercise such as yoga or Tai Chi, done a little at a time as and when the client feels able, is a good way to begin. For those who are a little more active gentle walking or swimming may be possible. CFS sufferers will need more recovery time after exercise and should take great care not too attempt too much too soon in this area. This is often difficult as well meaning people, including some health professionals, can tend to have the attitude that the CFS sufferer would feel better if only they took more exercise. The physical fitness and exercise capacity of people with CFS is often the last thing to surface when other matters have been rectified and there is more energy available. |
|
Relaxation techniques can be taught as well as self hypnosis and meditation. Clients should be encouraged to relax fully several times a day. By this I mean completely switch off to recharge the batteries, not just slump in front of the TV. Teaching clients progressive relaxation and suggesting that they listen to relaxing music or guided visualisations works well, especially visualisations that encourage the healing process in the client such as chakra meditations or positive imagery. |
|
Massage of all kinds can be helpful although should be done with care as the effects of detoxification can hit someone with CFS very hard and make them feel worse for quite some time. Gentle massage of short duration to assess the healing reaction can then be followed by regular treatments tailored specifically to the client's threshold although this may vary. Aromatherapy oils can be helpful for additional relaxation and pain relieving purposes but again care is needed not to use anything with powerful detoxification properties. If in doubt put the oil in a vaporiser. |
|
Over time CFS patients respond well to massage therapies and as the client improves their tolerance to massage time and intensity can be increased and can be very beneficial. In addition to the relaxation aspect, massage therapy can release tension which can in turn release deeper issues trapped in the body/mind. For clients suffering from fibromyalgia symptoms, treatment of trigger points is helpful. Acupressure and acupuncture can also be used to good effect in balancing the energy system. In Traditional Chinese Medicine CFS has been associated with both a Qi deficiency and a Yin deficiency. |
|
Counselling should be included to help uncover any deeper issues that may be preventing recovery. Many clients need to change longstanding beliefs in order to make the necessary lifestyle changes associated with recovery from CFS. Learning to live more in the present moment and take each day at a time is beneficial and something that many people are not used to doing. Letting go of the past, learning forgiveness and not being overly concerned about tomorrow can ease the psychological burden tremendously and allow clients more energy to deal with moment to moment living. Financial and work related difficulties can cause great concern for CFS suffers and outside support in these areas is often needed. |
|
Life skills training is useful especially in areas such as communication and assertiveness skills as these will help the client deal effectively with others. Unfortunately many sufferers of CFS have what many would call 'doormat syndrome' and have difficulty dealing with conflict. Facilitating an attitude of self worth and self love in the client is a fundamental part of the healing process and so often overlooked. |
|
Time and priority management, anger management, goal setting, managing anxiety and other life skills may need addressing in order to help clients cope more effectively with day to day life. The illness and it's underlying causes erode confidence and self esteem and clients should be encouraged to find hobbies that they are capable of doing and which reflect their interests and give meaning and value to themselves and their lives. Often these people have not spent much time on themselves and have spent most of their time doing things for others. CFS can be a valuable learning experience and a chance for men and women to reflect on life and what they would like for the future |
|
A positive vision of the future should be encouraged. Recovery is possible if the client is willing to make the necessary lifestyle changes. Most clients, once they experience some recovery, will ask what else they can implement to aid further recovery. Something to note is that clients with CFS may be suffering from depression and this is more often than not a consequence of the illness rather than the cause of it. An optimistic but realistic view of recovery should be encouraged. Attending to spiritual values is important. CFS is a life changing experience and as such contains great potential for personal and spiritual growth. |
|
Another supportive therapy is Reiki. This and similar hands on healing systems which can aid healing at all levels, combined with chakra clearing and rebalancing, can often release longstanding trauma in a gentle and effective way. It is also intensely relaxing for the client. Meridian energy therapies such as EFT can also be useful in removing blocks to healing. |
|
The importance of support in CFS cannot be understated. Many clients will feel isolated and have little contact with others due to being unable to work or fulfil social obligations. It is unfortunate that some people still view CFS as malingering and do not take sufferers seriously, thereby rubbing salt into the wound at a time when they need support the most. It can be helpful to give out literature and information for friends, family and other carers to read or to invite a partner to come along for a chat. The partner may also be in need of some support and this can uncover issues revolving around the family which may be a part of the problem. CFS has ramifications on those closest to the sufferer which may also need to be addressed. CSF sufferers without close family or friends should be encouraged to find a support group to avoid further isolation. |
|
It can be seen that much can be done in the treatment of CFS by taking a holistic approach and addressing all the aspects of a person's life that may have had some bearing on the onset of their illness and which may be continuing to have an impact. All CFS sufferers have a reduced capacity to handle stressful events so clearly a comprehensive stress management plan will be beneficial in every case. With time and patience the devastating effects of this much misunderstood illness can be ameliorated. |
|
 |
|
References: |
|
G.E. Poesnecker. - Chronic Fatigue Unmasked - 2000, 3rd Edition.
Web Design by Solar Internet |
|
|
|
| CLICK HERE to email Denise Robson | |
| There Are More Articles In Our Reading Room |