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About the Author
Robert H. Shmerling, MD
Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

Robert H. Shmerling, MD
Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.
Through this comprehensive article, we aim to shed light on the intricate nature of chronic fatigue syndrome. Our goal is to offer a thorough understanding of this condition – its causes, symptoms, diagnosis, and available management strategies. By delving into the complexities of CFS, we aim to provide invaluable knowledge to individuals battling this condition, their loved ones, and the healthcare community as a whole.
Join us on this enlightening journey as we unravel the mysteries surrounding chronic fatigue syndrome, empowering individuals with knowledge and hope in the face of this challenging condition.
no mention of the delay.3. Post-Exertional Malaise: One of the distinguishing features of CFS is post-exertional malaise (PEM). Physical or mental activities that were once manageable can trigger a worsening of symptoms that last for hours, days, or even weeks. This exacerbation of fatigue, pain, cognitive dysfunction, and overall malaise can be debilitating.
In addition to ruling out other conditions, there are certain criteria recognized for diagnosing CFS. The most widely used criteria is the Fukuda criteria, established by the Centers for Disease Control and Prevention (CDC). According to these criteria, individuals must experience persistent fatigue for at least six months, along with the presence of other symptoms such as cognitive impairments, post-exertional malaise, and unrefreshing sleep.
https://chgeharvard.org/understandi...ing-the-complexities-of-persistent-tiredness/One integral aspect of managing CFS involves implementing lifestyle modifications. This includes practicing good sleep hygiene, maintaining a balanced diet, and engaging in regular physical activity within the limits of one's energy levels. Encouraging patients to pace themselves, balance rest and activity, and prioritize self-care can contribute to better symptom management.
Cognitive-behavioral therapy (CBT) is another valuable tool in CFS management. CBT aims to identify and modify negative thought patterns and behaviors that may contribute to the perpetuation of CFS symptoms. Patients learn coping mechanisms, stress management techniques, and strategies to gradually increase activity levels while conserving energy.
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