Chronic fatigue syndrome symptoms: Watch out for depression, insomnia, bloating

While fatigue is central to CFS, many sufferers also experience issues with sleep quality and patterns. (Image: Canva)

Chronic fatigue syndrome (CFS) is a complex and debilitating disorder characterised primarily by fatigue that is not alleviated by rest and persists for more than six months. While fatigue is the hallmark symptom, CFS can manifest in a variety of other symptoms, some of which are lesser known.

Alongside fatigue, individuals often experience a range of symptoms including cognitive difficulties (commonly referred to as brain fog), sleep disturbances, pain, and post-exertional malaise (PEM), where physical or mental exertion exacerbates symptoms.

Let’s take a detailed look of these symptoms:

Post-exertional malaise (PEM): This is a key feature of CFS where physical or mental exertion can lead to a worsening of symptoms, says Felix hospital neurologist Manish Sharma. It's not just ordinary tiredness but a profound exacerbation of fatigue, pain, cognitive difficulties, and other symptoms that can persist for days, weeks, or even longer.

Cognitive difficulties: Often referred to as brain fog, this symptom includes difficulties with memory, concentration, and information processing, says Sharma. It can make simple tasks challenging and greatly impact daily functioning.

Sleep disturbances: While fatigue is central to CFS, many sufferers also experience issues with sleep quality and patterns. Insomnia, where one struggles to fall or stay asleep, or non-restorative sleep, where sleep doesn't leave one feeling refreshed, are common. Disrupted sleep patterns, such as waking frequently throughout the night, can also occur.

Pain: Muscle pain, joint pain, headaches, and sore throat are frequent complaints among CFS patients. These pains are often unrelieved by rest and can fluctuate in intensity.

Orthostatic intolerance: This refers to symptoms that occur upon standing upright and improve upon lying down. It can include dizziness, lightheadedness, palpitations, and fainting. It's thought to be related to autonomic nervous system dysfunction.

Sensitivity to stimuli: Many CFS patients experience heightened sensitivity to various stimuli such as light, noise, odours, and certain foods. Exposure to these triggers can exacerbate their symptoms, making them feel worse.

Digestive issues: Gastrointestinal symptoms like bloating, nausea, abdominal pain, and irritable bowel syndrome (IBS) can be present in some individuals with CFS. These symptoms can contribute to overall discomfort and further impact quality of life.

Temperature regulation problems: Fluctuations in body temperature are reported by some CFS patients. They may feel excessively cold or experience sudden episodes of sweating. These temperature dysregulations can be distressing and disruptive.

Emotional symptoms: Depression, anxiety, irritability, and mood swings are common in individuals with CFS. These can arise because of dealing with the chronic nature of the illness, its impact on daily life, and the uncertainty surrounding diagnosis and treatment.

Immune system dysfunction: While not universally present, abnormalities in immune function can be observed in some CFS patients. This can manifest as recurrent infections or symptoms resembling autoimmune diseases, further complicating the clinical picture.

Each of these symptoms contributes to the complexity and heterogeneity of CFS, making it a challenging condition to diagnose and manage effectively. Treatment often involves a multidisciplinary approach addressing various aspects of the illness, including symptom management, lifestyle modifications, and psychological support.