Prof John Jackson PhD, FRCPath, Dr Padraic Dunne PhD
This programme is designed for those coping with chronic fatigue and or pain disorders such as fibromyalgia. It involves an individualised graded exercise programme and a mindfulness based cognitive therapy which helps deal with unhelpful attitudes to illness. Cost of initial assessment. €75.
Fatigue information sheet.
Fatigue is a very common problem and has many causes. In most cases, fatigue is transient and self-limiting. In these circumstances it may be caused by work, social or family pressures, (eg a busy period in work or a young child persistently waking at night). This type of fatigue usually disappears as the factors which precipitate it are resolved.
Chronic fatigue on the other hand, is fatigue which persists for four months or more. Again, it may have many causes, social, work related, or medical, such as a chronic illness. Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis or ME) is fatigue lasting more than four months and for which no apparent cause can be found. It is often accompanied by other features such as muscle pains, headache and sore throat.
The causes of chronic fatigue syndrome are unknown but like all other illnesses it is almost certain that there are many factors involved in determining why the illness develops. There are some studies suggesting that some individuals may have a genetic predisposition to developing chronic fatigue syndrome. There is evidence that in some cases it may run in families, although it is important to remember that as well as sharing some genes, families also usually have similar environments.
There have been a lot of studies investigating factors that may precipitate the disease and most of these have looked at the impact of viral infection. It is certainly true that many people describe having a severe flu like illness before they developed their fatigue. It is also noteworthy that fatigue during and following a viral illness (eg influenza) can be quite severe. It is thought that the reasons for this is that your immune system needs you to rest, while it performs the important job of ridding your body of the infection. We have a poor understanding of the mechanisms that your body uses to get over the fatigue once the infection has been cleared. It is likely that these are a combination of immune system pathways, hormonal and nervous system factors. There is no convincing evidence that chronic infection is a causative factor in the illness.
Many medical and drug treatments have been tried in Chronic fatigue Syndrome. Unfortunately, there is no firm evidence that any drug treatment is of benefit for most people with the syndrome Chronic fatigue can be very debilitating and interfere with work, family and interpersonal relationships. Perhaps not surprisingly, it may be accompanied by depression or anxiety. As the fatigue becomes severe it may become more limiting and the sufferer may begin to avoid activity which they believe may exacerbate their feelings of fatigue and lack of energy. If this persists it can lead to a vicious circle of deconditioning with diminishing muscular and cardiovascular fitness which in turn precipitates further fatigue. Furthermore, as anyone who exercises regularly will testify, exercise often gives you a feeling of having more energy and those with chronic fatigue may miss out on this positive feedback. It is thought that the reason exercise may be energising, is that natural energy giving hormones e.g. endorphins circulate in higher levels in individuals post exercise and in addition, enhanced circulation promotes physical and mental well-being.
It is for these reasons that Graded Exercise Programmes and programmes which help the sufferer cope better with their symptoms (cognitive behavioural therapy) are the only approaches which have proven to be effective in the majority of patients with chronic fatigue. These individualised programmes improve general conditioning, exercise tolerance, energy levels and help with re- learning how best to deal with feelings of fatigue . It is important also, that the sufferer learns to accept that the cause(s) are unknown and does not become preoccupied with trying to figure out why they have developed the illness, as this often enhances feelings of fatigue. However, these methods take time to have an effect (partly depending on how long you have been ill) and it may be a couple of months before improvement is felt. The road to recovery will have setbacks but the majority of people significantly improve and no troubling side effects have been reported with this therapy.
Before Graded Exercise Programmes are initiated, it is important that all medically treatable causes of fatigue are excluded. For this reason, appointments for admission to individualised graded exercise programmes can only be made following a doctor’s referral. This referral letter must confirm the diagnosis of chronic fatigue and have eliminated other medically treatable causes of the illness.
This programme is designed for those coping with chronic fatigue and or pain disorders such as fibromyalgia. It involves an individualised graded exercise programme and a mindfulness based cognitive therapy which helps deal with unhelpful attitudes to illness. Cost of initial assessment. €75.
Fatigue information sheet.
Fatigue is a very common problem and has many causes. In most cases, fatigue is transient and self-limiting. In these circumstances it may be caused by work, social or family pressures, (eg a busy period in work or a young child persistently waking at night). This type of fatigue usually disappears as the factors which precipitate it are resolved.
Chronic fatigue on the other hand, is fatigue which persists for four months or more. Again, it may have many causes, social, work related, or medical, such as a chronic illness. Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis or ME) is fatigue lasting more than four months and for which no apparent cause can be found. It is often accompanied by other features such as muscle pains, headache and sore throat.
The causes of chronic fatigue syndrome are unknown but like all other illnesses it is almost certain that there are many factors involved in determining why the illness develops. There are some studies suggesting that some individuals may have a genetic predisposition to developing chronic fatigue syndrome. There is evidence that in some cases it may run in families, although it is important to remember that as well as sharing some genes, families also usually have similar environments.
There have been a lot of studies investigating factors that may precipitate the disease and most of these have looked at the impact of viral infection. It is certainly true that many people describe having a severe flu like illness before they developed their fatigue. It is also noteworthy that fatigue during and following a viral illness (eg influenza) can be quite severe. It is thought that the reasons for this is that your immune system needs you to rest, while it performs the important job of ridding your body of the infection. We have a poor understanding of the mechanisms that your body uses to get over the fatigue once the infection has been cleared. It is likely that these are a combination of immune system pathways, hormonal and nervous system factors. There is no convincing evidence that chronic infection is a causative factor in the illness.
Many medical and drug treatments have been tried in Chronic fatigue Syndrome. Unfortunately, there is no firm evidence that any drug treatment is of benefit for most people with the syndrome Chronic fatigue can be very debilitating and interfere with work, family and interpersonal relationships. Perhaps not surprisingly, it may be accompanied by depression or anxiety. As the fatigue becomes severe it may become more limiting and the sufferer may begin to avoid activity which they believe may exacerbate their feelings of fatigue and lack of energy. If this persists it can lead to a vicious circle of deconditioning with diminishing muscular and cardiovascular fitness which in turn precipitates further fatigue. Furthermore, as anyone who exercises regularly will testify, exercise often gives you a feeling of having more energy and those with chronic fatigue may miss out on this positive feedback. It is thought that the reason exercise may be energising, is that natural energy giving hormones e.g. endorphins circulate in higher levels in individuals post exercise and in addition, enhanced circulation promotes physical and mental well-being.
It is for these reasons that Graded Exercise Programmes and programmes which help the sufferer cope better with their symptoms (cognitive behavioural therapy) are the only approaches which have proven to be effective in the majority of patients with chronic fatigue. These individualised programmes improve general conditioning, exercise tolerance, energy levels and help with re- learning how best to deal with feelings of fatigue . It is important also, that the sufferer learns to accept that the cause(s) are unknown and does not become preoccupied with trying to figure out why they have developed the illness, as this often enhances feelings of fatigue. However, these methods take time to have an effect (partly depending on how long you have been ill) and it may be a couple of months before improvement is felt. The road to recovery will have setbacks but the majority of people significantly improve and no troubling side effects have been reported with this therapy.
Before Graded Exercise Programmes are initiated, it is important that all medically treatable causes of fatigue are excluded. For this reason, appointments for admission to individualised graded exercise programmes can only be made following a doctor’s referral. This referral letter must confirm the diagnosis of chronic fatigue and have eliminated other medically treatable causes of the illness.
