Are You Simply Tired Or Is It Chronic Fatigue Syndrome?

Your body needs rest — but feeling tired all the time can become a serious problem. Here’s when to see a doctor.

Woman rubbing her eyes with tired expression


Over 800,000 people in the United States suffer from Chronic Fatigue Syndrome (CFS). Also known as Myalgic Encephalomyelitis (ME), the CDC estimates that 90 percent of people living with the condition haven’t been diagnosed.

However, not all fatigue-related illnesses are classified as CFS. Fatigue falls into a few different classifications. Let’s have a look at the differences and what makes each unique.

General fatigue
We’ve all woken up feeling tired and drained, as though our get-up-and-go just got-up-and-went. This is fatigue. General fatigue can happen due to a lack of sleep, getting the flu or another short-term illness — or even a great day out hiking with friends.

This kind of fatigue is our body’s way of signaling it needs rest. It’s not long-term and generally goes away once you’ve rested-up and recovered from whatever brought the fatigue on.

Chronic fatigue
When fatigue doesn’t go away after catching up on rest and sticks around for six months or more, it’s then classified as chronic fatigue.

There are quite a few medical conditions that can cause chronic fatigue. While lifestyle factors like drug or alcohol abuse commonly contribute to ongoing fatigue, illnesses such as liver and kidney disease, hyper- and hypothyroidism, fibromyalgia, arthritis, depression, diabetes and more can all cause long-lasting feelings of fatigue. Certain medications can also cause feelings of fatigue if taken for a long period of time.

It's worth noting that insomnia usually plays a role in chronic fatigue as well. People with chronic pain often find their sleep disrupted, which makes fatigue symptoms worse.

Chronic Fatigue Syndrome (CFS) 
So, how do you know when long-term fatigue could be Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)? ME/CFS is a specific diagnosis that’s not made until someone’s experienced over six months of persistent fatigue and diagnostics have ruled out other possible causes.

While the exact cause of ME/CFS isn’t known, those with ME/CFS often begin to have symptoms following a flu-like illness or a traumatic psychological event.

Those suffering from ME/CFS typically have a significantly diminished quality of life. They can find getting out of bed an extreme effort and their ability to carry out daily tasks, or even hold a job, can be severely impacted. Those with Chronic Fatigue Syndrome can find that simple activities, like taking a bath or shower, will leave them exhausted for days.

In addition to the extreme exhaustion, those with ME/CFS present with at least four of the following conditions to be officially diagnosed:

  • Joint pain
  • Sore throat
  • Muscle pain
  • Unproductive sleep that doesn’t leave you rested
  • Impaired short-term memory and/or concentration
  • Extreme adverse reactions to physical activity, such as the shower example above
  • Unusual headaches
  • Enlarged lymph nodes

If your doctor is concerned you have Chronic Fatigue Syndrome, she’ll likely get an extensive medical history from you. The doctor will want to know how long you’ve been having symptoms, what makes your exhaustion worse, and order labs that can help rule out other illnesses that could cause your exhaustion. You may also undergo some testing for your central nervous system.

After a Chronic Fatigue Syndrome diagnosis
While there’s no cure for ME/CFS, you and your physician will work together to manage your symptoms and help improve your quality of life.

Some of the most common ways to manage ME/CFS symptoms are a slow increase in physical activity; lifestyle changes; addressing any mental health issues that might be making your ME/CFS worse; medications to manage pain and allergies; and integrated medicine therapies that can help with wellness.

When to see a doctor
If you’ve had fatigue symptoms for multiple months and your fatigue is impacting your quality of life, it’s time to see a medical professional. Starting a conversation can help you pinpoint any medical issues that might be causing your fatigue and put you in a position to take control of your health.

E. Napoletano is an award-winning journalist and the recipient of the 2019 Illinois Women’s Press Association first-place prize for her feature on the traumatic effects of family separation policies at the border.