While there is no magic cure for the neurocognitive symptoms of CFS, we can effectively manage them with practical lifestyle adjustments.

Photo byNick KarvounisonUnsplash

Scientific

Chronic fatigue syndrome (CFS) is a long-lasting illness that causes extreme tiredness. People with CFS may also have cognitive symptoms, like difficulty thinking, concentrating, learning, making decisions, and remembering things. These symptoms are publicly known as brain fog, which I discussed in a previous article.

CFS is a collection of symptoms for a specific condition. This condition is known for causing extreme tiredness that lasts for more than six months. It is complex and affects multiple systems in the body, leading to various symptoms. However, not everyone with CFS will experience all these symptoms, and having all of them is not necessary for a diagnosis.

Neurocognitive challenges top the list. Therefore, I wrote this important and nuanced article. People with CFS might struggle with thinking, concentrating, learning, making decisions, and remembering things and have trouble with their vision, coordination, muscle twitches, or tingling sensations. These are called neurocognitive problems.

Disrupted sleep patterns are common, causing problems with restfulness. Muscle pain, joint pain, and headaches are frequent discomforts.

Some people might experience blood pressure changes, leading to dizziness or appearing pale. Heart-related issues include palpitations, increased heart rate, or shortness of breath during physical effort or standing. Some people might struggle to deal with temperature changes.

Allergies or sensitivities to light, smells, touch, sound, certain foods, chemicals, and medications might be present. Gastrointestinal symptoms include nausea, bloating, constipation, or diarrhea.

Some people may experience urinary issues. Some experience flu-like symptoms such as a sore throat or tender lymph nodes. Significant weight changes, either gaining or losing, might occur.

Insights from the Scientific Literature

The exact cause of CFS is unknown. Hypotheses from studies indicate that it may be due to a combination of factors like immune, gut, or adrenal systems (HBA axis) dysfunction, an association with specific genetic markers, or a history of childhood trauma.

Measurable effects of CFS on the brain are chronic orthostatic intolerance, decreased cerebral blood flow, and increased brain activation, as documented in this scientific paper.

This government resource informs that for some people, the disease may be triggered suddenly by an infection, toxic exposure, anesthetic, immunization, or trauma like a car accident. In other people, it may develop slowly over months or years.

This 2019 scientific review critiques a flawed cognitive-behavioral model and informs that studies clearly demonstrate CFS as a biological illness. It is not caused by being unfit or mental health problems.

The cognitive symptoms of CFS can be debilitating. Working, attending school, or caring for daily activities can make it difficult. Unfortunately, there is no cure for CFS yet. However, some treatments can help relieve the symptoms.

As documented in a paper published in the Annals of Internal Medicine in 1994, the CDC officially defined CFS. According to this definition, “fatigue must be new, not related to overexertion, not getting better with rest, and seriously affecting a person’s everyday life.”

Moreover, clinical diagnosis requires six months duration of four of these symptoms: pain in the throat, swollen lymph nodes in the neck or armpits, muscle pain, joint pain without redness or swelling, new headaches, not getting restful sleep, feeling extremely tired even after a bit of exercise, and struggling with serious problems in short-term memory and staying focused.

The literature classifies severity levels as mild, moderate, severe, and very severe. To illustrate, a 50% reduction in pre-illness activity is considered mild, mostly housebound is moderate, and primarily bedridden is severe. Being completely bedridden and requiring assistance for basic tasks like eating and drinking falls under the very severe category.

Based on my research and observations of some people in my circles, I will discuss three key factors to understanding cognitive symptoms. I also provide some practical tips to address overall symptoms.

1 — Orthostatic Stress and Orthostatic Hypotension

In scientific terms, orthostatic stress “results in a shift of blood away from the chest to the distensible venous capacitance system below the diaphragm. Venous pooling is the term commonly used to describe this process.”

In simple terms, orthostatic stress happens when we stand up from lying or sitting. Gravity pulls blood toward our feet, temporarily lowering blood pressure in our heads and upper bodies. To counteract this, the body takes measures to ensure the brain still gets enough blood.

Our heart beats faster to pump more blood. The blood vessels in our legs constrict, which means they narrow. This helps to prevent too much blood from pooling in our legs. The muscles in our legs contract, which helps to push blood back up towards our hearts.

Orthostatic stress is why we might feel lightheaded or dizzy when standing up too quickly, especially if we have been sitting or lying down for a while. It is a normal response as our body quickly adjusts to maintain proper blood flow to our brain. Most people experience orthostatic stress without any problems.

However, sometimes, our bodies don’t compensate well enough for the change in blood pressure. This can lead to a condition called orthostatic hypotension, where the blood pressure drops significantly when we stand up. This can cause dizziness or even fainting.

Dehydration, some medications, and underlying medical conditions can cause orthostatic hypotension. It can also signify a more serious condition like heart disease or Parkinson’s disease, which requires medical attention.

If no underlying conditions are diagnosed, we can get up slowly from a lying or sitting position, keep the body hydrated, avoid standing for long periods of time, wear compression stockings, and take medications to increase blood pressure if we have such a medical condition.

2 — Decreased Cerebral Blood Flow

Cerebral blood flow (CBF) is the amount of blood that flows to the brain. The brain needs to get enough blood because blood carries oxygen and nutrients that the brain needs to function correctly.

Decreased cerebral blood flow can cause headaches, dizziness, confusion, memory problems, and visual disturbances like blurry or double vision. In Chronic Fatigue Syndrome (CFS), the exact cause of reduced blood flow isn’t fully understood, but it may result from a combination of inflammation, stress, and poor circulation. These factors contribute to the reduced blood flow seen in CFS patients.

Decreased CBF can happen for a number of reasons. Vasoconstriction, arteriosclerosis, and thrombosis all reduce blood flow to the brain by narrowing or blocking arteries, which can lead to a stroke — a serious condition where blood flow to the brain is interrupted.

3 — Increased Brain Activation

Increased brain activation occurs when the brain dedicates more of its resources to finish a task. This might arise from challenging tasks demanding extra resources or the brain’s reduced efficiency due to tiredness, forcing it to utilize more resources.

fMRI studies suggest that people with CFS may require increased cortical and subcortical brain activation to complete complex mental tasks. This likely contributes to the fatigue and cognitive difficulties experienced by people with CFS.

Heightened brain activity in CFS can cause tiredness, cognitive difficulties (thinking, focusing, and remembering), headaches, and visual issues. The exact cause is unclear, but stress, inflammation, and impaired circulation are potential factors. These elements might force the brain to work harder, leading to the symptoms observed in CFS.

Easy, Useful, and Proven Tips to Lower CFS Symptoms

Based on my reviews and observations, I’d like to offer some simple strategies to tackle the cognitive symptoms of chronic fatigue syndrome (CFS). These practical tips based on healthy lifestyle principles can help manage energy and improve thinking.

Tip 1: Pace Yourself: Break tasks into smaller, manageable steps to avoid feeling overwhelmed. Start small and gradually increase activity. Plan ahead, schedule rest periods, and enjoy low-energy activities. Pacing helps improve energy levels, reduce fatigue, and enhance quality of life.

Tip 2: Take Mental Breaks: Short mental breaks can reduce stress, improve concentration, and boost energy. Move around slowly, take a walk, stretch, get fresh air, listen to calming music, or enjoy a favorite activity. These breaks are crucial for managing CFS.

Tip 3: Listen to Your Body: Pay attention to your body’s signals. Take breaks when you feel tired, and avoid pushing too hard. Let your mind guide you on when to ease up or take a day off to rest and recharge.

Tip 4: Recharge and Relax to Beat Stress: Stress worsens CFS, so it’s vital to recharge and relax. Sleep well, meditate regularly, and practice mindful breathing. Reducing stress daily can prevent hazy thinking and improve overall well-being.

Tip 5: Be Careful with Exercise: Exercise can be tricky for CFS patients due to the risk of post-exertional malaise (PEM). Start slowly, take breaks, avoid exhaustion, and choose low-impact activities like yoga or tai chi. Consult your doctor before starting any exercise routine.

Tip 6: Obtain Timely Professional Support: If lifestyle strategies don’t help, seek professional support. A healthcare provider can offer diagnosis and treatment plans, including medication and cognitive behavioral therapy, to manage symptoms and improve quality of life.

Conclusions

CFS can affect people of all ages, including young children who may struggle to express their symptoms. They might not understand that their fatigue and other symptoms aren’t normal or lack the words to describe their feelings. Both children and teenagers can have their schooling impacted by CFS, which is different from school refusal, where symptoms ease at home.

CFS symptoms might worsen with activity and may persist after attending school. Pacing and rest, including taking breaks or time off, are crucial. Given CFS’s energy limits, parents, healthcare professionals, and schools must collaborate on flexible and creative education plans.

Building a strong support network with family, friends, schools, teachers, employers, and healthcare professionals is essential to improving the quality of life for CFS patients of all ages. Understanding Post-Exertional Malaise (PEM) and its impact on activity is vital.

Tailoring practical, social, and emotional support to each individual’s needs is key. This support may include help with daily tasks, family responsibilities, healthcare access, and personal priorities. Our well-being is invaluable, and supporting CFS patients is crucial.

Thank you for reading my perspectives. I wish you a healthy and happy life.

If you found this story helpful, you may also check out my other articles on NewsBreak. As a postdoctoral researcher and executive science/technology consultant, I write about important life lessons based on my decades of research and experience in cognitive, metabolic, and mental health.