Darlene Silvernail, Ph.D, LMHC, CAP


March is National Chronic Fatigue Awareness Month. As practitioners, it is important for us to be aware of the symptoms of chronic fatigue, as they may sometimes mirror symptoms of depression or other mental health disorders with low mood or affect. Additionally, many patients who suffer with chronic fatigue may have been told that their illness is psychosomatic or that they’re not feeling what they say they’re feeling. Unfortunately, chronic fatigue is still an illness that is not well understood.

Chronic Fatigue Syndrome (CFS) is recognized as a medical illness. People that suffer with chronic fatigue experience symptoms of extreme fatigue that lasts longer than six months and often becomes worse after physical or mental exertion and which seems to have no other medical explanation. In order to meet diagnostic criteria for CFS, symptoms must significantly impact the individual’s ability to perform daily activities or work and they must also experience at least four of the following:

  •  Post-exertion malaise lasting more than 24 hours
  • Unrefreshing sleep
  • Significant impairment of short-term memory or concentration
     Muscle pain
  • Pain in the joints without swelling or redness
  • Headaches of a new type, pattern, or severity
  • Tender lymph nodes in the neck or armpit
  • Frequently recurring sore throat

In addition to the diagnostic criteria listed above, according to the CDC, chronic fatigue patients often report a host of other symptoms, including irritable bowel, depression or other psychological illnesses, chills, night sweats, visual disturbances, brain fog, difficulty maintaining an upright position, dizziness, balance problems, fainting, allergies or sensitivities to food, odors, chemicals, medications, or noise.

While researchers still do not understand what causes CFS, they have found that it typically begins following some sort of trigger; this may be an infection, immune system dysfunction, hypotension, nutritional deficiency, or prolonged stress. There is also no specific treatment for CFS; practitioners currently take the approach of managing specific symptoms and treatment often fluctuates over time.

As mental health workers we know that we often experience secondary trauma, that is, our bodies react to and store trauma messages we hear from clients. This is another reason it is so important to practice good self-care as a mental health worker. We must also recognize that failing to do so could result in burn out and fatigue. There are excellent resources on compassion fatigue at the Compassion Fatigue Awareness website www.compassionfatigue.org. If you are experiencing symptoms including preoccupation, difficulty concentrating, sadness, mental and physical malaise, chronic physical ailments, or poor self-care you may be experiencing compassion fatigue.

It may be difficult to admit that we are experiencing compassion fatigue and difficult to ask for help, but recovery is possible and it begins with honest appraisal and loving self-care. So take care of you, and you will be the best practitioner that you can be.

Darlene Silvernail is the Clinical Supervisor at Total Recovery Now in Lake Worth, Florida. She is also President of the FMHCA.

References Provided Upon Request