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Independent expert answers
on psychiatry and psychology

How to Diagnose Chronic Tiredness (CFS)

Abstract: Tiredness can have many different somatic and/or mental causes.

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How to Diagnose Chronic Tiredness (CFS)

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Question(s): 
Written by: Martin Winkler
First version: 22 Jul 2008.
Latest revision: 28 Aug 2008.

How do I diagnose chronic tiredness (CFS)?
When to suspect a mental illess in case of chronic tiredness?

Answer:

Tiredness is one of the most common causes of impairments at work, family life and well being. While there are many possible somatic causes of tiredness, some mental disorders or chronic stress can also cause tiredness.

Any condition lasting longer than 2 weeks is a chronic tiredness.

You should only consider a mental health problem if a skilled doctor has not found any physical disease like moderate or severe anaemia (lack of iron), diabetes, chronic diesease (including kidney diseases, rheumatoid arthritis), chronic pain, severe chronic infections (e.g. hepatitis, tuberculosis, HIV) or cancer. These conditions can be easily examined by a doctor because these patients usually :

  • feel sick and have a sickly appearance
  • have fever or other abnormal pulse and blood pressure
  • signs of anemia (pale eyes or fingernails)
  • weight loss
  • lack of energy and thinning of the muscles
A doctor will ask you some of these question to get a diagnosis:
    1. How long have you been tired?
    Short term tiredness can be causes by a psycho-social stress event (e.g. some trouble at home or work, financial problems). Any longer duration of tiredness can be influenced by a chronic sleeping problem (e.g. different types of insomnia, sleep apnea)

    2. Have you examined any symptoms of physically sickness? Any impairments like coughing, shortness of breath, Losing weight, pass blood in your stools?

    3. Any reasons for ongoing stress? Worries about anything?

    4. Any symptoms of a depressive disorder or anxiety problem?

    5. Describe a typical week of your present life. What are you doing on a normal day (try to be precises).

    6. Any changes of your normal behaviour due to tiredness? (Sometimes weakness and tiredness are a kind of excuse not to go to public places or situation which might cause panic attacks).

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