Take a test for chronic fatigue syndrome. Test: chronic fatigue syndrome

Chronic fatigue is an ailment that can creep up unnoticed. Thanks to this test, you can independently check your condition and understand whether it is time to take action to prevent chronic fatigue from developing. The necessary information is provided after the test on how to do this.

Test

Try as honestly, sincerely, to answer “yes” or “no” to all questions of this small test. So:

1. When you wake up in the morning, do you need to “swing” longer than usual, making an effort on yourself in order to get involved in your usual (including work) life?

2. In the midst of work, do you begin to feel a drop in its productivity, the need to strain, to make additional efforts for its quality performance?

3. Do you need some kind of “dope” (coffee, strong tea…) to feel in good shape at least during working hours?

4. Have you begun to react badly to weather changes that cause you pain in your back, joints, headaches, weakness?

5. Does your appetite go up and down?

6. Have you started to experience unpleasant, sometimes painful sensations in the heart area?

7. Are your hands and feet starting to feel cold?

8. Have you started to worry about some dysfunctions, some disturbances in the functioning of the gastrointestinal tract?

9. Have you become increasingly irritable, hot-tempered, or have you had episodes of causeless depression in your mood?

10. Have you started to experience allergic reactions or become more frequent?

11. Does your sex drive decrease?

12. Has your sleep become intermittent, restless, superficial, or have you had trouble falling asleep?

If most of your answers to the questions posed in the test turned out to be positive, then it’s time for you to think about the state of your health! And, of course, begin to take the necessary measures in order not to be overcome by chronic fatigue.

Find opportunities to fully rest and relax

First of all, you should not allow the occurrence and development of chronic fatigue. But not every person succeeds in avoiding stress and establishing a rational, healthy lifestyle.

And therefore, first of all, you should not gather your strength, not mobilize the remaining energy (as, alas, not very experienced specialists quite often recommend doing this), but, on the contrary, give yourself the opportunity to rest and relax.

To do this, you should sleep at least 8 or even 9 hours. And if possible, add sleep during the daytime.

The so-called can help relieve muscle tension. relaxation exercises based on releasing tension from muscles and maximizing their relaxation.

Positive emotions also help to relax. And their occurrence is facilitated by various kinds of hobbies (including the sauna, which is fashionable these days, but you shouldn’t be in it to the point of weakness and dizziness), music, and simply rational relaxation. The pleasure hormones produced in this process - endorphins - relieve irritability, unmotivated excitability, and pain, and, of course, improve mood.

Do exercises

While working, it is best to do a light warm-up every two hours. Then you can sit, relax and slightly wiggle your fingers and toes in your work chair.

If your job (and your boss) allows, you can warm up with the following simple exercises:

1) Jump (feet together - arms apart) for 1 minute. Do 20 squats, 25 push-ups, or run in one place for a couple of minutes. This is most often enough to speed up blood circulation and increase the flow of oxygen.

2) You can use self-massage to “recharge your internal battery.”

Change clothes after work

When you return home after a hard day at work, you should definitely immediately change your clothes (especially your underwear!). The fact is that after a difficult day filled with stress, biologically active substances produced by the body in response to stressful influences remain on it. Being absorbed into the skin, they can increase your discomfort, if not even pain.

Do self-massage

Don't forget about the healing effects of water! By washing your hands under running water for at least a short time, you will thus cleanse yourself and free yourself from the painful, “evil” energy that accumulates throughout the day. At the same time, we should not forget that in the hot summer season the water should be cold, but in winter, on the contrary, warm.

In addition, by rubbing your hands under running water, you will influence certain biologically active points, performing a kind of tonic self-massage.

Well, since after a hard working day, especially one filled with stress, most people still have a feeling of facial tension, you can stretch it by barely touching your cheeks and forehead with your fingertips.

Drink vitamin drinks and moderate the influence of bad habits

And it’s also a good idea to drink vitamin drinks - a decoction of rose hips, an infusion of stinging nettle (3-4 tablespoons of it should be infused for 1-2 hours in 1 liter of boiling water and drunk 2/3 cup 3-5 times a day after meals) or an infusion dried rowan fruits (brew a glass of boiling water, let it brew for 1 hour) - take 0.5 cups 2-3 times a day.

Try to limit the time you work with the computer, spend less time watching TV shows. Avoid strong alcoholic drinks. Try to quit smoking. And don’t forget about the need for a balanced diet. It is advisable to drink fresh carrot juice with cream for breakfast; focus your diet on plant foods (especially nuts, herbs, vegetables, fruits) with a reduction in the amount of meat and animal fats.

Further information: Causes of chronic fatigue

Not everyone knows that chronic fatigue can develop not only and not so much as a result of overwork, but also be the result of prolonged stress on a person. There is another reason, but here we will not talk about the so-called. chronic fatigue syndrome, which has not yet been fully studied by modern medicine, the cause of which is a certain infectious factor.

So, what does this chronic fatigue manifest itself in? And it differs quite radically from ordinary fatigue. Because this is not only physical, but also emotional, nervous, and intellectual depletion of the body’s reserves.

Usually a person continues to live and work in the same, familiar rhythm, still performing ordinary duties, and at the same time begins to feel that he is already on the edge. Remember that you can determine whether you have already fallen into the tightening grip of this disease if you feel frequent or constant malaise for six months, and at the same time you do not seem to be sick with anything (at least during examinations of you no pathology is detected). Well, you can do it even more accurately using this test.

Chronic fatigue syndrome is a disease that occurs quite often in modern society. Probably everyone has experienced such a state when, after hard physical or mental work, severe fatigue sets in. Usually, it can be relieved with proper rest and sleep. But, if this condition persists for several weeks, then most likely you have chronic fatigue. And it is impossible to get rid of it with ordinary rest. Need help from a specialist.

The causes of the described disease are different. If the body experiences overwork for a long time, then the cause of this problem may be a serious illness. Often, attacks of chronic fatigue syndrome (CFS) occur after viral illnesses.

IMPORTANT: Unfortunately, modern medicine cannot clearly name the causes of CFS. But almost all researchers of this problem agree that there is a connection between chronic fatigue and the presence of viruses in the body. Another “obvious” cause of this problem is disturbances in the functioning of the nervous system caused by stress, excessive mental fatigue, etc.

Also among the causes of this disease, experts identify:

taking certain medications
diseases such as asthma, bronchitis and emphysema
disruptions in the functioning of the cardiovascular system
sleep disturbances and insufficient rest
poor nutrition
depression and negative emotional state

Chronic fatigue syndrome can strike a person at any age. But, as statistics show, women most often suffer from this disease.

Chronic fatigue symptoms and signs

Consequences of CFS

The symptoms of CFS vary, but most often appear in combination. Typically, experts include these signs:

Feeling tired for more than 3 weeks
Muscle discomfort similar in sensation to that which occurs after excessive physical activity
Noticeable memory loss and frequent occurrence of depression
Violations of the “wake-rest” regime: insomnia, increased sleepiness
Joint pain
Frequent headaches
Enlarged lymph nodes

If chronic fatigue is not treated in time, then all of the above symptoms may begin to progress. In this case, the presence of diseases accompanying these symptoms will be absent. Even laboratory tests will not be able to detect violations of the physiological norm.

Diagnosing chronic fatigue syndrome is quite difficult due to the fact that blood and urine tests will be normal. Ultrasound and x-rays of a patient with this problem will not show abnormalities. That is why, most often, people with CFS are diagnosed with vegetative-vascular dystonia or neurotic reaction. However, treatment of these diseases does not produce any results.

Mental Fatigue Test by Akiyoshi Kitaoka

As mentioned above, this problem has a viral and neuralgic pathology. Everything is clear with viruses; the body’s immune system spends a lot of energy to fight them, which leads to chronic fatigue. As for nervous exhaustion, it is also a common cause of this illness.

Visual illusions of Akiyoshi Kitaoka

In order to determine chronic fatigue caused by a mental state, you can use Akioshi Kitaoka's tests. This famous Japanese psychology professor developed a method for studying a person’s mental state based on “visual illusions.”

Focus your gaze on one point in the picture:

If the drawings are motionless, then the mental state is normal. Professor Kitaoka believes that this is only possible in a rested, balanced person
If, when focusing the gaze, the picture continues to move, then the patient urgently needs rest, both psychological and physical. Adequate sleep is especially recommended for such a person.

The movement of “visual illusions” indicates physical fatigue, a person’s stressed state and a deterioration in his health. Akioshi Kitaoka developed this test to identify mental problems, but it can also be used to identify chronic fatigue syndrome.

IMPORTANT: CFS can be diagnosed with another test that was developed by Australian scientists from Griffith University. They found several biomarkers (single nucleotide polymorphisms) in the body that were present in 80% of subjects who had symptoms of chronic fatigue syndrome. Now, with the help of simple tests, you can not only identify the presence of such a problem, but also find out the effectiveness of its treatment.

Chronic fatigue syndrome Epstein Barr virus

Not so long ago, Andrew Lloyd from the University of New South Wales in Australia found a connection between the Epstein-Barr virus and chronic fatigue syndrome. This virus belongs to the herpesvirus family and is the causative agent of mononucleosis. According to statistics, it is in the body of almost every adult and every second child.

Epstein Barr virus

The scientist believes that the activity of the Epstein-Barr virus can temporarily "damage" the brain. Which can lead to chronic weakness and apathy. A group of specialists led by Andrew Lloyd tested people who complained of chronic fatigue syndrome. Most of them had traces of the virus in their blood.

But, the presence of the Epstein-Barr virus does not necessarily lead to CFS. Of the 39 people who suffered from mononucleosis, only 8 could not recover quickly. This difference, according to experts from the University of New South Wales, depends on the state of the patient's immune system. The stronger it is, the faster the patient with chronic fatigue syndrome will be able to recover.

How to improve performance?:

A decrease in efficiency can hurt the “pocket”, the psychological and physical state of the body. It happens that if you give yourself slack, then everything starts to fall, problems grow lumpy. But the opposite happens. When you seem to want to work productively, but something gets in the way. This may just be the notorious chronic fatigue syndrome.

If your vitality is at zero, then you cannot sharply force events. We need to find out the reason for this situation. If it is caused by fatigue, then you need to ensure yourself proper rest. If you ignore it, it can only make the situation worse.

Improving performance

Drinking liters of coffee is not an option. Firstly, this amount of caffeine has a negative effect on the nervous system. And if 1-2 cups of coffee can invigorate the body, then all subsequent cups of this drink will have a detrimental effect on well-being
Secondly, coffee is a diuretic. That is, it has a diuretic effect. Which can lead to dehydration and, as a result, fatigue. Therefore, if you need to increase your efficiency, you need to drink no more than two cups of coffee a day and provide water access to your body.
It helps to improve the performance of such a drug as "Deanol aceglumate". With it, you can improve mood, increase brain function and improve well-being during depression. This drug is indicated for memorization and reproduction of large amounts of information, as well as for excessive physical activity.
Also, Phenotropil has proven itself well to stimulate the brain and improve its blood supply. This drug in tablet form stimulates intracellular metabolism. What helps increase physical and mental performance
But, you cannot use these medications without consulting a doctor!

Which doctor should I go to?

Chronic fatigue syndrome is a problem that should only be treated under the guidance of a specialist. Unfortunately, it is not uncommon for CFS to be a symptom of a serious illness. And success in its treatment will depend only on the timely assistance of a qualified specialist. If you have symptoms of this disease, it is best to consult a therapist. He will be able to assess the patient’s condition and refer him to a specialist.

If chronic fatigue syndrome occurs as a result of frequent stress, anxiety and unreasonable fear, then it is best to seek help from a psychotherapist or psychologist. This specialist will help you overcome psychological problems.

If CFS is caused by overstrain of the nervous system, it would be more advisable to consult a neurologist or neurologist. This specialist will help you choose the right treatment for this disease and help you get rid of this disease.

Sometimes chronic fatigue can cause disruptions in the endocrine or immune system. In this case, help should be obtained from specialists in these areas.

Chronic fatigue syndrome treatment with drugs

There are several medications that are used in the treatment of this disease. These include:

sleeping pills and sedatives
agents that activate serotonin production
psychotropic drugs
vitamins B1, B6, B12 and C
immunocorrectors with adaptogenic effect
anti-inflammatory drugs
other auxiliary agents (tranquilizers, enterosorbents, nootropic drugs, antihistamines in the presence of allergies)

Staphylococcal vaccines Staphypan Berna and intravenous immunoglobulin have a good effect on the treatment of CFS. Also, recent studies have shown that some antidepressants have a good effect on the body with the problem described above.

The symptoms of this disease can be significantly reduced with the help of L-carnitine and magnesium. A special place in this list is given to drugs containing L-carnitine. This substance is responsible for transporting fatty acids. If they are deficient, the body's cells will receive less energy. If the lack of L-carnitine in the body drags on for a long time, it can lead to chronic fatigue.

As for magnesium, it is this macroelement that is responsible for the production and consumption of energy in the body. And its lack can also result in the disease described above. That is why, when diagnosing CFS, doctors often prescribe medications with magnesium and L-carnitine.

IMPORTANT: Chronic fatigue syndrome may be a consequence of a lack of iodine in the body. A lack of this element can lead to disturbances in the functioning of the thyroid gland. Such violations are very dangerous and can lead to various negative consequences. In particular, to loss of strength, lethargy and muscle weakness.

Non-drug treatment of chronic fatigue syndrome

You can restore your strength not only with the help of pills, mixtures and injections. The main factor for success with this disease is proper rest. And that is why it must be provided. Good sleep is especially important.

Another non-drug treatment for CFS is physical exercise. Moderate physical activity can increase the “capacity” of a person’s energy reserves. Regular fitness classes, running, swimming and other physical activities will help accumulate energy over time and improve the condition of the body.

Equally important for defeating chronic fatigue is proper nutrition. After all, it is through nutrition that a person can stock up on energy. Deficiency of some nutrients can lead to serious consequences. Fruits, vegetables, cereals and unground grains are the main sources of many useful nutrients that will not only help overcome fatigue, but also improve health.

You also need to keep a record of the liquid you drink. Two to three liters of clean water a day will help get rid of toxins, improve metabolic processes in the body and, as a result, overcome the problem described above.

Chronic fatigue syndrome treatment with folk remedies

In folk medicine there are also several recipes that can help you cheer up and overcome CFS:

Honey and vinegar. Mix 100 g of honey and 3 tablespoons of vinegar. The resulting mixture should be consumed one teaspoon per day. After 1.5 weeks there should be no trace of fatigue left

Based on this mixture, you can prepare a healthy energy drink. To do this, mix a teaspoon of vinegar, honey and iodine in a glass. The mixture must be poured with boiled water and stirred. You should drink this mixture only after meals, one glass per day.

Cinnamon tincture. Cinnamon helps to cope well with this disease. But simply adding it to baked goods is not enough. A more effective remedy is a tincture of this spice. To prepare it, you need to pour a bag of cinnamon (50 g) into a container and pour vodka (0.5 l). This product should be infused in a dark room for three weeks. Cinnamon tincture is good for calming the nervous system and relaxing the body.
Ginger. Another natural immunostimulant is ginger root. This natural product has many beneficial qualities, and one of them is helping with chronic fatigue syndrome. The greatest effect can be achieved with ginger tincture. To do this, you need to grate 150 g of the root of this plant and mix it with 800 ml of vodka. This remedy should be infused for at least a week. You can also use ginger in tea. To do this, you need to divide the root into 6 parts and squeeze the juice from each. Then the juice should be poured with a glass of boiling water. You need to add honey and lemon to this drink.
Kefir and honey. Before going to bed, you can help your body relax and fall asleep faster with the help of kefir and honey. To do this, half a glass of kefir needs to be diluted with half a glass of boiled water. Then add honey to this drink and mix

Prevention of chronic fatigue syndrome

In order to prevent CFS, you need to change your daily routine. It is advisable to try to go to bed and get up earlier. Such a change in daily routine will be beneficial not only in terms of preventing chronic fatigue syndrome, but also in terms of increasing productivity
It is also very important to devote at least 30 minutes a day to physical activity. And for this it doesn’t matter to go to the gym. There are sets of exercises that you can do at home or at work. Physical activity will not only help keep your body in good shape, but will also significantly reduce mental stress.
Bad habits such as smoking and excessive alcohol consumption can also cause CFS. That's why you need to get rid of them
Walking in the fresh air and vivid impressions help cope well with fatigue. Visit theater and cinema regularly. This will help get rid of the above-described illness associated with mental problems.

Nature is an excellent antidepressant. Therefore, at least once a year you need to get out to the sea or to the mountains. On vacation, you need to relax not inside concrete walls, but where there is a lot of clean air devoid of city dust. In addition, the air in such places is saturated with useful substances that can improve health.

Chronic fatigue syndrome is not a harmless disease. It can cause not only loss of performance, but also negatively affect the health of the body as a whole. In addition, treating this disease is very difficult and takes a long time. Therefore, it is easier to warn him. And the best way to do this is through proper rest, good sleep, physical activity and proper nutrition.

Sophia. I recently read somewhere that chronic fatigue syndrome is associated with disturbances in brain function. And in order to prevent such violations, it is necessary to consume foods rich in omega 3. After this article, I try to eat fish and nuts once a week.

Elizabeth. I am also susceptible to this type of fatigue. For me it is more of a moral plan. Sometimes everything gets boring: monotony, lack of joy in life, etc. Hands down. I don't want anything. I don’t know if it’s fatigue or something else. But I'm trying to please myself with something. I’ll go to the museum or cook some delicious dessert. And you see, life is getting better. And immediately performance increases and fatigue increases like never before.

Video: Disease of a city dweller. Great Race

Before you start writing material that will be useful to you in mastering computer knowledge, determine the degree of your fatigue. Define.
As a result of long and hard work, a person experiences fatigue, which occurs as a result of hard and long work. Efficiency decreases, a person gets tired quickly, and doesn’t want to do anything. If this condition continues for a long time, fatigue occurs. This is dangerous for your health.

If you do not pay attention to this, CFS (chronic fatigue syndrome) may occur:
- Are you tired;
- you have insomnia;
- you get irritated over trifles;
- you can’t even remember your own husband’s name;
- depression occurs;
- unreasonable apathy or anger, which can manifest itself as aggression.

If there are at least one or two signs, then you have become a victim of the currently widespread disease CFS. In the 80s this disease did not exist. It is associated with an increase in psychological stress and an acceleration of the rhythm of life. Predisposing factors may be viral infections, various chronic diseases, poor ecology and sanitary conditions. This is what can happen if a person does not pay attention to his health.

I offer you, which was developed at the University of Japan (Ritsumeikan) in Tokyo, by Professor Akioshi Kitaoka.
This is a picture that you need to look at for 30-60 seconds.

E If you do not see movement in this picture, that is, it remains motionless, then you are not overworked and you are completely calm - this is very good.

Experts do not yet have a complete consensus on the nature of chronic fatigue syndrome (CFS). It seems that this is some kind of general specific “imbalance” of the body that occurs as a result of prolonged nervous overload, leading to a decrease in immunity and disruption of the functioning of the central and peripheral nervous system.

The test results are indicative only. Only a doctor can make a correct diagnosis.

Chronic fatigue syndrome

Chronic fatigue syndrome is a psycho-emotional disease. It most often occurs due to prolonged physical and mental stress. Middle-aged people living in the city are more susceptible to the disease.

The main symptom of the disease is a stable feeling of powerlessness: it is difficult for a person to cope with daily tasks at home and at work. It seems that such a state drags on like a swamp. However, it can and should be treated.

Causes of fatigue

Chronic fatigue syndrome is a medical phenomenon that has not yet been fully studied. Opinions about the reasons were divided into two groups:

1. The disease is a consequence of hidden chronic processes in the body or provoked by experienced nervous disorders.

2. Constant exhaustion occurs due to poor lifestyle and excessive stress. That is, developing “visible” symptoms, such as decreased immunity or mental instability, are considered to be the result of regular overwork.

If we summarize all the possible reasons, they can be presented as follows:

Symptoms and diagnosis

To identify the disease and isolate it from other similar diseases, medical scientists have developed a classification of symptoms of chronic fatigue syndrome:

1. Main features. There are two of them: permanent fatigue, not eliminated even by prolonged sleep, which has been observed for more than six months, and the exclusion of obvious ailments in the body.

2. Minor. These are physical symptoms:

feeling of chills;
migraine;
dry throat and mucous membranes of the eyes;
muscle and spinal pain;
shortness of breath;
low-grade fever;
enlarged lymph nodes.

3. Neuropsychological signs. These include various phobias (especially fear of bright light), irritability, poor concentration, feelings of depression and hopelessness.

If more than eight signs are present (both major ones, about six from the list of minor ones, plus at least one of the third group), the diagnosis is chronic fatigue syndrome.

What to do for treatment

First, you can visit a doctor to understand the possible root causes of the syndrome. What kind of specialist is needed for this? It all depends on the goal:

they go to a therapist and immunologist to identify the presence of chronic diseases, infections and viruses in the body;
see a psychologist - to test yourself for the presence of psychologically traumatic factors and get a referral for individual or group therapy;
other specialists (endocrinologist, cardiologist, etc.) are contacted to treat symptomatic manifestations of the disease (enlarged lymph nodes, tachycardia, etc.).

If necessary, doctors will prescribe treatment with medications or physical procedures:

soothing relaxing massages;
therapeutic exercises;
water procedures;
acupuncture (a method of influencing the body with acupressure).

Unfortunately, chronic fatigue syndrome, in its early stages, is very difficult to identify. You'll have to help yourself. If you notice signs from all three groups listed in the “symptoms and diagnosis” section, you need to begin self-organization measures:

1. Establish normal nutrition:

don’t forget about a hot lunch;
reduce consumption of fatty foods;
drink a lot of clean water;
enrich the diet with vitamins.

2. Organize your daily routine:

try to do all important things before lunch;
avoid doing several things at once;
take time for walking;
take five minutes at work to warm up and just relax.

3. Get a good night's sleep:

go to bed early;
ventilate the room;
sleep in comfortable clothes.

The last point is the most important. A good rest is the first thing you need to organize for yourself if you have symptoms of an illness. On weekends, turn off your phone and sleep as much as your body needs.

Drug treatment

To alleviate the condition, homeopathic remedies are often prescribed. The most popular of them are shown in the table:

Attacks of “lack of air”;

Palpitations after slight physical exertion;

Minor shaking of hands.

Decreased concentration;

Loss of vision;

Discomfort in muscles and joints;

In addition to taking homeopathic and anti-inflammatory drugs, doctors recommend treating chronic fatigue syndrome with other groups of medications:

complexes of vitamins and minerals;
drugs that modulate immunity;
antiviral drugs;
antidepressants.

Psychotropic drugs (strictly prescribed by a doctor) help treat disorders of the autonomic nervous system.

A simple self-diagnosis test

Many of us do not have the fortitude or time to visit doctors. You can find out whether you really have chronic fatigue syndrome and how serious the problem is with a small test.

Answer the questions provided in each block by answering “Yes” or “No”:

1. The appearance of frequent pain:

2. Regular gastrointestinal problems:

3. Increasingly frequent attacks:

rapid heartbeat;
arrhythmias;
holding your breath;
dizziness;
presyncope;
paleness of facial skin;
darkening in the eyes.

4. I really want:

sleep;
lie down on the bed;
fall asleep right at your desk;
wake up without feeling “broken”;
stop having nightmares.

5. There is noticeable discomfort when changing:

6. Progression of difficulties:

when remembering new information;
concentration;
decision making;
manifestations of a timely reaction to someone else’s action or question.

7. Loss of interest:

8. The appearance of obsessive states:

9. Frequent painful condition:

persistent colds;
chronic tonsillitis;
exacerbation of a chronic disease;
muscle cramps;
the appearance of allergies;
permanent runny nose;
pain in the eyes;
feeling of persistent thirst.
low-grade fever for no apparent reason.

10. Emotional instability manifested as follows:

in outbursts of unreasonable anger;
irritability over small things;
in reactive mood changes;
in frequent apathy;
in acute anguish.

11. We began to “calm down” ourselves with new methods:

learned to smoke or increase the number of cigarettes;
I developed a craving for drinking alcohol in the evenings.

12. Terribly annoying:

13. No strength for simple housework.

In total, 60 questions were asked in 13 blocks. If you only answered “Yes” to 20 or fewer questions, you are simply exhausted. A good rest will fully restore your strength.

If the positive answers were in the range of 20-40, chronic fatigue syndrome is already present, but you can try to fight it yourself.

But if the result is more than 40 “Yes”, you should consult a doctor.

How to help yourself

Many psychologists believe that a person's greatest battles are with himself and with his weaknesses. Many sages are confident: the most significant victory is the one where you were able to give up the fight, realizing the vanity of the goal (the idea that life is good not because of achievements, but something more, is perfectly revealed in the film “Peaceful Warrior”).

Write a rough list of things that, in your opinion, are not very important, but take up a lot of time. Having managed to refuse any of them, put a bold tick on yourself and say “Well done!” You truly deserve self-respect.

Before you start fighting the disease called “chronic fatigue syndrome,” give yourself plenty of rest and gain strength. In any case, something will have to be sacrificed. For example, cleaning the kitchen to a perfect shine or participating in a corporate “beer meeting” to mark the end of Friday.

Review the possible reasons that led to your deplorable physical condition and write another list of not the best habits that you are quite capable of getting rid of.

The main thing is not to rush to change your lifestyle too zealously:

if you are used to fatty foods, do not exclude them from the menu all at once, gradually replace them with energy products (porridge, nuts, dried fruits);
if you have never drank 2 liters of clean water daily, an excessively sharp increase in fluid can cause swelling;
If you decide to improve your physical tone, do not plan to do 40 push-ups today.

Chronic fatigue syndrome took months to develop. Don't think that you can remove its effects in a week. Do not forget that the main task is to give the body a rest, and not to starve it even more. Be patient. Take small steps towards your goal. And be sure, just be sure to praise yourself.

Chronic fatigue syndrome: what it is, symptoms, signs and treatment

In the 19th century, it was condescendingly called “hypochondria.” In the 20th century, it became known as “chronic fatigue,” and in the 21st century, “the disease of the century.” The symptoms are the same, but the age and extent of the spread have changed significantly. The disease is like an epidemic; more and more young people, residents of megacities, and the population of economically prosperous countries are falling into its sphere of influence.

Scientists are at odds arguing about the causes of various nervous system disorders characteristic of this syndrome, and cannot come to a common denominator. However, they are unanimous on one thing: CFS is a diagnosis officially recognized by medicine..

What is chronic fatigue syndrome?

Chronic fatigue syndrome is a disease in which a feeling of weakness and fatigue accompanies a person for a long time (more than six months). Moreover, this condition does not disappear even after prolonged sleep and rest.

Figures and facts: Chronic fatigue syndrome has been considered an independent disease since 1988, with recognition of the need for treatment.

Symptoms of CFS have been identified in 20% of the inhabitants of planet Earth. And this number is growing.

2% of adolescents suffer from CFS.

80% of patients are women.

Causes: 3 different opinions

There are many versions about the mechanism and causes of the disease, but there are three main ones that deserve attention.

Intense rhythm of modern life. This version is supported by the fact that the age most susceptible to chronic fatigue syndrome is 25–45 years old - the most productive age, when a person places unreasonable burdens on himself in an effort to succeed. The body cannot stand it and fails. Persistent symptoms of fatigue appear. The unfavorable ecological situation of polluted megacities also contributes, provoking oxygen starvation - brain hypoxia. A decrease in oxygenation entails disruptions in the body’s metabolic processes and leads to its slagging
It's all the fault of the virus. A fairly common theory is that CFS is caused by a group of viruses - herpes, retrovirus, enterovirus, cytomegalovirus. Recently, scientists at Stanford University received new confirmation of the viral nature of the syndrome. They identified its specific biomarkers - increased levels of hormone-like proteins, peptides, and cytokines in the body of some people. It has been shown that the higher a patient's levels of certain anti-inflammatory cytokines, the more severe their CFS symptoms.
Chronic diseases are to blame. At risk are patients suffering from cardiac pathology, autoimmune disorders - those who often “catch” viral infections. And also those who, trying not to miss anything at work, do not take sick leave and suffer from sore throats and acute respiratory viral infections. This often results in retribution in the form of chronic fatigue. The mechanism of this relationship is simple: an undertreated organism, weakened by a disease, malfunctions. The immune system is undermined, the nervous system is overloaded, the physical system is exhausted. As a result, there is a persistent feeling of fatigue, decline, physical and moral. In this case, the quality of life really deteriorates - dark thoughts attack the subconscious, anxiety and fear do not leave.

Scientists from the Netherlands have discovered a connection between the syndrome and a lack of iodine in the body or chronic problems with the thyroid gland. The blood composition of patients suffering from a lack of the hormones TSH and T4, as well as people with CFS, is similar. If this conclusion is correct, then an iodine diet can return a patient with the syndrome to normal life.

Risk factors

Representatives of professions exposed to constant stress, from whom increased responsibility and concentration are required - air traffic controllers, military personnel, firefighters, surgeons.
Workers with intense mental work who ignore vacations and weekends.
Teenagers preparing to enter university, students during the session.
Not receiving adequate nutrition.
Sleep deprived.
Leading a sedentary lifestyle.
Living in an unfavorable ecological environment.
Not getting enough sunlight and fresh air.
Those experiencing life's troubles and troubles.
Possessors of a suspicious, conflicting psychotype.

Thus, the main factor leading to the occurrence of CFS is of a nervous nature - emotional burnout, nervous stress, insomnia, mental fatigue. All this provokes endocrine and metabolic disruptions in the body, reducing the protective forces of the immune system.

What to look for when diagnosing CFS

How to recognize chronic fatigue syndrome: signs and symptoms

Jamming the nervous system in a constant state of emergency is fraught with serious health problems and far-reaching consequences, so it is important to recognize the “enemy” in the early stages in order to know how to deal with it.

Symptoms of CFS are divided into mental and somatic.

Decreased performance - absent-mindedness, problems with concentrating, remembering, systematizing information, inability to perform creative activities.
Psychological disorders - depression, anxiety, anxiety, irritability, gloomy thoughts.
Intolerance to bright light.

Decreased physical activity - weakness, feeling tired and exhausted even after doing simple work.
Migraines - frequent, accompanied by “pulsation of the temples”, dizziness.
Insomnia - despite fatigue, sleep does not come or is weak and intermittent.
Tachycardia.
Enlarged and painful lymph nodes.
Impaired motor functions - muscle and joint pain, hand tremors, muscle weakness.
Decreased immunity - pharyngitis, sore throat, frequent colds, exacerbation of chronic diseases.

Symptomatic diagnosis of chronic fatigue syndrome

The presence of these symptoms is a reason to consult a doctor so that he can prescribe the necessary studies and tests. And based on the results obtained, he made an expert opinion and prescribed treatment. It is useless to wait for it to “go away on its own”, just as it is useless to hope that this is normal overwork and that it is enough to go to the seaside and sleep on the weekend. Neither a change in activity nor a change in environment will help with CFS. Qualified treatment is required.

Note: a full examination is also important because such dangerous diseases as early stage oncology and tuberculosis are cleverly disguised as chronic fatigue syndrome.

Doctors you should contact

Psychologist/psychotherapist - for symptoms such as insomnia, anxiety, and increased psycho-emotional stress.
Neurologist - for migraines, dizziness, decreased performance, depressive states that arise against the background of constant stress and nervous tension.
Endocrinologist - for tremors, muscle pain, constant state of weakness and fatigue.
Immunologist - for frequent colds and exacerbations of chronic diseases.
Therapist - if the symptoms are difficult. The therapist will either prescribe treatment himself or give a referral to the right specialist.

Basic treatment methods

The disease requires complex therapy, which includes 4 important components:

Adequate rest - a deep night's sleep of at least 8 hours, daily half-hour walks in the fresh air.
Balanced nutrition - high-quality products that supply the body with the necessary amount of proteins, fats and carbohydrates, vitamins and minerals. Minimize or eliminate sweets, which cause sudden spikes in blood sugar, which a weakened body does not need.
Psychotherapy is the help of a psychologist or psychotherapist aimed at improving mood, self-confidence, and getting out of a stressful situation.
A competent daily routine - eliminating overload, emotional and physical, alternating work and rest, 3 food breaks, more time in the fresh air.

Note: it is important to treat diseases that can provoke constant hypoxia - sinusitis, rhinitis or chronic inflammation - carious teeth, tonsillitis.

Drug treatment

In addition to psychotherapeutic treatment, medications are often prescribed for CFS. There are 5 groups of drugs that are used for therapy.

Non-steroidal anti-inflammatory drugs. They are prescribed for pain syndromes - headaches, muscle pain, joint pain.
Vitamin complexes. Their goal is to restore proper metabolism, the body’s energy reserves, and strengthen the immune system - B vitamins, magnesium.
Immunomodulators. They are prescribed to increase the body's immune forces and its resistance to infections, viruses.
Antiviral drugs. They fight viruses in the body and prevent their reproduction.
Psychotropic drugs. Antidepressants and daytime tranquilizers normalize the functioning of the nervous system. Relieves feelings of restlessness and anxiety.

The fact that taking tonics, such as eleutherococcus and lemongrass, is useful for raising vitality is a myth. In fact, they are not able to eliminate any of the causes of a decrease in vitality. Their intake by people with chronic fatigue syndrome will only lead to an increased consumption of internal reserves, which are already scarce. As a result, worsening health problems.

Taking tonic drugs is indicated only for healthy people who are facing serious physical or nervous stress.

Treatment at home

At home, simple folk remedies and preventive measures are available, in which there is also nothing complicated.

You can resort to traditional medicine methods and prepare an “invigorating oil”.

For this you will need:

olive oil - 1 bottle;
fresh rosemary - 1 teaspoon.

Mix and use when cooking.

Licorice root is an excellent anti-inflammatory agent that reduces the level of cortisol in the blood. Its regular use (2 g each) can restore vitality in 2 weeks.

Aromatherapy with lavender oil, rosemary or sandalwood. A few drops - on a handkerchief and inhale. Helps to relax, promote healthy sleep.

Breaks every 2 hours.
Physical activity - walking, swimming, morning exercises.
Refusal of bad habits and fast food.
Increase in the diet of fresh vegetables and fruits with the addition of nuts, honey, berries.
A full 8 hours of sleep.
Change of scenery - trips to nature, out of town, visits to resorts.

Acupuncture is often used to combat chronic fatigue.

Useful physiotherapy for chronic fatigue syndrome

Acupuncture / acupuncture - impact on certain points of the body helps relieve pain, calms the nervous system, restores energy balance. It has a positive effect on the immune system, helps relieve tension, both muscular and nervous.
Massage - therapeutic, acupressure, lymphatic drainage. Improves blood circulation and lymph flow, metabolic processes, helps cleanse the body of waste and toxins, and improves immunity.
Therapeutic exercise - activation of different muscle groups, improvement of blood circulation and restoration of energy.
Laser therapy - activates metabolism, stimulates the activity of the nervous system.
Magnetotherapy - has a good effect on the endocrine and immune systems. Has analgesic and relaxing effect.
Hydrotherapy - water treatments relieve stress, soothe and relax.

Can idleness be cured?

The answer to this question is not as simple as it seems. On the one hand, there is a common misconception that laziness is an excuse for those who avoid work. In fact, laziness may be a manifestation of a natural instinct - the desire to save vitality.

Important: if the desire to lie down and rest arises often and becomes regular, then this is an alarming signal that the body is on the verge and its supply of vitality has depleted. Laziness can be evidence of both CFS and another serious illness.

On the other hand, there is another persistent myth: “Chronic fatigue will go away if you rest a little.”

It won't work! If a person is healthy, then even with heavy physical activity his strength will be restored after a night's sleep. With CFS, you can not bother with anything, sleep all night and the next morning feel completely broken and empty.

The causes of fatigue are inside, not outside. For example, this could be a malfunction of the thyroid gland, which slows down metabolism and deprives the brain of adequate nutrition.

Fact: 14% of patients referred to a psychiatrist with signs of depression and weakness actually suffer from a low thyroid function.

The question arises: what leads to a malfunction of the thyroid gland? Psychologists believe that the imbalance between stimuli is to blame for this - those that are sent to us by the external environment and those that we give in response.

Most often this occurs in housewives and people of monotonous work. They don't get enough stimulation of their nervous system. In other words, they lack impressions, a certain dose of stress, so that the body has the opportunity to shake itself up, mobilize and react properly.

When there are few such incentives, the settings begin to go astray. A similar situation occurs when there is too much stress.

Everything is good in moderation. Achieving the golden mean, finding harmony with yourself and the world around you will become the very antidote that will save humanity from the disease of the 21st century - chronic fatigue syndrome.

Fatigue test

Usually those who already feel that they have practically left the strength want to take the fatigue test. Perhaps there is no clear understanding of the cause of overwork, but you need to learn in detail about its root and what to do about it. It is important to understand why the body is so overworked, and in order to do this, it is useful to pass a special psychological test for fatigue.

It is possible that chronic fatigue syndrome (CFS) comes from another, more serious underlying condition. Maybe overwork came as a result of incorrect formation of thinking, or recently there have been many stressful situations in life. It may also turn out that the cause of moral fatigue lies in constant physical stress, or vice versa, its absence.

Why fatigue came: a test to determine the cause

The upcoming test will help to find out internal patterns and understand what is going wrong in life. One should read the indicated questions, and then honestly choose the most appropriate, and reflective of the current state of the answer.

When is fatigue most pronounced?

The statement that most accurately describes patterns between wakefulness and sleep.

A. In the morning you feel tired, and by lunchtime you want to lie down.
B. It is difficult to fall asleep, but awakening occurs early in the morning.
C. Lots of things to do, no time to get enough sleep.
D. Sleep well, the morning is cheerful, I have enough energy.

Which statement is most accurate regarding nutrition?

A. You have to eat irregularly throughout the day.
B. Breakfast is skipped, but lunch and dinner are included.
C. Full meals - three times a day, while lunch and dinner are solid.
D. Meals are regular, several times a day.

What food is the most preferred?

A. Favors fatty, salty and sweet foods.
B. Habitual in the diet of cereals and pasta.
C. More inclination towards hearty-type meals.
D. Nutrition is improved, there is more plant-based food, and portions are moderate.

What is stress exposure?

A. Constant tension, worries and anxiety.
B. There are worries about obligations and ordinary life problems.
C. Calm always, except for unpleasant situations that cause experience.
D. There is self-control, but it happens that the stressful situation periodically absorbs completely.

How well do you manage your emotions independently?

A. I usually manage my emotions.
B. Sometimes you can control them perfectly, but sometimes they take over.
C. Feeling depressed often comes.
D. Every day, regardless of the emotional background, time is allocated for relaxation.

How often do you have physical activity in your life?

A. Extremely rare.
B. Lifestyle is sedentary, but a walk is performed every day.
D. Regular moderate physical activity, which only gives more energy and strength.

What do you usually do with your free time?

A. It is practically non-existent.
B. Free time is spent relaxing and calming down.
C. It’s practically impossible to relax; my head is full of unnecessary thoughts, even during free time.
D. Free hours are spent on hobbies, family and friends.

The most preferred drink that is consumed most often?

A. This is usually coffee, or, in extreme cases, strong tea.
B. Carbonated drinks.
C. There is no particular difference in what to drink, but in general, it is preferable to drink with friends.
D. Pure water or juices.

How would you like to continue living, or in what direction should you change it?

A. Live without frequent stress.
B. Stop worrying about lack of strength.
C. I would like to manage my life better.
D. Become the leader and soul of the company.

Test: chronic fatigue syndrome

Try as honestly, sincerely, to answer “yes” or “no” to all questions of this small test. So:

1. When you wake up in the morning, do you need to “swing” longer than usual, making an effort on yourself in order to get involved in your usual (including work) life?

2. In the midst of work, do you begin to feel a drop in its productivity, the need to strain, to make additional efforts for its quality performance?

3. Do you need some kind of “dope” (coffee, strong tea…) to feel in good shape at least during working hours?

4. Have you begun to react badly to weather changes that cause you pain in your back, joints, headaches, weakness?

5. Does your appetite go up and down?

6. Have you started to experience unpleasant, sometimes painful sensations in the heart area?

7. Are your hands and feet starting to feel cold?

8. Have you started to worry about some dysfunctions, some disturbances in the functioning of the gastrointestinal tract?

9. Have you become increasingly irritable, hot-tempered, or have you had episodes of causeless depression in your mood?

10. Have you started to experience allergic reactions or become more frequent?

11. Does your sex drive decrease?

12. Has your sleep become intermittent, restless, superficial, or have you had trouble falling asleep?

Find opportunities to fully rest and relax

First of all, you should not allow the occurrence and development of chronic fatigue. But not every person succeeds in avoiding stress and establishing a rational, healthy lifestyle.

To do this, you should sleep at least 8 or even 9 hours. And if possible, add sleep during the daytime.

The so-called can help relieve muscle tension. relaxation exercises based on releasing tension from muscles and maximizing their relaxation.

Positive emotions also help to relax. And their occurrence is facilitated by various kinds of hobbies (including the sauna, which is fashionable these days, but you shouldn’t be in it to the point of weakness and dizziness), music, and simply rational relaxation. The pleasure hormones produced during this process - endorphins - relieve irritability, unmotivated excitability, and pain, and, of course, improve mood.

Do exercises

While working, it is best to do a light warm-up every two hours. Then you can sit, relax and slightly wiggle your fingers and toes in your work chair.

If your job (and your boss) allows, you can warm up with the following simple exercises:

2) You can use self-massage to “recharge your internal battery.”

Change clothes after work

Do self-massage

In addition, by rubbing your hands under running water, you will influence certain biologically active points, performing a kind of tonic self-massage.

Drink vitamin drinks and moderate the influence of bad habits

Further information: Causes of chronic fatigue

Chronic fatigue syndrome: symptoms and diagnosis

The modern world requires maximum effort and constant tension from a person. All you have to do is relax a little and you're already out of your element. That's why most people are always in a hurry to get somewhere, live at a frantic pace and don't give themselves a moment's rest.

This behavior has a downside in the form of health problems. Moreover, they result in completely different diseases: some are overcome by frequent acute respiratory infections, some experience hormonal imbalances, and some even get cancer this way. The formulations of the main diseases are more or less understandable to the common man. But since the end of the last century, an official separate disease has appeared in medicine under the strange name “chronic fatigue syndrome.” Yes, yes, chronic fatigue, today, is a disease, and not just a temporary condition. And like every disease, chronic fatigue syndrome has its own causes, symptoms and treatments. Since a state of prolonged fatigue has accompanied almost every one of us at least once in our lives, let’s try to figure out where is the line between normal and pathological? What is considered ordinary fatigue, and what is considered a disease? How to determine if a person has chronic fatigue syndrome? You can find answers to these questions by reading this article.

Definition

The official definition of chronic fatigue syndrome is something like this: chronic fatigue syndrome (CFS) is a disease characterized by excessive physical and mental fatigue, lasting at least 6 months, not relieved by rest or sleep, accompanied by numerous joint, muscle, infectious and neuropsychological symptoms. Thus, it becomes clear that fatigue can be considered a disease only if it exists for at least six months and in combination with other symptoms.

The first mention of chronic fatigue syndrome dates back to the 30s of the twentieth century, but until 1988 the wording was different. Synonyms for CFS are the following: benign myalgic encephalomyelitis, chronic mononucleosis, myalgic encephalopathy, post-viral fatigue syndrome. This is how the disease was called throughout the 20th century. Such different formulations of the same condition were associated with the search for the immediate causes of CFS. Since the only cause was never established, scientists decided to associate the name with the main symptom. So, in 1988, the Americans proposed the term “chronic fatigue syndrome,” and since 1994 the name has become international.

Causes of CFS

A reliable source of CFS development has not yet been established. There are only assumptions about the leading role of one or another process in each specific case. Among the conditions with which CFS is directly linked, it is worth noting the following:

past viral infections (Epstein-Barr virus, Coxsackie virus group B, cytomegalovirus, herpes virus type 6, hepatitis C virus, enteroviruses);
disturbances in the control of body functions by the nervous system. This is especially true for the autonomic nervous system, the sphere of higher nervous activity (memory, thinking, and so on);
mental disorders. In most cases of CFS, precursors are identified in the form of changes in mood, feelings of unmotivated anxiety;
being in a state of chronic stress;
unfavorable environmental conditions combined with an unhealthy lifestyle. Residents of large cities who work too hard, with an inadequate diet, without a sufficient amount of physical activity and in conditions of constant lack of sleep are the first candidates for CFS.

It cannot be said that any one of the above factors is decisive or more significant. Modern scientists believe that it is the coincidence of a number of conditions that leads to the development of CFS.

There are predisposing factors for CFS. This:

female gender (according to statistics, 60-85% of all those suffering from this pathology are women);
increased emotionality (cholerics are more likely to suffer from CFS);
age;
presence of a responsible profession (doctors, firefighters, emergency workers, pilots, etc.).

Symptoms

The main symptom of CFS is physical and mental fatigue, which bothers the person for at least 6 months. Fatigue seems overwhelming to the patient. “I’m squeezed like a lemon,” “I’m exhausted to the point of exhaustion,” “it’s like I’ve been put through a meat grinder,” this is approximately how patients with CFS formulate their feelings. The difference between simple overwork and chronic fatigue syndrome is that with CFS, no rest helps restore the body's strength. Neither sleep nor vacation with a change of scenery in any way affects the feeling of fatigue. However, you should not confuse the condition of CFS with depression. With depression, a person does not want to do anything, does not strive for anything, but with CFS the situation is the opposite - desires do not coincide with possibilities.

In addition to feeling tired, a patient with CFS has other symptoms:

pain. This can be joint and muscle pain, pain in the abdomen, throat, chest, eyes, bones, perineum, genitals, skin, headaches. The pain tends to migrate from place to place and lacks stability. Pain in the same place has different sensations (“yesterday it was shooting, today it aches or stings”);
deterioration of memory and attention. These changes are noticed by the patient and cause him a lot of trouble;
sleep disturbances (difficulty falling asleep, intermittent night sleep and, as a result, daytime sleepiness);
decrease in working capacity;
irritable bowel syndrome (bloating, nausea, diarrhea, abdominal pain);
trembling and sweating at night;
low or high body temperature (up to 36.0°C and 38.0°C, respectively);
difficulty breathing (“something is stopping you from breathing”), chronic cough in the absence of objective reasons for it;
increased sensitivity to noise, light;
sudden intolerance to smells and tastes that you previously liked;
problems associated with changing body position. In this case, we mean dizziness, increased heart rate, and faintness when changing body position from horizontal to vertical;
instability of mood, anxiety, irritability, apathy, unreasonable fears;
decrease or increase in body weight;
frequent colds.

Of course, not all symptoms are observed in every patient. Fatigue usually accompanies several additional complaints.

When analyzing all the above symptoms, one important fact should be taken into account: all of them can be regarded as indirect signs of CFS only if there are no other health problems. That is, for example, if a person suffers from migraines and has an intolerance to bright light and loud sounds, then this cannot be regarded as a symptom in the case of CFS. Modern medicine has identified a whole group of conditions, the presence of which obviously excludes the possibility of making a diagnosis such as chronic fatigue syndrome. These include:

chronic somatic diseases (hepatitis B or C, hypothyroidism, diabetes mellitus, severe anemia, chronic renal failure, chronic heart failure, bronchial asthma, cancer, and so on);
some mental disorders (anorexia or bulimia, dementia, depression, manic-depressive disorder, schizophrenia);
addiction to alcohol or drugs within 2 years before the onset of symptoms of chronic fatigue syndrome;
excess body weight (3rd degree obesity);
taking medications that themselves can provoke a feeling of general weakness (for example, muscle relaxants, tranquilizers).

Today, official medicine has the following interesting information about the duration of CFS. The average lifespan of the disease is about 5-7 years, although cases of CFS lasting more than 20 years have already been described. Such a long existence of the disease is probably due to an underestimation of symptoms, a lack of perception of one’s condition as a disease, and also, to be honest, with the illiteracy of medical personnel, who often dismiss people with CFS.

Often the disease has an undulating course with periods of slight improvement in well-being. Periods of partial or even complete remission are possible, but relapses almost always occur. Constant fatigue prevents a person from working, so up to 2/3 of all patients with such problems do not work at all or have part-time work.

Diagnostics

There is no specific diagnostic test or examination for CFS. Domestic medicine generally rarely establishes such a diagnosis. And, nevertheless, since such a disease exists, let's try to understand the intricacies of its diagnosis.

In 1994, clinical criteria for chronic fatigue syndrome were developed. According to them, to establish a diagnosis of CFS, the presence of 4 or more of the following 8 symptoms is necessary:

deterioration of memory, ability to concentrate;
pain when palpating the cervical or axillary lymph nodes;
pain or feeling of muscle tension;
joint pain (without other signs of joint damage such as redness or swelling);
new headache or change in the characteristics of a previously existing headache;
unproductive sleep (without feeling of recuperation);
increased fatigue up to complete exhaustion after any physical or mental stress, lasting more than a day.

The next important step in diagnosing chronic fatigue syndrome is to exclude other diseases that may manifest symptoms of CFS. To do this, an exhaustive examination of the patient is carried out (after all, the symptoms are so nonspecific and can serve as a manifestation of a huge number of somatic problems). The main studies include:

general blood test (including determination of leukocyte formula, ESR, platelets);
biochemical parameters (liver and kidney tests, protein, glucose, calcium, sodium, potassium, alkaline phosphatase and others);
general urine analysis;
acute phase reactions (determination of C-reactive protein and rheumatoid factor);
specific tests for infectious diseases (they are carried out if the patient associates the appearance of symptoms with a previous infectious disease): examination for syphilis, viral hepatitis, herpes viruses, toxoplasmosis, chlamydia, candidiasis, and so on. An HIV test is mandatory for every patient who complains of constant fatigue;
study of the patient’s hormonal background;
electrocardiography;
MRI (magnetic resonance imaging) of the brain;
polysomnography (computer study of the sleep period with simultaneous recording of many indicators).

This is by no means the entire range of possible examinations. Their list may be different, depending on the complaints of a particular patient (for example, for chronic cough, a chest x-ray is necessary). You may need to consult several specialists (otorhinolaryngologist, ophthalmologist, gastroenterologist, cardiologist, infectious disease specialist, oncologist and others) to ensure that there is no organic cause of CFS. We can say that chronic fatigue syndrome is more of a diagnosis of exclusion than of establishing specific disorders.

In addition to laboratory and instrumental research methods, patients undergo a screening study of cognitive and mental status. They are also asked to complete special questionnaires developed for CFS (Multidimensional Fatigue Questionnaire, Quality of Life Questionnaire, McGill Pain Questionnaire and Sleep Quality Questionnaire). Such a versatile and multifaceted study of the human body allows us to clarify the nature of the disorders.

The result of the examination is as follows: in the absence of obvious signs of another disease and the presence of at least 4 clinical criteria out of 8 (from 1994), we can talk about the presence of CFS.

Chronic fatigue syndrome is a relatively new formulation of modern human health problems associated with urbanization and the accelerated pace of life. Humanity has existed for many centuries, but only the last 100 years have been associated with such a condition as chronic fatigue syndrome. And although CFS is not yet a very common diagnosis, perhaps in the future much more attention will be paid to this problem due to the increasing number of cases of treatment with this pathology.

Channel “Israeli Medicine”, program on the topic “Chronic Fatigue Syndrome”:

Chronic fatigue syndrome

Chronic fatigue syndrome is a disease characterized by excessive, disabling fatigue that persists for at least 6 months and is accompanied by numerous joint, infectious and neuropsychiatric symptoms.

Chronic fatigue syndrome is defined as prolonged, severe, disabling fatigue without obvious muscle weakness. There are no associated disorders that could explain the fatigue. There are typically no depression, anxiety or other psychological diagnoses. Treatment is rest and psychological support; often with the use of antidepressants.

ICD-10 code

Epidemiology

This definition of chronic fatigue syndrome (CFS) has several variations, and the heterogeneity of patients who meet the criteria for this definition is significant. Prevalence cannot be accurately determined; it varies from 7 to 38/person. Prevalence may vary due to differences in diagnostic evaluation, physician-patient relationships, social acceptability, risk of exposure to an infectious or toxic substance, or case identification and definition. Chronic fatigue syndrome is more common in women. Office-based studies have shown that the incidence is higher among people with white skin color. However, reviews of various communities indicate a higher prevalence among people of color, Hispanics, Latin Americans, and American Indians.

Approximately every fifth patient (10-25%) seeking medical help complains of prolonged fatigue. Typically, the feeling of fatigue is a transient symptom that disappears spontaneously or with treatment of the underlying disease. However, in some patients this complaint begins to persist and have a negative impact on their overall health. When fatigue cannot be explained by any disease, it is assumed that it is associated with chronic fatigue syndrome, the diagnosis of which can only be made after excluding other somatic and mental disorders.

The prevalence of chronic fatigue syndrome in the adult population, according to some data, can reach 3%. Approximately 80% of all cases of chronic fatigue syndrome remain undiagnosed. Children and adolescents develop chronic fatigue syndrome much less frequently than adults. The peak incidence of chronic fatigue syndrome occurs in active age (40-59 years). Women in all age categories are more susceptible to chronic fatigue syndrome (60-85% of all cases).

Causes of Chronic Fatigue Syndrome

Initially, they were inclined to the infectious theory of the development of chronic fatigue syndrome (viral infection), but further research revealed a wide variety of changes in many areas, including the structure and function of the brain, neuroendocrine response, sleep structure, immune system, and psychological profile. Currently, the most common stress-dependent model of the pathogenesis of chronic fatigue syndrome, although it cannot explain all the pathological changes characteristic of this syndrome. Based on this, most researchers postulate that chronic fatigue syndrome is a heterogeneous syndrome, which is based on various pathophysiological abnormalities. Some of them may predispose to the development of chronic fatigue syndrome, others directly cause the development of the disease, and still others determine its progression. Risk factors for chronic fatigue syndrome include female gender, genetic predisposition, certain personality traits or behavioral style, etc.

Stress-dependent hypothesis

The premorbid history of patients with chronic fatigue syndrome, as a rule, contains indications of a large number of stressful life events, previous infectious diseases and surgical interventions. Manifestation or exacerbation of chronic fatigue syndrome and its comorbid conditions in adults is often associated with stress or conflict situations.
Mental trauma in childhood (child abuse, abuse, neglect, etc.) is considered an important risk factor for the development of chronic fatigue syndrome. High reactivity to unfavorable psychosocial factors is characteristic of the entire spectrum of disorders associated with mental trauma in childhood. Early life stress, during a critical period of increased brain plasticity, persistently impacts brain regions involved in cognitive-emotional processes and regulating the endocrine, autonomic, and immune systems. There is experimental and clinical evidence that traumatic events experienced at a young age lead to long-term disruption of the hypothalamic-pituitary-adrenal system and a more pronounced reaction to stress. However, not all patients with chronic fatigue syndrome have a history of childhood psychological trauma. Probably, this mechanism can play a leading role in the pathogenesis of only a certain group of patients with chronic fatigue syndrome.
Comprehensive studies of neuroendocrine status in chronic fatigue syndrome have revealed significant changes in the activity of the hypothalamic-pituitary-adrenal system, which confirms a violation of the physiological response to stress. One third of patients with chronic fatigue syndrome have hypocortisolism, which is likely to be of central origin. Also worthy of attention is the discovery in families of patients with chronic fatigue syndrome of a mutation that disrupts the production of a protein necessary for the transport of cortisol in the blood. Women (but not men) with chronic fatigue syndrome have a reduced morning cortisol peak compared to healthy women. These sex differences in the circadian rhythm of cortisol production may explain the higher risk of chronic fatigue syndrome in women. Low cortisol levels lead to disinhibition of immune mediators and determine the response to stress of the suprasegmental parts of the autonomic nervous system, which in turn causes fatigue, pain phenomena, cognitive impairment and affective symptoms. Taking serotonin agonists in patients with chronic fatigue syndrome leads to a greater increase in plasma prolactin levels compared to healthy individuals. In patients suffering from major depression, the pattern of neuroendocrine disorders is reversed (hypercortisolism, serotonin-mediated suppression of prolactin). In contrast, depletion of morning cortisol levels has been observed in individuals suffering from chronic pain and various emotional disorders. Currently, dysfunction of the hypothalamic-pituitary-adrenal axis, the hormonal response to stress, and the neurotransmitter effects of serotonin are the most reproducible changes found in patients with chronic fatigue syndrome.
Patients with chronic fatigue syndrome are characterized by a distorted perception of natural bodily sensations as painful symptoms. They are also characterized by increased sensitivity to physical stress (low threshold for changes in heart rate, blood pressure, etc.). A similar pattern of impaired perception can be observed in relation to stress-related bodily sensations. It is believed that perceptual disturbances, regardless of the etiology of chronic fatigue syndrome, are the basis for the appearance and persistence of symptoms and their painful interpretation.

Central nervous system disorders. Some symptoms of chronic fatigue syndrome (fatigue, impaired concentration and memory, headache) suggest the pathogenetic possibility of dysfunction of the central nervous system. In some cases, MRI reveals nonspecific changes in the subcortical white matter of the brain, which, however, are not associated with cognitive impairment. Regional abnormalities in cerebral perfusion (usually hypoperfusion) on SPECT scans are typical. In general, all changes identified to date are not clinically significant.

Autonomic dysfunction. D.H. Streeten, G.H. Anderson (1992) suggested that one cause of chronic fatigue may be failure to maintain blood pressure in an upright position. It is possible that a separate subgroup of patients with chronic fatigue syndrome has orthostatic intolerance [the latter refers to symptoms of cerebral hypoperfusion, such as weakness, lipothymia, blurred vision, occurring in an upright position and associated with sympathetic activation (tachycardia, nausea, tremors) and an objective increase in heart rate more than 30 per minute]. Postural tachycardia associated with orthostatic intolerance is quite often observed in individuals with chronic fatigue syndrome. Symptoms characteristic of postural tachycardia (dizziness, palpitations, pulsations, impaired tolerance to physical and mental stress, lipothymia, chest pain, gastrointestinal symptoms, anxiety disorders, etc.) are also noted in many patients with chronic fatigue syndrome. The pathogenesis of postural tachycardia syndrome remains unclear; they suggest the role of baroreceptor dysfunction, increased sensitivity of alpha and beta adrenergic receptors, pathological changes in the venous system, disturbances in norepinephrine metabolism, etc. In general, in some patients, chronic fatigue syndrome may indeed be pathogenetically caused by autonomic dysfunction , manifesting orthostatic intolerance.

Infections. Epstein-Barr virus, herpes virus type 6, Coxsackie virus group B, T-cell lymphotropic virus type II, hepatitis C virus, enteroviruses, retroviruses, etc. were previously considered as possible etiological agents of chronic fatigue syndrome. evidence of the infectious nature of chronic fatigue syndrome has not been obtained. In addition, therapy aimed at suppressing viral infection does not improve the course of the disease. Nevertheless, a heterogeneous group of infectious agents continues to be considered as a factor contributing to the manifestation or chronic course of chronic fatigue syndrome.

Immune System Disorders. Despite numerous studies, only minor abnormalities in the immune status have been identified in patients with chronic fatigue syndrome. First of all, they relate to increasing the expression of active markers on the surface of T-lymphocytes, as well as increasing the concentration of various autoimmune antibodies. Summarizing these results, it can be stated that mild activation of the immune system is typical for patients with chronic fatigue syndrome, but it remains unknown whether these changes have any pathogenetic significance.

Mental disorders. Since there is no convincing evidence of a somatic cause of chronic fatigue syndrome, many researchers postulate that it is a primary mental illness. Others believe that chronic fatigue syndrome is one of the manifestations of other mental illnesses, in particular somatization disorder, hypochondria, major or atypical depression. Indeed, in patients with chronic fatigue syndrome, the incidence of mood disorders is higher than in the general population or among people with chronic somatic diseases. In most cases, mood disorders or anxiety precede the onset of chronic fatigue syndrome. On the other hand, the high prevalence of affective disorders in chronic fatigue syndrome may be the result of an emotional response to disabling fatigue, immune changes, and CNS disorders. There are other objections to the identification of chronic fatigue syndrome with mental illness. Firstly, although some manifestations of chronic fatigue syndrome are close to non-specific mental symptoms, many others, such as pharyngitis, lymphadenopathy, and arthalgia, are not at all typical for mental disorders. Secondly, anxiety-depressive disorders are associated with central activation of the hypothalamic-pituitary-adrenal system (moderate hypercortisolism), on the contrary, in chronic fatigue syndrome, central inhibition of this system is more often observed.

Symptoms of chronic fatigue syndrome

Subjectively, patients can formulate the main complaint in different ways (“I feel completely exhausted”, “I constantly lack energy”, “I am completely exhausted”, “I am exhausted”, “normal loads bring me to exhaustion”, etc. .). With active questioning, it is important to differentiate the actual increased fatigue from muscle weakness or a feeling of despondency.

Most patients rate their premorbid physical condition as excellent or good. Feeling extremely tired comes on suddenly and is usually associated with flu-like symptoms. The disease may be preceded by respiratory infections, such as bronchitis or vaccination. Less often, the disease has a gradual onset, and sometimes begins gradually over many months. After the onset of the disease, patients notice that physical or mental efforts lead to an aggravation of the feeling of fatigue. Many patients find that even minimal physical effort leads to significant fatigue and an increase in other symptoms. Prolonged rest or lack of physical activity can reduce the severity of many symptoms of the disease.

Often observed pain syndrome is characterized by diffuseness, uncertainty, a tendency to migration of pain sensations. In addition to muscle and joint pain, patients complain of headache, sore throat, soreness of the lymph nodes, abdominal pain (often associated with a comorbid condition - irritable bowel syndrome). Chest pain is also typical for this category of patients, some of them complain of "painful" tachycardia. Some patients complain of pain in unusual places [eyes, bones, skin (pain at the slightest touch to the skin), perineum and genitals].

Immune system changes include tenderness of the lymph nodes, repeated episodes of sore throat, recurrent flu-like symptoms, general malaise, and hypersensitivity to previously well tolerated foods and/or drugs.

In addition to the 8 main symptoms that have the status of diagnostic criteria, patients may have many other disorders, the frequency of which varies widely. Most often, patients with chronic fatigue syndrome note a decrease in appetite up to anorexia or its increase, fluctuations in body weight, nausea, sweating, dizziness, poor tolerance to alcohol and drugs that affect the central nervous system. The prevalence of autonomic dysfunction in patients with chronic fatigue syndrome has not been studied; nevertheless, autonomic disorders have been described both in individual clinical observations and in epidemiological studies. More often than others, orthostatic hypotension and tachycardia, episodes of sweating, pallor, sluggish pupillary reactions, constipation, frequent urination, respiratory disturbances (feeling of lack of air, obstruction in the airways or pain when breathing) are observed.

Approximately 85% of patients complain of impaired concentration, memory impairment, however, routine neuropsychological examination usually does not reveal impaired mnestic function. However, an in-depth study often reveals minor, but undoubted violations of memory and digestibility of information. In general, patients with chronic fatigue syndrome have normal cognitive and intellectual capabilities.

Sleep disorders are represented by difficulty falling asleep, interrupted night sleep, daytime sleepiness, while the results of polysomnography are highly variable. The most commonly described are “alpha intrusion” (imposition) during non-REM sleep and a decrease in the duration of stage IV sleep. However, these findings are unstable and do not have diagnostic value; in addition, sleep disturbances do not correlate with the severity of the disease. In general, fatigue should be clinically distinguished from drowsiness and take into account that drowsiness can either accompany chronic fatigue syndrome or be a symptom of other diseases that exclude the diagnosis of chronic fatigue (for example, sleep apnea syndrome).

Almost all patients with chronic fatigue syndrome develop social maladjustment. Approximately a third of patients are unable to work and another third prefer part-time professional employment. The average duration of the disease is 5-7 years, but symptoms can persist for more than 20 years. The disease often occurs in waves, with periods of exacerbation (deterioration) alternating with periods of relatively good health. Most patients experience partial or complete remissions, but the disease often recurs.

Additional symptoms identified in patients with chronic fatigue syndrome

Irritable bowel syndrome (abdominal pain, nausea, diarrhea, or bloating).
Chills and sweats at night.
Feeling of fog, emptiness in the head.
Chest pain.
Labored breathing.
Chronic cough.
Visual disturbances (blurred vision, intolerance to bright light, eye pain, dry eyes).
Food allergies, hypersensitivity to alcohol, odors, chemicals, medications, noise.
Difficulty maintaining an upright position (orthostatic instability, irregular heartbeat, dizziness, unsteadiness, fainting).
Psychological problems (depression, irritability, mood swings, anxiety, panic attacks).
Pain in the lower half of the face.
Increase or decrease in body weight

The feeling of excessive fatigue, as well as chronic fatigue syndrome itself, is comorbid with many functional diseases, such as fibromyalgia, irritable bowel syndrome, post-traumatic stress disorder, mandibular joint dysfunction, chronic pelvic pain, etc.

Diagnostic criteria

Chronic fatigue syndrome has been described many times under various names; searching for a term that most fully reflects the essence of the disease. continue to this day. The following terms were most often used in the literature: “benign myalgic encephalomyelitis” (1956), “myalgic encephalopathy”, “chronic mononucleosis” (chronic infection with the Epstein-Barr virus) (1985), “chronic fatigue syndrome” (1988), “post-viral syndrome fatigue." ICD-9 (1975) did not mention chronic fatigue syndrome, but did include the term “benign myalgic encephalomyelitis” (323.9). ICD-10 (1992) introduced a new category - post-viral fatigue syndrome (G93).

The term and definition of chronic fatigue syndrome were first introduced by US scientists in 1988, who suggested a viral etiology of the syndrome. The Epstein-Barr virus was considered as the main pathogen. In 1994, a revision of the definition of chronic fatigue syndrome was carried out and in an updated version it acquired international status. According to the 1994 definition, the diagnosis requires persistence (or remittance) of unexplained fatigue that is not relieved by rest and significantly limits daily activities for at least 6 months. In addition, 4 or more of the following 8 symptoms must be present.

Problems with memory or concentration.
Pharyngitis.
Pain on palpation of the cervical or axillary lymph nodes.
Muscle soreness or stiffness.
Joint tenderness (no redness or swelling).
New headache or change in its characteristics (type, severity).
A dream that does not bring a feeling of restoration (freshness, vigor).
Worsening fatigue to the point of exhaustion after physical or mental effort, lasting more than 24 hours.

In 2003, the International Group on Chronic Fatigue Syndrome recommended the use of standardized scales to assess the main symptoms of chronic fatigue syndrome (impaired daily activities, fatigue and accompanying symptom complex).

Conditions that exclude the diagnosis of chronic fatigue syndrome are the following:

The presence of any current somatic diseases that may explain the persistence of chronic fatigue, such as severe anemia, hypothyroidism, sleep apnea syndrome, narcolepsy, cancer, chronic hepatitis B or C, uncontrolled diabetes, heart failure and other severe cardiovascular diseases , chronic renal failure, inflammatory and dysimmune diseases, diseases of the nervous system, severe obesity, etc., as well as taking medications, the side effects of which include a feeling of general weakness.
Mental illness (including history).
- Major depression with psychotic or melancholic symptoms.
- Bipolar affective disorder.
- Psychotic states (schizophrenia).
- Dementia.
- Anorexia nervosa or bulimia.
Abuse of drugs or alcohol for 2 years before the onset of fatigue and for some time after.
Severe obesity (body mass index 45 or more).

The new definition also includes diseases and conditions that do not exclude the diagnosis of chronic fatigue syndrome:

Disease conditions that are diagnosed based on clinical criteria only and that cannot be confirmed by laboratory tests.
- Fibromyalgia.
- anxiety disorders.
- Somatoform disorders.
- Non-melancholic depression.
- Neurasthenia.
Diseases associated with chronic fatigue, but whose successful treatment led to an improvement in all symptoms (the adequacy of therapy must be verified). For example, the success of replacement therapy for hypothyroidism must be verified by the normal level of thyroid hormones, the adequacy of treatment for bronchial asthma - by assessing respiratory function, etc.
Diseases associated with chronic fatigue and caused by a specific pathogen, such as Lyme disease, syphilis, if adequate treatment was carried out before the onset of symptoms of chronic fatigue.
Isolated and unexplained paraclinical abnormalities (changes in laboratory parameters, neuroimaging findings), which are not sufficient to strictly confirm or exclude any disease. For example, these findings may include elevated antinuclear antibody titers in the absence of additional laboratory or clinical evidence to reliably diagnose a connective tissue disorder.

Unexplained chronic fatigue that does not fully meet diagnostic criteria may be considered idiopathic chronic fatigue.

In 2007, the UK National Institute of Health (NICE) published less stringent criteria for chronic fatigue syndrome, recommended for use by various specialists.

The presence of new, persistent or recurrent fatigue (over 4 months in adults and 3 months in children), which:
- cannot be explained by any other disease;
- significantly limits activity level;
- characterized by malaise or worsening fatigue after any effort (physical or mental), followed by extremely slow recovery (over at least 24 hours, but usually within a few days).
The presence of one or more symptoms from the following list: sleep disturbance, muscle or joint pain of polysegmental localization without signs of inflammation, headache, tenderness of the lymph nodes without pathological enlargement, pharyngitis, cognitive dysfunction, worsening of symptoms with physical or mental stress, general malaise, dizziness and/or nausea, palpitations in the absence of organic heart pathology.

The NICE criteria for chronic fatigue syndrome have received considerable criticism from experts, which is why most researchers and clinicians continue to use the 1994 international criteria.

Along with chronic fatigue syndrome, secondary forms of this syndrome are also identified in a number of neurological diseases. Chronic fatigue is observed in multiple sclerosis, Parkinson's disease, motor neuron diseases, chronic cerebral ischemia, strokes, post-polio syndrome, etc. Secondary forms of chronic fatigue are based on direct damage to the central nervous system and the influence of other factors indirectly related to the underlying disease, for example, depression that has arisen as a reaction to a neurological disease.

Diagnosis of chronic fatigue syndrome

There are no specific paraclinical tests to confirm the clinical diagnosis of chronic fatigue syndrome. At the same time, a mandatory examination is carried out to exclude diseases, one of the manifestations of which may be chronic fatigue. Clinical evaluation of patients with the leading complaint of chronic fatigue includes the following measures.

Detailed medical history, including medications used by the patient that may be causing fatigue.
Exhaustive examination of the patient’s somatic and neurological status. Superficial palpation of somatic muscles in 70% of patients with chronic fatigue syndrome with gentle pressure reveals painful points localized in various muscles, often their location corresponds to that of fibromyalgia.
Screening study of cognitive and mental status.
Carrying out a set of screening laboratory tests:
- general blood test (including leukocyte count and ESR determination);
- biochemical blood test (calcium and other electrolytes, glucose, protein, albumin, globulin, creatinine, ALT and AST, alkaline phosphatase);
- assessment of thyroid function (thyroid hormones);
- urine analysis (protein, glucose, cellular composition).

Additional studies usually include determination of C-reactive protein (a marker of inflammation), rheumatoid factor, and CPK (muscle enzyme) activity. Determination of ferritin is useful in children and adolescents, as well as in adults if other tests confirm iron deficiency. Specific tests confirming infectious diseases (Lyme disease, viral hepatitis, HIV, mononucleosis, toxoplasmosis, cytomegalovirus infection), as well as a serological panel of tests for Epstein-Barr viruses, enteroviruses, retroviruses, herpes viruses type 6 and Candida albicans are carried out only when a history of indications of an infectious disease. On the contrary, MRI of the brain and examination of the cardiovascular system are considered routine methods when chronic fatigue syndrome is suspected. To exclude sleep apnea, polysomnography should be performed.

In addition, it is advisable to use special questionnaires to help assess the severity of the disease and monitor its course. The most commonly used are the following.

The Multidimensional Fatigue Inventory-MFI assesses general fatigue, physical fatigue, mental fatigue, reduction in motivation and activity. Fatigue is defined as severe if the score on the general fatigue scale is 13 points or more (or on the activity reduction scale - 10 points or more).
Quality of life questionnaire SF-36 (Medical outcomes survey short form-36) to assess impairment of functional activity in 8 categories (limitation of physical activity, limitation of usual role activities due to health problems, limitation of usual role activities due to emotional problems, physical pain, general health assessment, vitality assessment, social functioning and general mental health). The ideal norm is 100 points. Patients with chronic fatigue syndrome are characterized by a decrease in functional activity (70 points or less), social functioning (75 points or less) and a decrease in the emotional scale (65 points or less).
List of CDC symptoms (CDC Symptom Inventory) for identifying and assessing the duration and severity of the symptom complex associated with fatigue (in a minimized form, it is a total assessment of the severity of 8 symptom-criteria of chronic fatigue syndrome).
If necessary, the McGill Pain Score and the Sleep Answer Questionnaire are also used.

Differential diagnosis

Chronic fatigue syndrome is a diagnosis of exclusion, that is, its formulation requires careful differential diagnosis to exclude many severe and even life-threatening diseases (chronic heart disease, anemia, thyroid pathology, tumors, chronic infections, endocrine diseases, connective tissue diseases, inflammatory diseases intestines, mental disorders, etc.).

In addition, it should be remembered that feeling tired can be a side effect of certain medications (muscle relaxants, analgesics, beta blockers, benzodiazepines, antihistamines and anti-inflammatory drugs, beta interferons).

Akioshi was born on August 19, 1961 in Kochi.

At the University of Tsukuba, the future professor studies the psychology and behavior of animals, as well as the brain activity of monkeys at the Department of Biology, and receives a bachelor's degree.

In 1991, Akioshi Kitaoka received a doctorate in psychology, specializing in illusions of movement, visual illusions, perception of geometric shapes, color, brightness and other visual phenomena.

According to Akioshi Kitaoka, with the help of pictures, so-called “visual illusions,” one can determine a person’s mental state; they help reflect his inner mood.

01. If the drawings are absolutely motionless, you have nothing to worry about, your mental health is in perfect order
The professor believes that such a result is possible in a balanced, calm and rested person

02. If the drawings move slowly, you need rest, both physical and mental
Particularly important is proper sleep, which is the best antidepressant.

03. Active movement of the pattern can serve as a symptom:
accumulated fatigue
the high level of stress you are currently experiencing
deterioration in health

Perhaps you should reconsider your lifestyle and thinking patterns, turn to a psychologist for help in order to establish mental harmony and improve your health. Of course, this test cannot be used to accurately diagnose your mental state.

Look. Analyze. And be healthy!

To make sure that the image is static, you need to focus your vision on one area of the picture - the movement, if you observed it, stops. This convinces us that the movement of the drawing is created by our imagination.

Yes, Akioshi Kitaoka is also famous for the fact that Gaga used his drawings for the album cover.

Yes! Pictures can be printed and hung above the table. For current diagnostics, so to speak!

Be healthy!