A gradual awakening stephen levine pdf


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Diagnosis is based on a person’s symptoms. Fatigue is a common symptom in many illnesses, but the unexplained fatigue and severity of functional impairment in CFS is comparatively rare. No medications or procedures have been approved in the United States. Estimates of the number of persons with the condition vary from 7 to 3,000 per 100,000 adults. 5 million Americans, and 250,000 people in the UK have CFS. CFS occurs more often in women than in men.

2 in 100 children are estimated to struggle with CFS, and it is more prevalent in adolescent than younger children. Medications can also cause side effects that mimic symptoms of CFS. Central sensitization, or increased sensitivity to sensory stimuli such as pain have been observed in CFS. Sensitivity to pain increases post-exertionally, which is opposite to the normal pattern. Studies have mixed results as to whether a gradual onset or sudden onset is more frequent. The functional capacity of individuals with CFS varies greatly.

For the majority of persons with CFS, work, school, and family activities are significantly reduced for extended periods of time. Persons report critical reductions in levels of physical activity. Also, a reduction in the complexity of activity has been observed. CFS affects a person’s functional status and well-being more than major medical conditions such as multiple sclerosis, congestive heart failure, or type II diabetes mellitus. Often, there are courses of remission and relapse of symptoms, which make the illness difficult to manage.

Persons who feel better for a period may overextend their activities, and the result can be a worsening of their symptoms with a relapse of the illness. CFS are house-bound or bedridden for long periods during their illness, often for decades. More than half were on disability benefits or temporary sick leave, and less than a fifth worked full-time. CFS patients were consistent with or not substantially lower than healthy controls. 51 billion a year in the U. 14 billion annually in the U.

Cognitive symptoms are mainly from deficits in attention, memory, and reaction time. The deficits are in the range of 0. 0 standard deviations below expected values, and are likely to affect day-to-day activities. Simple and complex information processing speed, and functions entailing working memory over long time periods were moderately to extensively impaired. These deficits are generally consistent with those reported by patients.

Perceptual abilities, motor speed, language, reasoning, and intelligence did not appear to be significantly altered. There is an increased frequency of neuropsychiatric and neuropsychological symptoms in persons with CFS. The cause of CFS is unknown. Genetic, physiological and psychological factors are thought to work together to precipitate and perpetuate the condition. CFS is a biologically-based illness, but that the biologic abnormalities are not sensitive enough to be useful diagnosis. It may begin as a flu-like illness with a sudden onset, or it may occur gradually. All ethnic groups and income levels are susceptible to the illness.

A 2009 meta-analysis, however, showed that compared with the White American majority, African Americans and Native Americans have a higher risk of CFS, though it acknowledged that studies and data were limited. The illness is reported to occur more frequently in persons between the ages of 40 and 59. CFS is less prevalent among children and adolescents than among adults. Blood relatives of those who have CFS appear to be more predisposed.

Psychological stress, childhood trauma, perfectionist personalities, old age, lower middle education, low physical fitness, preexisting psychological illness, and allergies may be risk factors for developing chronic fatigue syndrome. This has led some to believe that stress-related visceral responses underlie CFS. Pre-existing depressive and anxiety disorders, as well as high expectation of parents and family history were predisposing factors identified in another review. Such attributions are associated with increased symptoms and impairment, and worse outcomes over time. CFS which occurs after viral infection. Biological factors such as CD4 and CD8 activation and liver inflammation are predictors of sub-acute fatigue, but not CFS. A study comparing diagnostic labels found that people labelled with ME had the worst prognosis while those with PVFS had the best.