6 Tips to Deal with the Cognitive Symptoms of Chronic Fatigue Syndrome

There is no magic bullet, but practical ways to manage CFS symptoms exist.

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

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

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

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

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

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

CFS is a collection of symptoms for a specific condition. This condition is known for causing extreme tiredness that lasts for more than six months.

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

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

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

Based on my research and observations of some people in my circles, In this article, I will discuss the common symptoms of CFS, three key points to understanding cognitive symptoms, and six easy and practical tips to address overall symptoms.

Awareness of CFS Symptoms

CFS is a complex and long-lasting illness that affects multiple systems in the body, leading to various symptoms. However, not everyone with CFS will experience all these symptoms. Having all of them is not necessary for a diagnosis.

Neurocognitive challenges top the list. People with CFS might struggle with thinking, concentrating, learning, and remembering things and have trouble with their vision, coordination, muscle twitches, or tingling sensations — which are called neurocognitive problems.

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

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

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

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

Understanding the mechanisms of the following three critical effects in the brain can empower us to notice cognitive symptoms and follow the treatment plans better.

Step 1: Understand orthostatic stress.

Orthostatic stress is what happens when we stand up from a lying or sitting position. When we do this, gravity pulls blood down towards our feet.

This can cause a temporary decrease in blood pressure in our head and upper body. To counteract this, the body does a few things to ensure that our brain still gets enough blood.

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

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

Orthostatic stress is why we might feel a bit lightheaded or dizzy when standing up too quickly, especially if we’ve been sitting or lying down for a while. It’s a normal response as our body quickly adjusts to maintain proper blood flow to our brain.

Most people experience orthostatic stress without any problems. But sometimes, our bodies don’t compensate for the change in blood pressure well enough. This can lead to a condition called orthostatic hypotension, where the blood pressure drops significantly when we stand up. This can cause dizziness or even fainting.

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

There are a number of things we can do to manage orthostatic hypotension. We can get up slowly from a lying or sitting position, keep the body hydrated, avoid standing for long periods of time, wear compression stockings, and take medications to increase blood pressure if we have such a medical condition.

Step 2: Understand decreased cerebral blood flow.

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

Decreased CBF can happen for a number of reasons, like vasoconstriction, arteriosclerosis, thrombosis, and stroke. I will briefly explain them.

Vasoconstriction is when the blood vessels in the brain narrow, which decreases the amount of blood that can flow through them.

Arteriosclerosis is a condition in which the arteries in the brain harden and narrow, which can decrease blood flow.

Thrombosis is when a blood clot forms in an artery in the brain, which can block blood flow.

Stroke is a serious health condition that occurs when blood flow to the brain is interrupted.

Decreased cerebral blood flow can cause headaches, dizziness, confusion, Memory problems, and visual disturbances like blurry or double vision.

The exact cause of decreased cerebral blood flow in CFS is not fully understood. Some hypotheses in the literature attribute them to a combination of inflammation, stress, and poor circulation. These factors could contribute to the reduced blood flow observed in people with CFS.

Step 3: Understand increased brain activation.

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

This heightened brain activity can result in tiredness, cognitive difficulties (thinking, focusing, and remembering), headaches, and visual issues.

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

While the exact cause of this heightened brain activation in CFS isn’t entirely clear, hypotheses point to factors like stress, inflammation, and impaired circulation. These factors might push the brain to work harder, potentially leading to the symptoms observed in CFS.

Six Easy, Useful, and Powerful Tips to Lower CFS Symptoms

Let’s quickly explore some tactics to tackle the cognitive symptoms of chronic fatigue syndrome. These uncomplicated strategies can genuinely help us better manage our energy and boost our thinking abilities.

Tip 1: Pace yourself.

Pacing is a strategy that can help manage cognitive symptoms. Pacing involves breaking down tasks into smaller, more manageable steps. This allows us to rest when we need to and avoid getting overwhelmed.

Start with small tasks and gradually increase the amount of activity you do each day. Avoid multitasking. Plan ahead and schedule rest periods throughout the day. Find activities that are enjoyable and don’t require too much energy.

Pacing is not always easy. However, it is an essential strategy for managing CFS symptoms. By pacing ourselves, we can improve our energy levels, reduce fatigue, and improve our overall quality of life.

Tip 2: Take mental breaks.

Taking mental breaks can help us manage the cognitive symptoms of CFS. Mental breaks are short periods of time when we can relax and clear our heads. This can help us to reduce stress, improve our concentration, and boost our energy levels.

Get up and move around slowly. Take a short walk, stretch, or stand up and gently move your body. Get some fresh air and sunshine. Listen to calming music. Take a few deep breaths. And do something you enjoy, like reading a pleasant book or spending time with loved ones.

Taking mental breaks can be helpful for everyone, but they are vital for people with CFS. We can give our mind and body a chance to rest and recharge by taking mental breaks.

TIP 3: Listen to Your Body

Tuning into our body is crucial. Think of your body as a friendly companion. When it says, “Hey, I’m tired,” it’s wise to pay attention — no need to push too hard.

Taking frequent breaks is perfectly okay. We must observe the body’s cues before, during, and after breaks. Our nervous system gives us clues.

Our mind is like the captain steering the body’s ship. So, it’s necessary to let the mind decide when to ease up or take a day off by understanding the signals from the body.

TIP 4: Recharge and Relax to Beat Stress

Stress makes CFS worse. Therefore, rejuvenating the body and mind to beat stress is essential. Recharging and relaxing are important for everyone but significantly more important for people with CFS.

Imagine your brain as a battery that needs recharging. Sleep is like plugging in that battery. The brain also needs downtime to chill out. Meditate and try to work in a flow state where the body and mind use less energy.

Too much stress can make our thinking hazier. So, it’s crucial to kick stress to the curb every day, and even every hour, by embracing rest, mindful breathing, and gentle stretches.

Tip 5: Be careful with exercise.

Exercise, in general, can be helpful for many conditions. However, not everyone with CFS can tolerate exercise. If you are unsure whether or not exercise is right for you, you must discuss it with your family doctor.

In addition to cognitive symptoms, CFS patients often experience fatigue and post-exertional malaise (PEM). PEM is a worsening of CFS symptoms that can occur after physical or mental exertion.

Therefore, it is essential to be careful with exercise if you have CFS, as it can trigger PEM. Here are some tips for exercising safely with CFS:

Start slowly and gradually increase the amount of exercise you do.

Listen to your body and take frequent breaks when you need them.

Avoid exercising to the point of exhaustion.

Choose activities that are low-impact and do not require a lot of exertion.

Try yoga or tai chi, which are gentle exercises that can help to improve your fitness without triggering PEM.

TIP 6: Obtain timely professional support.

If these lifestyle strategies don’t work and our condition gets worse, there must be underlying conditions that imbalance the body and mind.

In this case, we need professional support for diagnosis and treatment plans.

In addition to medication, cognitive behavioral therapy can help us with CFS to learn how to manage our symptoms and improve our quality of life.

Concluding Insights and Takeaways

CFS can impact people of all ages, even young children. For kids, especially those under ten, expressing that something is wrong might be tough.

They might not realize that feeling tired or other symptoms they experience aren’t normal. Or they might lack the words to describe how they feel.

Both younger children and teenagers can have their schooling affected, but it’s important to note that CFS isn’t the same as school refusal.

While school refusal often accompanies physical complaints that fade when the child stays home, CFS symptoms behave differently.

Symptoms of CFS might not ease, and activity can trigger them. Symptoms tend to worsen after attending school, but pacing and rest can help, including taking time off or during breaks.

Considering CFS's energy limits, parents, healthcare professionals, schools, and young people must collaborate on an education plan. Flexibility and creativity are essential.

Creating a strong support network comprising family, friends, school, teachers, work, employers, and healthcare professionals is crucial to enhancing the quality of life for CFS patients of all ages.

It’s vital that everyone understands the Post Exertional Malaise situation, which limits the patient’s ability to engage in their previous activities.

Tailoring practical, social, and emotional support to each person’s unique needs and preferences is key to their well-being.

The key approaches might involve aiding with daily tasks, family responsibilities, healthcare access, and personal priorities. Our life is finite, and our well-being is an invaluable treasure.

I also document observations in story format and compile them in a collection. Regarding CFS, I wrote a story about a friend that you might find inspiring.

I trust this information will be beneficial for those facing challenges with CFS. If you find it useful, kindly share this story with others. I also wrote about many other conditions and compiled them in a list to find easily.

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

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You may find more optimistic and empowering stories like these on EUPHORIA, where I share my insights and life lessons. My focus is on cellular, mitochondrial, metabolic, and mental health + JOY. Here is my collection of Insightful Life Lessons from Personal Stories.

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