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Journalism of Courage
Twenty-nine-year-old Sidharth could not understand the cause of his ill-health. A South Delhi buisnessman, he was doing exceedingly well. Suddenly he started having joint pains and constant headaches. He would feel sleepy at work8212;that too around 10 to 11 am.
His life became a conscious battle against perpetual tiredness and trying to keep himself awake. It started affecting his life. And still, doctors found little that was physically wrong with him.
Sidharth was suffering from what is fast becoming the commonest urban malady8212;the Chronic Fatigue Syndrome CFS. Though there is no specific data for India, conservative estimates say globally, 10-15 per cent of the population suffers from it.
Doctors treating Sidharth said he had abused his body for years, working long hours. Lately, with the resignation of two of his trusted workers, the problem had worsened.
What is CFS
Chronic Fatigue Syndrome is severe fatigue lasting six months or longer. It may involve other medical conditions8212;kidney or liver diseases.
Four or more of the following symptoms can indicate CFS: Substantial impairment in short-term memory or concentration, sore throat, tender lymph nodes, muscle pain, multi-joint pain without swelling or redness, headaches, unrefreshing sleep and post-exertional malaise lasting over 24 hours.
Untreated, CFS leads to demotivation, mood swings and emotional changes.
Extreme cases feel paralytic.
Who8217;s in Danger
Sidharth, say doctors, belongs to a special category of people called the 8220;Type A personalities8221;.
8220;These people are achievers, set unrealistic targets for themselves and suffer in return,8221; said Dr Jitendra Nagpal, psychiatrist at VIMHANS in Delhi. To make things worse, 8220;these people have less stress tolerance8221;.
Once dismissed by medical experts as being all in the head, CFS has been found to have a clear biological basis.
Some years ago, scientists thought viruses like the Epstein-Barr virus were the cause. Others suggested that it can be a weakness of the immune system that caused it. Scientists now say CFS can be in your genes.
The Gene Story
The Center for Disease Control CDC, Atlanta, in study released last month has showed that CFS is linked to five mutations in three genes that are related to the body8217;s ability to handle stress. Which means people who are genetically predisposed to it, are not able to handle stress.
Led by William Reeves from CDC, the researchers, who published their findings in the April issue of Pharmacogenomics, documented that people with CFS have certain genes that are related to those parts of brain that mediate stress response. These people have differences in genetic activity levels, that affect the way they respond to stress accumulated over a lifetime.
The researchers arrived at the results after a comprehensive study of 227 Chronic Fatigue Syndrome patients. For the genetic analysis, they targeted about 50 genes and 500 polymorphisms in genes that are active in the brain8217;s hypothalamus-pituitary-adrenal HPA axis. It turned out that three are responsible for the fatigue.
Heredity And Environment Too?
While more research is needed to buttress the new findings, doctors here say the effects of environment cannot be ignored. Some, in fact, say the findings are debatable.
8220;Genes might be playing a role, but that does not mean it is just genes that are involved. Even if you are genetically predisposed, social factors also have an effect. It is like all mental illnesses, including depression and anxiety, which might have a genetic bias. But genes don8217;t have the greater role,8221; said Dr Samir Parikh, Senior Psychiatrist with Max Healthcare. 8220;People prone to it are mostly workoholics or those who put excessive effort in work and work tampers with the day to day rhythms of the body,8221; said Dr Parikh.
Doctors point out that given the specific conditions of CFS occurance, it is difficult to put it down to gene alone.
CFS is an urban phenomenon. More common in the age group of 26 to 40 and in India, at least one in every 1000 individuals suffer from it. 8220;More and more cases are being seen in young corporate employees. An upwardly mobile career with a hire and fire policy puts a lot of pressure on individuals to perform. It adds up to a lot of stress,8221; said Dr Nagpal.
The Way Out
8220;You have to make sure that CFS and burnout syndrome is different. It isn8217;t necessarily due to overexhaustion and it doesn8217;t get better with rest,8221; Parikh said. 8220;Depression and Chronic Fatigue Syndrome are close cousins. It has been found that 80 per cent of CFS patients also suffer from depression8230; These individuals are hard pressed on time, unrealistic in time target.8221; Only way to deal with it is to streamline life and work8212;in other words, a lifestyle change. 8220;Stress-coping mechanism is the mantra in today8217;s world,8221; said Dr Nagpal
PREVENTION, NOT CURE, IS THE IDEA
8226; Identify the optimal level stress you can take, the areas which trouble you most and the errors in your work system
8226; Alter food and work habits if necessary, stick to a time table
8226; Have six to eight hours of sleep every day
8226; Drink a lot of water
8226; Do breathing exercises when you feel stress
8226; Seek help if needed.
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