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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Chronic Fatigue Syndrome, Genetics and Stress

Allan N. Schwartz, LCSW, Ph.D. Updated: Apr 23rd 2006

In a very exciting development American Scientists reported finding evidence for a genetic cause for Chronic Fatigue Syndrome (CFS). This is exciting for a number of reasons, not the least of which it serves to quiet the controversy of whether or not this disease is a real entity or a psychiatric variation of depression and hysteria. In addition, this finding makes it possible for researchers to find ways to treat this illness.

Symptoms of CFS:

1) Severe fatigue that prevents the sufferer from performing normal activities on a daily basis.

2) It is impossible for the sufferer to go to school, work or engage in social activities.

3) There are serious sleep disturbances in the form of insomnia but, most commonly the need to sleep too much.

4) A full night of sleep does not prevent the feelings of extreme tiredness the next day.

5) Some people experience muscle pain known as myalgia.

6) The illness is characterized by such flu-like symptoms as sore throat, fever and chills and headaches.

7) Lymph nodes become tender and swollen.

8) Many people with CFS also experience difficulty concentrating and memory loss.

A recent study at Johns Hopkins University found an abnormality in blood pressure regulation in 22 of 23 patients with CFS. This abnormality, called neurally mediated hypotension, causes a sudden drop in blood pressure when a person has been standing, exercising or exposed to heat for a while. When this occurs, patients feel lightheaded and may faint. They often are exhausted for hours to days after one of these episodes. When treated with salt and medications to stabilize blood pressure, many patients in the study had marked improvements in their CFS symptoms.

Diagnosing CFS:

Doctors usually use the following criteria before giving a positive diagnosis for CFS:

  1. A. The ongoing experience of debilitating fatigue which is not relieved by sleep is not attributable to any other factors such as extreme physical exertion and that has been experienced for six consecutive months.


  1. Four or more of the following symptoms:
  • Inability to concentrate along with short term memory problems.
  • Sore throat and tender lymph nodes
  • Headaches
  • Chronic joint pain
  • Muscle pain

The Role of Stress and Trauma:

One of the eternal battles that has been waged in psychology for a century or more has to do whether genetics or environment exerts the greatest influence on human behavior. If our personality and behavior are influenced primarily by genetics then we must look at organic or biological roots to everything we do as human beings. If these things are determined by the environment then we must look at how we raise our children to determine how we become who we are.

Today, in the fields of psychology and psychiatry practitioners and scientists tend to take a bio-psycho-social view of how we become who we are and why what determines our behavior and personality. The implications of this bio-psycho-social view of human behavior are great. What it means is that there are both biological and environmental forces that shape our destiny. Consequently, there are many things we can do to solve psychiatric illnesses and improve human life. To do this we have both medical and behavioral tools to help people over come their problems.

What Does This Mean for Suffers of CFS?

For one thing it means that there are many factors that may cause CFS. Even if there is a genetic or biological to this illness it may only mean that a stress and trauma experienced by these individuals clicks on the genes for CFS, allowing the illness to take hold.

It has been the experience of this practitioner that psychotherapy patients with CFS are not only depressed but experienced severe trauma during childhood. Of course, that raises the question of why everyone who experienced trauma does not become ill with CFS. Of course the answer is that only those with the genetic and physical constitution for the illness will become sick when enough trouble has occurred in their lives.

It is exciting to now have clear evidence that CFS is very real and that it is not the expression of a mental illness but is a very real clinical syndrome. It is also exciting to realize that medical science can now find ways to treat and even cure CFS. However, it is also the opinion of this practitioner that psychotherapy will become even more important than ever in helping these suffers find relief from this chronic sickness.

What do you think?


Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

Successes & not - Lee Cornett - Mar 22nd 2010

I am 48.  I was 7 the first time I was hosiptalized.  I saw a psychiatrist who told my parents I was stressed out.  I later went to a physician who treated me for allergies to aleved the immune system.  It helped a lot.  When I was 19 I became constipated, lethargic, lost cooridination, became foggy, forgetful and of course fatigued.  29 years of doctors, tests and efforts to boost my immune system and know that it is not pyschological.  After about 25 years of trying everything(vitamins, minerials, colloidal minerials, aminoe acids, enzymes, pro-biotics, essential oils, herbal cleansers, chelation, ozone and hydorgene peroxide theropy, doctors and psychiatrists and many self help books and preyor).  I know I have active HHV-6 and I am hypoglycemic and bipolar.  I settled on faith, the 30-30-40 diet, psyllium husk for cleansing, enzymes to help digestion for absorbtion, pro-biotics to hold back candida.  I feel good most of the time.  I don't have the ability to perform physical work unless it is very aerobic and I am not having any CFS symtoms.  

Yet When for what ever reason my immune system start failing or my brain chemistry is off and things are challenging or difficult I have to work to stay focused and when things seem questionable, I become immobile and suicidal. But most the time I am healthy enough when difficulties accure I survive them.  But when things seem really bad with my business surviving or not, or when emotionally tramadic things accure, it doesn't seem to matter if I was feeling healthy when the accurance araises.  I grow apathetic and want out and away.


psychotherapy and cfs - Linda - Sep 26th 2006
I find much to agree with here. As someone who has been living with Chronic Fatigue for at least the past 2 years and been in intensive psychotherapy for the past 3 years, I agree that therapy has a vital part to play in helping us understand and make sense of our experience. Although it is sometimes very stressful in itself revisiting unresolved feelings and past traumas, it is vital in learning to build a future and promoting acceptance. Buddha teaches that life is suffering, and that when you have truly embraced that life becomes easier (I am not a Buddhist but gratefully receive help and wisdom from wherever it comes!). I have also found yoga very supportive, not yoga as a work-out though, but as a work-in! I still deal with CFS on a daily basis, I am not able to work or do anything in the way I could before CFS, but I have a supportive partner and am learning to view achievement in a different way. At times I have been suicidal, but the pyschotherapy has supported me and my partner in understanding the process and in establishing a better way of regulating myself.

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