An exhaustion that cannot be relieved by relaxation
Drastic drop in energy/strength levels to only 20-30% of their previous performance level
Other physically fluctuating ailments
The individual symptoms are often subject to extreme fluctuations within a very short period of time.
Phases of exhaustion lasting in part more than 24 hours to several days depending on the strain.
Why is CFS so difficult to diagnose?
Patients often have had a large number of visits to the doctors. The doctors were unable to diagnose CFS/ME and, therefore, have not initiated any treatment for the disease.
Test your suspicions of CFS with the “Canadian Interview”
Dealing with the examining doctors
In the case of CFS patients, the usual previous diverse findings typically do not contain any somatic (physical) indications. Rather, doctors express the suspicion of a psychological superposition or a suspected diagnosis of a somatization disorder or a depressive episode. At present, the problem is that the doctor´s evaluations are usually carried out purely as a cross-sectional examination, or they only examine the previous findings. As a result, there are no findings that points to the way forward. The neuropsychological tests usually yield average to slightly below-average results.
From these facts it is then concluded, that CFS patients should actually be able to work at least up to 6 hours a day. If anything at all, they are granted an impairment due to psychological reasons.
In these assessments, without prior knowledge of CFS/ME clinical pathology, it is overlooked that the usual statistical determinations cannot do justice to the endurance abilities of the patient’s situation.
The determining and meaningful factor for an appropriate assessment of CFS patient performance is that the individual symptoms are often subject to extreme fluctuations within a very short time. These are performance limiting. On the one hand, it does not take into account the environment in which the person is acting; and on the other hand, it is unsuitable for defining adequate limits for such complex symptoms which fluctuate strongly within a short period of time, without recognizable causes.
The symptoms are often subject to extreme fluctuations within a very short time.
The fundamental dilemma with CFS/ME disease is that the test subjects are able to obtain nearly normal performance in a short period of time. By using up energy for both cognitive and physical/muscular performance, the system’s resources are depleted to such an extent that the exhaustion phase, during which the previous performance can no longer be accessed, lasts more than 24 hours and sometimes several days, depending on the intensity of strain.
These functional impairments and loss of performance cannot be systematically perceived or detected in the usual cross-sectional assessment of CFS/ME patients. Therefore, expert statements of evaluation that do not explicitly take this aspect into account, systematically leads to an incorrect diagnosis.
The explanation for this incorrect diagnosis is that doctors, who are not familiar with CFS, misinterpret the diverse symptoms from previous findings. This is done in such a way, that the doctors attribute the symptoms more to a common somatic disorder or a depressive illness; both of which do not exhibit the phenomenon of sustained exhaustion after exertion, which automatically leads to the lack of regular and continuous availability of energy. Based on these assumptions, the doctor concludes that the CFS patient has the ability to perform/work in everyday life.
In the case of CFS patients, experts repeatedly argue that those affected either exaggerate the complaints or deliberately make too little effort during examinations. The most sweeping criticism is that the CFS clinical picture is not scientifically proven and remains confined to a few outsiders. This only speaks to the ignorance or the lack of discussion with the predominantly international scientific literature.
Adapting diagnostic guidelines to new research findings
Diagnostic guidelines have been in development since 1994 (Fukuda) and are continually adapted to current research findings. Consequently, the disease was included in the International Classification of Diagnostic Diseases as a “Neurological Diseases”.
Laboratory and imaging tests are only used to exclude other diseases, since a definitive diagnostic test does not exist. As a result, such tests do not provide any indications of the cause or therapy for CFS disease, but only helps the detection of comorbidities.
Given the current state of medical knowledge, it is by no means a question of selecting highly differentiated test procedures proving the disease and pointing to the disabilities caused by it, in particular work-related performance. Rather, the diagnosis is based on the scientifically elaborated interviews and the plausibility check of CFS pathology.
If CFS/ME disease is suspected, this phenomenon of sustained exhaustion, lack of energy and thus unpredictable efficiency, must be taken into account. Indeed, it is the main symptom in terms of diagnostic criteria.
To that extent, the examining doctor’s pre-conception of the existence or medical credibility of CFS/ME, determines its evaluation results.
A commission set up by the Centers for Disease Control and Prevention (CDC) was mandated to review the diagnosis and specificity of the disease, differentiating it from mental and neurological diseases. This commission concluded that CFS is originally not a mental disorder Additionally, the commission found the term “Myalgic Encephalomyelitis” misleading, since the term encephalomyelitis is an inflammation of the meninges, which cannot be diagnosed with the usual head CCT and/or MRI. Furthermore, this suggests that the term Myalgia (muscle pain), is not the core symptom, although present.
After reviewing all research findings on this topic, the committee concluded that the reported core symptoms indicate a failure in signal transmission structures; whether nervous, hormonal, or immunological. This is the only way to explain the massive limitation in performance (especially in repeatability), and the limitation in the lasting availability of energy to perform.
This overexertion of the physical “information system” physically, cognitively, and emotionally affects sick people in all organ systems (a basis for diagnosis) and in all aspects of their lives.
The Commission therefore recommends a new name more appropriate to current scientific findings: Systemic exertion intolerance disease (SEID).
How does this permanent strain on our system develop?
Chronic stimulation of the warning function of the amygdala (danger warning sensor) in the limbic system (emotional processing center) leads to chronic stimulation of the vegetative nervous system via the pituitary adrenal cortex stress axis. The result is a chronic imbalance of the sympathetic and parasympathetic nervous system which further leads to the detriment of the recovery function via the parasympathetic nervous system. This leads to changes in the chronobiological structures. Normal cortisol release changes. The daily rhythm of the cortisol level adjusts at a high point. This leads to the absence of evening relaxation necessary for recovery and REM sleep with the effect of soon to be perceived sleep disorders. In addition, the high cortisol level leads to an acceleration of the metabolic system which leads to thermal overheating. This is experienced more drastically at night, for example, as unexplained sweating. This results in an increased permanent tension of the muscular system. If chronic stress persists, the chronobiological rhythm changes, whereby the cortisol release during the day stabilizes at a low level and in the evening at a higher level.
As these processes progress in a vicious cycle, in terms of neurobiology, they lead to an encapsulation of the amygdala from the regulating systems – hippocampus (movement) and frontal brain (reason). Thus, the body system retreats into a flight or fight mechanisms.
This sets autonomous processes and mechanisms in motion. These are no longer controlled by the frontal brain. Psychologically, this process is perceived as diffuse fears and feelings of paralysis as far as intentional willingness to perform is concerned. Somatically, it is experiences as the narrowing or tightening of the heart, tightening of the muscular system resulting in tension, and diffuse pain. Further consequences are in the respiratory parameters, a system that has to adjust to seemingly dangerous situations, as the amygdala feigns causing the need for more oxygen. This leads to an increased oxygen demand, the breathing volume increases over increased breathing rate. Shortness of breath occurs and the pulse increases.
First indications of CFS effective treatment methods
Meanwhile, at the research level, there are first indications of effective treatment methods for CFS. The persistent pain, which is also partly resistant to analgesics, and the massive exhaustion lead to a deficit structure and reduction of the daily range of movement and training, as well as a widespread avoidance of rapid movement. As a result, the natural ability of the autonomous nervous system to regulate decreases to the disadvantage of the parasympathetic system. The sympathetic internalisation increases, also due to the psychological effect of the negative evaluation of the life situation perceived by the patient and the symptoms, which according to the literature are to be interpreted as an existential physical threat.
The patients are unable to access their usual performance level and are confronted with a large number of somatic complaints for which the doctors consulted have no well-founded explanation or therapy approach.
Commonly, patients are merely dismissed as having a psychological disorder, which is a far-reaching stigmatization. This is frightening. A secondary vicious circle of anxiety and thread is starting right now.
The Prof. Stark CFS Program
On the basis of the new scientific findings, which have also led to a reformulation of the concept of this disease, we have developed a special therapy program. This CFS therapy program rests on two pillars:
Psychotherapy phased according to the clinical picture with the aim of restoring the patient’s trust and ability to act by providing them with a conclusive explanatory model (psyche)..
Restoration of the regulatory abilities of the autonomous nervous system (body)
Normally, the CFS therapy program is carried out by specialized therapists at the doctor’s practice. However, there are exercises that the patient can do independently at home. The Seven Steps provide the necessary backgound knowledge and the weekly emails accompany you with helpful hints, tasks, and trainings for half a year.
The Seven Steps: Help for people suffering from Chronic Fatigue Syndrome
With the proven methods from his CFS therapy by Germany’s renowned CFS expert Prof. Dr. Michael Stark, you can regain more strength and zest for life. In “Seven Steps” the body can find strength, the soul courage, and the whole person is helped back into everyday life. The “Seven Steps” summarizes the theoretical basics. In the accompanying email program – for about 6 months you will receive weekly emails – you will find the concrete therapeutic instructions.
Learn more about Prof. Stark and how he became interested in CFS.
“The Seven Steps”: proven methods from the CFS therapy program of Prof. Stark
People suffering from chronic fatigue syndrome often find it difficult to get their condition recognized as a true disease. In my daily practice, I hear again and again that the grievances of my patients are not taken seriously in their professional environment and circle of friends. Only very slowly is a rethinking taking place here. Fortunately, there are good results in the work with my patients, which confirm the newest research findings.
I have developed this self-help program especially for people who find it difficult or impossible to see any treatment in a practice.
All booked contents (The Seven Steps) can be accessed online at any time. Whenever, wherever, and as often as you want or can.
Of course, this self-help online program cannot be a substitute for medical treatment. If you are already undergoing medical treatment, please discuss with your doctor how these services can be integrated into the treatment plan.
The Seven Steps with my patients
You don’t have to work alone: Get yourself help!
Remember, with all the work coming your way, you are not alone! If you have a religious approach, ask your God/Creator to send his guardian angels to your side. If not, then connect to the common healing energy of all people facing this path. With such a sense of security, it is easier to motivate yourself again and again.
Your body is not the enemy
Remember that your body is not your enemy, but it is a marvellous wonder. It always tries to help you, sometimes quite drastically and, admittedly, awkwardly. However, the amygdala is not intelligent and not up to date and can only provide you with its old reactive patterns – fight or flight. You have to initiate the differentiation with your intellect/mind.
Finding a new and more benevolent self-conception
After decades of experience with people suffering from CFS, only those who were able to develop a new and more benevolent self-image, successfully followed this path. When time came to say final goodbyes, they said to me: “I am no longer the same person that I used to be, I had to re-invent myself.” Most of them did not return to their old professions as they had freed themselves from the inner slogan that earlier guided their lives. These slogans included: “Work before play/pleasure”; “An Indian knows no pain”; and “Not to be scolded is praise enough”. Now they could again say: “I can feel and enjoy the sun again, not just see it”.
I wish you the necessary strength to help stay on track. I will be happy if these guidelines and illustrations would make this path easier for you.
Your Prof. Dr Michael Stark
What can you do now, specifically?
This method I specifically developed for CFS patients to support them during treatment, and to positively influence the course of their treatment. To alleviate your suffering, you can now benefit from my many years of experience in the treatment methods I use on a daily basis. The Seven Steps contains the basic information and latest findings from cognitive behavioural therapy, on how we can restore the balance of your autonomous nervous system and achieve better regulatory abilities. This includes a variety of techniques on how we can curb our sympathetic nervous system (the stimulator/exciter), but also how to strengthen the parasympathetic nervous system (the erector and the repairer).
This regaining of the vibrational ability of our autonomous nervous system is the basic requirement for strengthening the self-healing powers of our body. Take time to read through all these steps. The accompanying weekly emails are similar to the weekly therapy sessions in practice. They contain the respective tasks for the Seven Steps and should encourage you to persevere throughout the process. I do not want to promise you a cure, nobody can guarantee that. But what I can say for sure is that with my Seven Steps method, you will have a new and important direction.
You can book the “Seven Steps” here. All courses are available online for your PC, mobile phone or tablet at any time and as often as you like or can.
After the booking you will receive your access data by email and can log in on my website. No installation is required and the whole program is immediately available. Go to START in the header bar and enter your email address and password. A list of the courses you have booked marked with a green arrow will be shown. In the Seven Steps CFS Course you will then see a list of the steps, which you can successively access. Just click directly on the respective step, in case you want to repeat a certain step. If you have any further questions, please do not hesitate to contact us at firstname.lastname@example.org
With these easy to understand, small exercises, which you can do comfortably from home; you have a proven help available to you at any time. You do not need any previous knowledge and only about 5 to 10 minutes a day, at your personal pace and according to your strength and possibilities.