Chronic fatigue syndrome is an ailment characterized by extreme tiredness that cannot be related to any underlying mental cause. Often, the fatigue gets worse after mental or physical activity. CFS is also known as myalgic encephalomyelitis or ME (Brues, 2013). Often there is contention about the two terms; however, many scientists refer to is as CFS/ME. People suffering from this ailment often suffer a wide range of symptoms. They vary from headaches, sore throat, dizziness, heart palpitations, sleep problems, muscle and joint pain and problems with concentration. The cause of this disease is unknown. However, several causes have been theorized to cause it.  These include hormonal imbalance, mental health problems, low immune system, bacteria infection such as pneumonia and viral infections (Sandoiu, 2017). Additionally, genes also seem to be a critical cause as well.

Recent studies published in the Lancet medical journal indicate that there is a correlation between the disease and incidence of suicide. Suicide is a common phenomenon when dealing with mental health issues, which is a potential cause of chronic fatigue syndrome. The findings show that persons suffering from CFS are six times more probable to commit suicide than those who did not have the disease. This number is significant.  The study, which was conducted over a seven-year period with more than 2000 participants, led to these findings (Kupar, 2016). However, many scientists claim that the data here is merely statistical and does not indicate whether the suicide is as a result of the disease itself or other ailments that come as a result of the condition. Nonetheless, it is undeniable that there is a correlation between the disease and incidence of suicide among its patients (Kupar, 2016). This report seeks to explore the causes of suicide in patients with chronic fatigue syndrome and possible remedies that can significantly reduce the number of people who use this channel to alleviate their suffering.

The decision to take one’s life is never an easy one. It comes from feelings of worthlessness and hopelessness from not being able to enjoy the pleasures of life as one is supposed to. It is difficult for the general population to understand the ongoing thoughts and processes in the mind of a suicidal person before they get to take their lives (Fisher, 2015). This lack of understanding does not take away the fact that these people indeed suffer the grave indignity of finding a way to escape from the pain and obscurity engulfing their lives by seeking out death as the ultimate solution.

According to McManimen (2016), persons with chronic fatigue syndrome have an elevated risk of suicide compared with the general population. Moreover, they have an earlier mortality as compared to patients with terminal diseases such as cancer and cardiovascular disease. This study analyzed the death of 56 ME patients. The resultant data indicated that while the average age for suicide in America was 47.4, those with ME had an average of 41.3. Of all the patients in the study, a significant 26.8 percent died from suicide. These findings indicate that indeed this ailment elevates the risk for suicide. Moreover, it was found that the risk of suicide was higher in male patients than in females. The difference between the two genders mirrors the general population (McManimen, 2016).

Collinge (2018) states two critical areas that result in emotional turmoil in patients offering from chronic fatigue syndrome.  One, the patient has to adjust and make significant life changes as they adjust to living with the disease. The inability to be active and sometimes confined to one location for a long period can be deliberating. One may have to adjust to having a caretaker and this takes away some of the independence that one has.  Secondly, the disease has a somato-psychic effect on the body. As the disease progresses, it affects the neurological system and alters that balance of chemicals in the body.  A study by the Georgetown University School of Medicine in 2016 examined the cerebrospinal fluid of patients with CFS and compared them to healthy controls. The study indicated that patients with CFS showed 12 diminished miRNAs after 24 hours of exercise (Sandoiu, 2017). This element is responsible for regulating protein production in the body. This reduction could explain the lethargy in chronic fatigue syndrome patients. This study therefore concluded that this malaise is not a neurological disorder but a distinct illness. Another study also showed that CFS could be caused by deficits in white matter in the left inferior fronto-occipital fasciculus or OFOF. The volumes of the white matter deteriorated at an abnormal rate (Sham, 2016).

One of the major downsides of having CFS is the ability not to engage in activities in a more interactive and active manner (Brues, 2013). Due to symptoms such as pain and the fatigue, patients often find themselves confined to wheelchairs, bed and even their homes for long durations. The person may feel frustrated, as they are not able to go about on their activities as they did before the illness. Resultantly, one may encounter thoughts of hopelessness and anger, which may cause them to resent living. The lack of energy and enthusiasm may shatter the patient causing him to become depressed and suffer from mood disorders.

Janssens (2015) conducted a study to determine the prevalence rate of psychiatric disorders between individuals suffering from irritable bowel syndrome, fibromyalgia and chronic fatigue syndrome. The study had 94516 participants.  The studies indicated that people suffering from chronic fatigue syndrome had higher incidences of mood and anxiety disorders as compared to their counterparts who had other illnesses that were part of the investigation.  However, they had a lower incidence of major depressive disorder.  The presence of mood disorders indicates a risk of suicidal ideation. According to Nierenberg (2001), mood disorders such as bipolar and unipolar major depression cause persons to suffer an unacceptable risk of death by completed suicide. The position of this study is supported by findings by Isometsa (2014) that hold the position that, about a half to two-thirds of all persons who commit suicide suffer from mood disorders that are under treated, undiagnosed or ineffectively managed. By CFS resulting or having co-occurring mental illness problems, it provides credence to reports that support the link between it and suicide.

One of the major problems that have been for long associated with CFS is the lack of understanding and stigma associated with the disease. Some of its critics argue that persons who are suffering from the diseases have been afflicted by shirkers syndrome. This is a condition whereby one claims to be ill to avoid working or taking part in physical activity. Those who do not understand the condition, may often tell persons with CFS that they are faking it or having an imaginary disease. Not only does this disparage the severity of the disease, but it also causes more turmoil and frustration in the patient. The resulting stigma and condemnation may lead the patient to suicide especially if they do not have a strong social support system.

There is a glaring lack of support for persons with CFS. One of the major reasons is that despite there being advances in science that has increased the knowledge pool about the disease, often these patients get misdiagnosed. The symptoms of the disease largely mimic other conditions such as lupus, Lyme disease, multiple sclerosis and mononucleosis among others (Kupar, 2016). Given that the treatment and management of these ailments is characteristically different from that of chronic fatigue syndrome, many patients may not have effective treatment that increases their frustration with the illness. On the other hand, unlike these other ailments, some medical bodies are yet to recognize CFS in their programs. In Australia, for instance, the National Disability Insurance Scheme (NDIS) still fails to affirm this malaise as part of its recognized conditions. Some argue that this failure is a result of lack of concession by doctors that CFS is a real disease (Sandoiu, 2017). The NDIS claims that chronic fatigue syndrome patients are insufficiently incapacitated and thus do not qualify for support. Such procedures greatly disenfranchise those who have this condition. Furthermore, they have little access to financial, medical and social support which is critical in making people with the disease live better and with dignity.

Due to the nature of chronic fatigue syndrome, patients often encounter social isolation. Because they have low energy and are lethargic, patients might not be in a position to engage in lengthy social interactions (Fisher, 2015). As such, they will be isolated from society, which may have negative implications of the mental heath of individuals.  Socializing satisfies the human need to be part of a society and something bigger than themselves.  It is a fundamental need according to the hierarchy of needs. The lack of it is likely to cause mental illness, negative thoughts and sleep problems (Fisher, 2015). These three outcomes are at the heart of chronic fatigue syndrome. Reducing interactions with others in patients with chronic fatigue syndrome may cause loneliness and result in suicidal thoughts and actions.

Again, CFS causes sleep problems. Patients often site sleep disorders ranging from excessive sleep, inability to stay asleep, insomnia, non-refreshing sleep, narcolepsy and sleep apnea.  Sleep is an important part of the body functions. Not only does it allow the body to rest and rejuvenate but it is also critical in maintaining the brain chemistry and hormonal balance of the body (Brues, 2013).  When a person has little or excess sleep over a long time, they may become irritable, sensitive to pain and moody. The lack of sleep may cause hallucinations and result in psychotic episodes for these patients further worsening their conditions. When one does not have enough sleep, they lack energy to perform everyday duties. For patients with chronic fatigue syndrome this may create self-defeating cycle. These sleep disruptions are also common in suicidal individuals. The Diagnostic Statistic Manual or DSM instructs doctors to ask patients about their sleeping patterns (Fisher, 2015). Personal with mood disorders have sleep problems and this is a risk for suicide. The lack of sleep inhibits the process or neurogenesis, which is critical in specific brain regions that deal with cognitive abilities and regulation of emotions. Both these functions are severely impaired in persons with chronic fatigue syndrome and may predispose the patient to depression and suicide. Often sleep problems precipitate depression and then suicide. For a CFS patient, their condition and predisposition to mood and cognitive disorders may push their transition through these stages at a much faster rate than healthy people may.

Additionally, chronic fatigue syndrome is known to be accompanied by chronic pain. Pain is often a result of swollen lymph nodes and muscles. This discomfort impairs the ability of the patient to move or perform tasks in the manner in which they were previously accustomed. In extreme cases, the person may become immobile. Pain often causes people to seek out suicide as a relief particularly if they have an incurable malaise such as chronic fatigue syndrome (Brues, 2013). The constant pain restricts them to certain activities and medications. Dealing with physical pain may drive one to depression as a result of frustration and distress (Fisher, 2015). Moreover, symptoms such as problem with sleeping patterns that is associated with chronic fatigue syndrome causes people to become more sensitive to pain since the body does not rest and it is not able to repair or heal inflamed parts of the body that cause the pain. This constant pain leads to suicidal deaths especially if medication is ineffective.

It is critical to create awareness on the relationship between suicide and chronic fatigue syndrome. Active denial is disenfranchising millions of deserving patients who require support to manage the disease. The prevalence of suicide among patients suffering from chronic fatigue syndrome is worrying and requires more consideration among the medical community. Consequently, it is imperative to accept that chronic fatigue syndrome is an actual disease that affects millions of people around the world (Sandoiu, 2017). It is essential to create support systems that allow these ailing individuals to receive support and empathy as they adjust to their ailments. Social support is a critical part of preventing suicidal ideation and death. Sufferers of CFS can become socially isolated and this may cause loneliness and negative thoughts. They may be unwilling to engage with others at a time when they need social support the most.

Due to evidence that dictates there is a link between CFS and mood disorders, it is essential to offer psychological counselling and cognitive behavioral therapy as tools to facilitate these ailing individuals react better in their circumstances (Brues, 2013). It is essential to offer those techniques and healthy coping mechanisms that will enable them to become more productive and efficient in their lives.  It is important that patients be informed that even though they do not have a cure for the disease, how they think about it can improve their outcomes and help them lead more fulfilling lives. This change in thought may drastically reduce their likelihood to commit suicide. On the other hand, those around chronic fatigue syndrome patients need to be keen on the behavioral changes of the patient. They must note any suicidal behaviors and take on medical help at the earliest stage. The patient, again, must be in a position to self evaluate and identify any mood or change in sleeping patterns that may worsen their depression or create suicidal thoughts.

In conclusion, it is clear that chronic fatigue syndrome and suicide are intricately linked. This link can be traced down to the chemicals changes in the brain as well as the emotional turmoil that results from having to adjust to the disease.  CFS increases incidence of suicide by six fold. This number is significant but with effective management can be reduced. On the other hand, co-occurring diseases such as mood disorders are likely to cause patients to have suicidal tendencies particularly if they have bipolar, depression or personality disorders. As such, these conditions need effective treatment to reduce incidences of suicide. Moreover, effectiveness in managing any illness begins with the ability to recognize the severity or the problem. Unfortunately, CFS has for long been seen as an imaginary ailment and this discourages many people from seeking and accessing the help that they need. The stigma attached to this ailment has the ability to increase hopelessness and social exclusion of patients causing a rise in suicide. With more evidence on the realism of this condition, this could tilt the scales in favor of patients and help them get the support they need to avoid seeking suicide as a potential solution to their suffering.

 

 

 

 

 

 

 

References

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Fisher, T. (2015, 10 21). The Disturbing Relationship Between Sleep, Depression and Suicide . Retrieved from Van Winkles : https://vanwinkles.com/the-confusing-relationship-between-insomnia-depression-and-suicide

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Nierenberg, A. A., Gray, S. M., & Grandin, L. D. (2001). Mood disorders and suicide. The Journal of Clinical Psychiatry, 11(2), 213-219.

Sandoiu, A. (2017, 11 13). Chronic fatigue syndrome: Changes in brain chemistry found. Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/320051.php

Shan, Z. Y., Kwiatek, R., Burnet, R., Del Fante, P., Staines, D. R., Marshall‐Gradisnik, S. M., & Barnden, L. R. (2016). Progressive brain changes in patients with chronic fatigue syndrome: A longitudinal MRI study. Journal of Magnetic Resonance Imaging, 44(5), 1301-1311.