Chronic fatigue a major worry in China(2)

It is estimated that up to 25 percent of people in China's first-tier cities could suffer from chronic fatigue syndrome. (Photo: GT/Li Hao)

"Others describe being very sensitive to their environment, and easily become upset by smells, noises and light."

Shia said SEID was more common in women than in men, and that people aged between 20 and 40 were the most susceptible to the disease.

Difficulties with diagnosis

There are currently no specific diagnostic tests for SEID. Instead, it is often diagnosed differentially - that is, by first ruling out other physiological and psychological medical conditions that might produce similar symptoms.

"Most of the symptoms of SEID overlap with symptoms that are common in a number of other diseases, such as hypothyroidism and anemia, diabetes and morbid obesity," said Liu Jun, a psychiatrist from Beijing Anding Hospital.

"So the doctors need to rule out other possible diseases first."

Among the psychological disorders that had to be ruled out, said Liu, were depression, schizophrenia, anorexia, bulimia and bipolar disorder.

Nevertheless, there remains debate among both patients and the medical communities as to whether SEID should be understood as primarily a physiological or psychosocial condition.

According to a 2013 report in the Journal of the Royal Society of Medicine, only 24 percent of medical authorities thought SEID to be primarily physiological, compared to 89 percent of patient organizations.

"In previous years, the public usually assumed that patients of SEID are suffering from imaginary symptoms," said Liu.

Liu said that there was no consensus in the medical community as to whether SEID should be thought of primarily as a psychological, psychosocial or physiological condition, but that it could functionally be thought of as all three.

He added that it remained a complicated and commonly misunderstood condition, with doctors sometimes misdiagnosing SEID as depression, given that the two share a number of similar symptoms, such as a sense of fatigue and impaired memory.

Bai said that initially, she was diagnosed as suffering from depression.

"The doctor prescribed me some antidepressants, but they didn't have any effect," she said.

Liu said that the way he distinguished between the two was that although those with SEID are debilitated by their sense of fatigue, they maintain a positive mental outlook, unlike those with depression.

Possible treatments

There is also little consensus about how SEID should be treated, although the most commonly prescribed treatments are cognitive behavioral therapy and graded exercise therapy. According to a 2005 report in the Journal of Occupational Medicine, most doctors agree that SEID is primarily managed rather than cured.

Cognitive behavioral therapy, explained Shia, focuses on modifying the kinds of thinking that can trigger symptoms of SEID as well as teaching patients how to cope with and better manage the symptoms of SEID, through techniques such as deep breathing.

Graded exercise therapy involves a program of physical exercise that gradually increases in duration and strenuousness over time.

The patient's response to the therapy is monitored by a medical professional, who will adjust the program of exercise accordingly.

"Patients might start with a simple aerobic exercise such as pacing or jogging," said Shia.

"At the beginning, they might do 5 to 10 minutes of the exercise per day. If their body can handle that amount of exercise, the patient will continue that way for two weeks, before increasing the duration of exercise term."

Shia also recommended a number of alternative therapies, such as meditation and breathing exercises.

It was also important for patients to have a regular sleeping pattern, and to eat healthily. Because SEID is a disease that needs to be managed, Shia preached diligence in maintaining healthy habits and a healthy lifestyle, even when the symptoms of SEID had eased.

Bai said that initially, she took a two-week vacation on her doctor's recommendation, but as expected, her fatigue did not cease.

She has since been engaging in moderate exercise as part of graded exercise therapy as well as doing regular breathing and meditation exercises on her doctor's advice.

"I feel a little better now, but the possibility of getting worse again scares me," Bai said.