Fibromyalgia and Chronic Fatigue Syndrome Treatment Program

Fibromyalgia and Chronic Fatigue Syndrome (Systemic Exertion Intolerance Disease) Treatment Program

What is Chronic Fatigue Syndrome*?

*Please note that, effective February 2015, Chronic Fatigue Syndrome has been renamed as Systemic Exertion Intolerance Disease*

A few short decades ago, people afflicted with constant exhaustion had no word for their suffering, and might even have been labeled as “crazy.” We now know that a disparate group of exhaustion-related symptoms are the result of a disorder called chronic fatigue syndrome. The diagnosis is still not well-understood, though, and many people with chronic fatigue syndrome spend years seeking the right medical care.

In some countries, chronic fatigue syndrome is known as myalgic encephalopathy, leading some practitioners to refer to the disorder as CFS/ME. No matter what you call it, though, CFS/ME can be debilitating, even undermining a sufferer's ability to work. The hallmark symptom of the disorder is chronic fatigue that is not well-explained by another condition.


What Causes Chronic Fatigue Syndrome?

For a long period of time, the Rochester Center has treated individuals with ADHD. This has led us to the observation that a number of individuals with ADHD (inattentive type) develop chronic fatigue and chronic pain. Oftentimes, by detecting whether ADHD exists, treatments for ADHD can address chronic fatigue. Dr. Young and the Rochester Center have published extensively on this issue.


What Are the Symptoms of Chronic Fatigue Syndrome?

Chronic fatigue syndrome is a diagnosis of exclusion. This means that there is no direct test for the condition. Instead, doctors diagnose CFS by testing for other conditions, excluding those conditions, and then evaluating symptoms. Consequently, you can help speed your diagnosis by keeping an accurate log of your symptoms. A symptom log can also help you determine whether any lifestyle choices or environmental issues – such as stress – affect your symptoms.

Symptoms of chronic fatigue syndrome include:

·         Ongoing fatigue that is not better explained by a medical condition or insufficient sleep. Fatigue from exercise and other strenuous activities may last 24 hours or more.

·         Difficulties with concentration, memory, or thinking.

·         Enlarged lymph nodes, particularly in the neck or under your arms.

·         Muscle pain that is not better explained by muscle strain or injury.

·         Joint pain not caused by another medical condition.

·         Chronic headaches or sore throats.

·         Feeling unrefreshed and exhausted even after a good night's sleep.

Note that not all patients with CFS experience all of these symptoms, and the symptoms you experience may change with time.


How The Rochester Center for Behavioral Medicine Can Help

Our medical team specializes in chronic fatigue syndrome, and has been at the cutting edge of new treatment developments. We regularly conduct CFS research, and we take the suffering of CFS patients seriously. We'll listen to you, carefully evaluate your needs, then find ways to improve your current symptoms. Individuals experiencing excessive fatigue will undergo a comprehensive evaluation to identify any underlying disorders, such as anxiety, depression and AD/HD.  Our approach is holistic, incorporating several treatment options, including:

·         The use of psychoactive medications to help you deal with the stress and pain of CFS and comorbid conditions.  Many patients with the disorder experience anxiety, depression, or sleep disturbances.

·         Helping you adopt lifestyle choices that can improve your symptoms. If you find making lifestyle changes difficult, we can counsel you about how to move past common roadblocks. We'll also work with your family to help them help you.

·         Aiding you in the development of coping skills that can improve the way you feel every day.

·         Investigating your symptoms and monitoring you for changes in your condition.

We're here to help you whenever you're ready. While there may not yet be a cure for CFS, there are many treatment options. Let us help you find something that works for you. Contact us today.



What is Fibromyalgia?
Fibromyalgia is a relatively new diagnosis, but has likely affected people for thousands of years. It remains poorly understood, partially because doctors have historically attributed the disorder to psychological problems. We now know that fibromyalgia is a real disease that afflicts between two and eight percent of the population. As many as 90 percent of people affected by the disorder are women, though doctors don't yet know why this is.

The disorder is a musculoskeletal disease characterized by widespread pain throughout the body. The pain is often localized at specific tender points primarily located along the upper body, but people afflicted with the condition can experience pain just about anywhere. The pain ranges from mild to debilitating, but it tends to get worse over time. For some people with the condition, symptoms start after a physical trauma, such as a fall or car accident. For others, symptoms come on slowly and get worse over time, and a few people with fibromyalgia experience a sudden and acute onset of symptoms.


What Causes Fibromyalgia?

The Rochester Center for Behavioral Medicine has been focused on the identification treatment of ADHD and related diagnoses for many years.  Dr. Young has written about the natural history of ADHD.  Many individuals with inattentive ADHD develop symptoms of chronic fatigue and Fibromyalgia.  Often, this is a missing link in the treatment of Fibromyalgia. Evidence suggests that treating the underlying ADHD can help to reduce fatigue and pain.


Symptoms of Fibromyalgia

Fibromyalgia is a diagnosis of exclusion. This means that there's no single medical test that can test for the condition. Instead, doctors evaluate patient symptoms and rule out other possible causes before diagnosing the patient with fibromyalgia. Many patients find that logging their symptoms over time helps them communicate clearly with their doctors. This practice can also help you determine whether any lifestyle choices or environmental issues trigger symptoms. Common symptoms of fibromyalgia include:

·         Pain throughout the body. If the pain is concentrated at specific points, this strongly suggests fibromyalgia. Even without these tender points, though, a doctor may diagnose fibromyalgia if the pain is a dull ache, gets worse over time, and has no other physiological cause – such as muscle injuries or rheumatoid arthritis.

·         Fatigue. People with fibromyalgia may also deal with chronic fatigue. The pain may keep you up at night, or you may have trouble sleeping. Some people with the disorder also report a sudden depletion in their energy levels.

·         “Fibro fog” is a change in cognitive abilities due to the disorder. Some people with fibromyalgia feel foggy or confused, like they're living in a dream state. If you have trouble remembering information or concentrating, be sure to note this at your doctor's appointment.

·         Frequent headaches or gastrointestinal disturbances.

·         Skin problems. Some people with the disorder report skin pain and itching. Others experience skin problems such as eczema or dry, scaly skin.


How The Rochester Center for Behavioral Medicine Can Help

The Rochester Center for Behavioral Medicine specializes in fibromyalgia, and we know the destruction this disease can cause. We'll listen to you and take your pain seriously, focusing on what you need – not what we think you should want. Our approach is holistic, embracing both lifestyle changes and appropriate medical care. Our doctors and therapists are fibromyalgia specialists who can help you with the following challenges:

·         Developing psychological coping skills that can help you manage your pain, communicate with friends and family about your disorder, and gain the motivation you need to implement healthy lifestyle choices.

·         Embracing lifestyle choices, such as exercise and a healthy sleep schedule, that can help you feel better. We work with you to cut through obstacles that make healthy lifestyle choices challenging, and we can help you tailor a plan that works with your lifestyle and personality.

·         Prescribing psychoactive medications where appropriate. If your fibromyalgia leaves you feeling anxious or depressed, the right medication can make a world of difference.  Many of the medications use to treat ADHD, anxiety and depression are helpful in our patients with Fibromyalgia.


***Please note that the Rochester center does not use opium medications in treatment of chronic nonterminal pain conditions.

We're standing by to help you when you need it, and we know that there's a solution for every problem – no matter how daunting things might feel right now. Contact us today.

If you would like to learn about possible participation in a clinical trial for Fibromyalgia, please contact one of our clinical coordinators, Lori Niewiarowski at or (248) 608-8800 x 249.


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Helena Sanchez, LMSW
Carol Rembor, MS, APRN, BC MS, APRN, BC
Derek Susalla, PA-C
Joel L. Young, MD MD
Judith C. Redmond, MA, LPC, LLP MA, LPC, LLP
Marie McMahon, LMSW, ACG LMSW, ACG
Melissa Oleshansky, PhD, LP, RYT PhD, LP, RYT
Sarah Hutton, M.D.