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Tired all the time
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==Comparison with myalgic encephalomyelitis and chronic fatigue syndrome== <blockquote>'''DR E.G. DOWSETT:''' One of the most striking features of [[myalgic encephalomyelitis|ME]] is that the patient is not tired all the time! Extreme and sudden variability of energy levels both within and between episodes of illness differentiate this syndrome from other diseases associated with fatigue.<ref name="Dowsett1992">{{Cite journal |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2399326/|pmc=PMC2399326 | last =Dowsett | first=E.G. | author-link = Elizabeth Dowsett| title = Conversation piece. Interview by PD Welsby|journal =Postgraduate medical journal|volume = 68 |issue = 795 |year =1992 | page = 63}}</ref></blockquote> {{See also|Post-exertional malaise}}{{See also|Idiopathic chronic fatigue}}{{See also|List of abnormal findings in chronic fatigue syndrome and myalgic encephalomyelitis}} Although many different diagnostic criteria exist for [[chronic fatigue syndrome]], all involve: * a group of different symptoms, not simply [[chronic fatigue]] or tiredness * long-lasting duration of symptoms * the hallmark symptom is now understood to be [[post-exertional malaise]], rather than [[chronic fatigue]] * symptoms significantly interfere with everyday life, to the degree that the person is forced to reduce some activities<ref name="CDC-symptoms">{{Cite web|url = https://www.cdc.gov/me-cfs/symptoms-diagnosis/symptoms.html | title = Symptoms {{!}} Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|website=[[Centers for Disease Control and Prevention]] | date = Jan 27, 2021|access-date = 2021-02-25}}</ref><ref name="niceng206">{{Cite web|url=https://www.nice.org.uk/guidance/ng206 | title = Myalgic Encephalomyelitis (or Encephalopathy)/Chronic Fatigue Syndrome:diagnosis and management. NICE guideline. | last=NICE Guideline Development Group | first = | authorlink = |publisher=[[National Institute for Health and Care Excellence]] | date = 2021-10-29}}</ref> {{See also|CDC Myalgic Encephalomyelitis/Chronic Fatigue Syndrome 2017 diagnostic criteria}} {{See also|NICE ME/CFS diagnostic criteria 2021}}
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