I missed 9 weeks of work in 1999 due to this disorder. Overlapping cycles occurring spring 2000. By summer 2000, the cycle is continuous - fatigue, perpetual unconsciousness, extreme mental anguish, basically a vegetable every day. Since cycles have become continuous, I have been having an additional crash on day-1. By fall 2000, acne and crashes are every 4-5 days with very little recovery in between.
Physical exertion can induce a crash of varying intensity.
Eating or increasing sugar intake does not restore energy. Eating in the morning causes sleepiness and fatigue. B Vitamins don't have any effect. No effect from St. John's Wort, ginseng, or gingko. Caffeine tablets cause shaking and extreme irritability.