The chronic phase is marked by settling into cycles of symptom severity. The degree of disability might vary according to a pattern for the individual. For many, the cyclical nature of CFS makes the road to recovery a bumpy one. In a few people, especially in more severe cases, there may not be such obvious cycles, but a more steady unrelenting state of debilitation. We will discuss this problem and how to prevent it in Chapter 5.
Remissions can be great or slight, brief or long.
They may follow a regular pattern or an irregular pattern. Some symptoms may go into remission while certain others remain. One of my patients, Helen, had a pattern in which her fatigue symptoms would improve markedly, but her mental confusion might not improve to such a noticeable degree. With a little self examination, you should be able to describe the pattern your remissions take. Many relapses are triggered by stressful events, which can be either physical or emotional.