When a debilitating chronic illness strikes, every individual, including those around the person, is effected. Each individual is effected differently based upon the role which they serve in the family and the expectations they place upon themselves as well as the expectations which others may place upon them. Such a case is true with Chronic Fatigue Syndrome.
Chronic Fatigue Syndrome (CFS) is an illness of unknown origin whose primary symptom is of extreme fatigue and flu-like symptoms. As published in the ANNALS OF INTERNAL MEDICINE in 1988, the Centers for Disease Control has developed a case definition for Chronic Fatigue Syndrome which includes:
I. New onset of persistent or relapsing fatigue, with at least 50% reduction of activity level for at least 6 months.
II. Exclusion of other conditions through History, Physical examination and Laboratory Examination.
III. 6 of the following 11 symptoms:
- Mild fever
- Sore throat
- Painful lymph nodes
- Muscle weakness
- Muscle pain
- Prolonged fatigue after exercise
- Headaches
- Joint pain
- Neuropsychologic complaints
- Sleep disturbance
- Acute onset of symptoms
And 2 of 3 signs on physical examination:
- Low grade fever
- Throat inflammation
- Palpable or tender lymph nodes
IV. OR 8 of the 11 symptoms without physical signs.
Chronic Fatigue Syndrome attacks all individuals regardless of race, gender, age and socio-economic status. It "robs" an individual of the opportunity to participate in generally perceived "normal" productive daily activities of work and play. While clearly all of the individuals afflicted are devastated by such, with our present culture, males facing this illness may find some additional burdens.
While societal expectations are indeed changing, it has long been perceived that the male has unique and different responsibilities, within the family, than does the female member. For many, a male may base his self-worth on his ability to perform, to succeed and to provide for the family. Being afflicted with CFS, the male cannot meet such self-imposed and societal expectations. Often times, it is not uncommon for the individual to attempt to push or fight to keep himself functioning at his pre-illness level. The goal of such behaviors may be to escape from the feelings of being a failure and of "letting others down."
However, pushing oneself beyond the physical limits will typically result in a relapse of the condition thus only placing the individual deeper and deeper into the hole of recovery and a never ending vicious cycle begins.
Staring at an illness which impedes or blocks the ability to perform at even a minimal degree of the pre-illness capacity makes this task even more difficult. It is essential that all individuals with CFS, and especially males, must confront their own expectations of themselves. The individual must question if such are truly realistic and accept their individual strengths and limitations. Having such an illness does not render the male "less masculine" or lower his value to the family or society. It is imperative that each individual must develop the mindset of setting realistic goals within the individual's PRESENT abilities and to stick with such regardless of the pressure which might be received.
Males have far too often attributed self-worth with their income potential or employment position. As the illness encompasses the individual's life, the capacity to be gainfully employed and to use the energy to "climb the corporate ladder" becomes an even greater and burdensome task. Many will see themselves gradually falling behind their peers up the ladder of success. They may hear of others successes which further deepens the undercurrent of their own present shortcomings. Furthermore, as they are unable to perform the tasks within the workforce, the likelihood of receiving supplemental income through disability can become even more possible.
Dating back to the Stone Age, males were taught to hunt, feed and protect the family from all outside predators. However, what if the "predator" is an illness from within which renders the protector unable to perform those duties? Males are often taught, at a very young age, that others will have certain expectations from and for them, roles to perform and they are to never relinquish such regardless. The family may be forced to make dramatic changes. Often times, males feel powerless to stop the negative changes, let alone view themselves as the cause of such. The "demons" in their own head may begin to surface as well as fearing others perceptions as the effects of the illness begins to take its toll. "Old lessons" must be rewritten or discarded. New lessons of each individual pulling a "fair share" must emerge. Change need not necessarily be negative. One must remember that no matter what happens, others will continue to think whatever they are going to think. Facing and confronting others expectations is a task which everyone, with or without CFS, must undertake.
As with the females affected by CFS, many individuals can experience some change in weight as they no longer possess the energy to engage in physical activities or exercise. The loss of their physique is often times extremely difficult to face. Many such individuals may fear rejection by their loved one due to their perceived "non-attractiveness." In such cases, open communication with the loved one is often recommended.
For the most part, in spite of recent movements, the societal view that males should not express or verbalize their fears and feelings continues to exist. It is almost as if many males fear becoming "weak" to express their feelings, fears and disappointments. It is well known that fewer males tend to seek counseling or attend area support groups. Hopefully, as our society continues to change, males will allow themselves this avenue of assistance. It is only through the verbalization of the fears and feelings that any individual can face and overcome them. Without such, the feelings and fears tend to grow and grow within their own being.
An individual's ability to be "productive" in life has far too long been correlated with self-worth. The basis for this standard of "productivity" is generally based upon the individual's pre-illness capacity or level of functioning. For all individuals getting older in years, this is an unrealistic standard as we all lose abilities with age. Such is especially true for those afflicted with CFS. When the individual attempts to continue judging their life by this unrealistic standard, secondary depression will develop.
For all, and especially males, afflicted with Chronic Fatigue Syndrome, the following suggestions should be considered:
- Do not attempt to push yourself beyond your present physical capacities. Accept and work within your present realm of abilities.
- Set immediate, realistic and obtainable short-term goals which can be achieved on a daily basis.
- Talk, talk, talk. Express your feelings and fears -- not for the purpose of having others refute your beliefs, but rather to assist you in seeing yourself in a more realistic perspective.
- Attend area support group meetings. Attend or develop a support group specifially designed to address the unique issues directly related to males afflicted with CFS.
- Throw out "old lessons" of roles which a male should or must meet in order to be of any value. Write "new lessons" for your individual life.
- Realize that change does not necessarily produce negative results or consequences. Look for the gains which can be achieved by and through the changes.
- Accept that you may not be as powerless as you feel or fear. While you may not have power over your own physical abilities now, or how others may perceive you, you always have absolute power and control over how you view yourself.
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