Yoga and Chronic Fatigue Syndrome (Also Known As Myalgic Encephalomyelitis Or M.E.)

Yoga and Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis or M.E.)

Compiled by: Trisha Lamb

Last Revised: April 27, 2006

International Association of Yoga Therapists P.O. Box 2513 • Prescott • AZ 86302 • Phone: 928-541-0004 E-mail: [email protected] • URL: www.iayt.org

The contents of this bibliography do not provide medical advice and should not be so interpreted. Before beginning any exercise program, see your physician for clearance.

NOTE: This bibliography includes resources on chronic fatigue, fatigue in general, and energizati on.

Acharya, Sophie. Yoga & M.E. Yoga & Health, Aug 1996, pp. 20-21.

Agni Sara: Solar Power. Yoga International Reprint Series. Honesdale, Pa.: The Himalayan International Institute Press, www.himalayaninstitute.org.

“Easy-to-follow directions in mastering agni sara, diaphragmatic breathing, and asanas for relaxation and energy.”

Agombar, Fiona. Beat Fatigue with Yoga: A Step-by-step Guide. Rockport, Mass.: Element Books, 1999.

“[This book] covers the whole range of fatigue—from ‘tired all the time’ to Chronic Fatigue Syndrome/Myalgic Encephalomyelitis [British term for CFS]. Yoga helped Fiona Agombar in her recovery from ME . . .”

______. Yoga for M.E. Yoga & Health, Aug 1996, pp. 26-28. Originally published in Interaction: The Journal of Action for ME, Autumn 1995, no. 19.

Ambikananda Saraswati, Swami. Tired all the time (TATT Syndrome). In Swami Ambikananda, Healing Yoga: A Guide to Integrating the Chakras with Your Yoga Practice. New York: Marlowe & Co., 2001, pp. 136-137.

Anderson, Sandra. Asana to the rescue. Yoga International, May/Jun 1994, pp. 8-15. (General fatigue.)

Angus, Carrie, M.D. Tired or toxic? Yoga International, Jun/Jul 1997, pp. 47-49.

Austin, Miriam. I’m fried! In Miriam Austin, Yoga for Wimps: Poses for the Flexibly Impaired. New York: Sterling Publishing, 2000, pp. 42-63.

Banfield, M. A. Classic fatigue. Yoga & Health, Feb 1997, pp. 31-32.

Bhajan, Yogi. Mental fatigue. In Alice Clagett and Elandra Kirsten Meredith, eds., Yoga for Health and Healing: From the Teachings of Yogi Bhajan, Ph.D. Santa Monica, Calif.: Alice B. Clagett, 1994, p. 86.

Bhat, Vasanthi. Energizing; Fatigue. In Vasanthi Bhat, The Power of Conscious Breathing in Hatha Yoga. San Jose, Calif.: Vasanthi Bhat, 1997, pp. 221; 221.

Breath of fire: Would you like to boost your energy? Yoga International, Aug/Sep 2001, pp. 36-38.

Bushey, Theresa. Chronic fatigue immune dysfunction syndrome (CFIDS). Structural Yoga Therapy Research Paper, Apr 2005. Author email: [email protected].

Carroll, Cain, and Lori Kimata. Fatigue. In Carroll Cain and Lori Kimata, Partner Yoga: Making Contact for Physical, Emotional, and Spiritual Growth. Rodale Press, 2000, p. 199.

Cazzaw. Benefits of yoga for those with ME/CFS. Article available online: http://www.sheffieldyogaforme.org (click on the “Information” tab, and scroll down to this article title).

______. Guided visualisation and yoga relaxation tapes [helpful for fibromyalgia]. Article available online: http://www.aqyo77.dsl.pipex.com/sheffieldyogaforme/review2.doc.

______. Yoga for ME [fibromyalgia] tape, CD and book review. Article available online: http://www.aqyo77.dsl.pipex.com/sheffieldyogaforme/review1.doc.

Chakravarti, Sree. Prithvi mudra (for increased bodily energy and flexibility of mind); Surya mudra (to rid the body of lethargy). In Sree Chakravarti, A Healer’s Journey. Portland, Ore.: Rudra Press, 1993, pp. 208-210.

Cheikin, Michael. Fibromyalgia: A Nine-Step Pathway to Healing workshop [also addresses Chronic Fatigue Syndrome]. Held at Kripalu Center for Yoga and Health. Email: [email protected].

Michael Cheikin, M.D., a student of Yoga and mother mind/body techniques for 20 years, is the medical director of Chestnut Hill Rehabilitation Hospital and its Integrative Medicine and Educational Services program located in suburban Philadelphia. He specializes in medical Yoga, medical acupuncture, and other complimentary methods.

In this workshop, Dr. Cheikin “will discuss in detail the four predominant theories (‘cause’) of FMS and CFS, and a step-by-step approach for healing, incorporating the ‘best’ of traditional and alternative medicine. Daily sessions will include a gentle, effective Yoga sequence that can be practices on the floor, in a chair, or standing. This sequence will be repeated and emphasized [during the course] so students can continue practicing at home. Each day will include time for questions and answers.”

Christensen, Alice. [20-minute workout for] Chronic Fatigue Syndrome (CFS). In Alice Christensen, 20-Minute Yoga Workouts. New York: Ballentine Books, 1995, pp. 122-123.

______. Chronic fatigue syndrome. The American Yoga Association Wellness Book. New York: Kensington Books, 1996, pp. 72-78.

3 Collinge, William, Paul R. Yarnold, and Ellen Raskin. Use of mind/body self-healing practice predicts positive health transition in chronic fatigue syndrome: A controlled study. Subtle Energies and Energy Medicine Journal, 1998, 9(3).

Abstract: Seventy subjects diagnosed with chronic fatigue syndrome were randomized to a control group (N = 33) or a treatment group (N = 37). All continued usual medical care. Treatment subjects were assigned to a 9 week, 2-hours-per-week group program teaching mindfulness meditation and medical qigong practices. The outcome variable was 12- month health transition at one-year follow-up, as defined by the SF36 12-month Health Transition score. The data yielded a classification tree with a 90% overall accuracy rate in classifying subjects as “improvers” or “non-improvers” (effect strength 80.5, experimentwise p < .05), based on SF36 Role Functioning-Physical score at follow-up and frequency of mind/body self-healing practice. Subjects in the highest quartile of Role Functioning-Physical improved regardless of practice. For the remaining 75%, those practicing three or more days per week at follow-up were 2.7 times more likely to report positive 12-month Health Transition than those practicing less.

Falloon-Goodhew, Peter. Yoga for Living: Boost Energy. New York: DK Publishing, 2002.

Farhi, Donna. Fatigue/Recuperation from illness. In Donna Farhi, The Breathing Book. New York: Henry Holt & Co., 1996, p. 217.

Felt, Susan. Mind control: Calming your thoughts can energize your body. The Arizona Republic, 20 Jul 2004.

“Fifteen years ago, Barbara Holt would have described herself as a classic Type A personality: hard-driving and goal-oriented.

“She also was scattered and exhausted.

“‘I would wake up and hardly be able to drag myself out of bed,’ she says . . .

“Then Holt found that the key to her energy lay in her mind.

“What causes us to drag through our days isn’t always physical, experts say. Our thoughts can make us tired. The events of everyday life, whether related to work, money or relationships, can trigger emotions that ignite the body’s stress response. If the stress is constant, fatigue can result.

“The good news is that you can get back in control.

“Holt eventually transformed her condition from tense and tired to calm yet energetic through yoga and meditation . . .”

Female Times: Health: Alternative medicine can beat chronic fatigue. News

4 Letter, 31 Jan 2001, p. 30.

Includes section on how the practice of Yoga helps with chronic fatigue.

Gach, Michael Reed, with Carolyn Marco. Fatigue. In Michael Reed Gach with Carolyn Marco, Acu-Yoga: The Acupressure Stress Management Book. Tokyo: Japan Publications, 1981, pp. 161-168.

Garde, R. K. Debility (general). In R. K. Garde, Principles and Practice of Yoga- Therapy. Bombay, India: D. B. Taraporevala Sons & Co., 1972, 1984, p. 66.

Gavalas, Elaine. The Yoga Mini-Book for Energy and Strength. New York: Fireside, 2003.

Grossblatt, Debbie. A restorative yoga fairy tale. Article available online: http://www.yoga.com/ydc/enlighten/enlighten_document.asp?ID=303§ion=9&cat=2 03.

“Have you ever felt so fatigued or stressed that you could not find the energy to practice the most basic yoga postures that you learned in a Level I class?”

Grumman, Rachel. Energy boosters [yoga moves] to do at your desk. New Woman, Oct 1998, 28(10).

Guru Ram Das Center for Medicine and Humanology. Utilizes a yogically based health recovery system integrated with medical treatment that serves people with medical conditions at all stages, including newly diagnosed, treatment phase, recovery, recurrence, and end-stage. Chronic fatigue syndrome is among their specialties. Guru Ram Das Center for Medicine and Humanology, P.O. Box 943, Santa Cruz, New Mexico 87567, USA, tel: 505-995-2086, toll free: 800-326-1322, email: [email protected], URL: http://www.grdcenter.com/.

Hale, Catherine. M.E. and the yoga of non-effort: A sufferer’s experience of the Scaravelli approach. Spectrum: The Journal of the British Wheel of Yoga, Autumn 2000, pp. 14-15.

Health & Fitness. Glamour, mar 1997, 95(3). (Yoga for energy.)

Holistic-Online.com. Chronic Fatigue Syndrome. URL: http://www.holistic- online.com/Remedies/CFS/cfs_yoga.htm

Iyengar, B. K. S. Fatigue. In B. K. S. Iyengar, Light on Yoga. Rev. ed. New York: Schocken Books, 1979, p. 496.

______. Guruji [B. K. S. Iyengar] answers queries on stress and fatigue. Yoga Rahasya, 1997, 4(2):27-31. (Includes chronic fatigue syndrome.)

5 ______. Physical fatigue; Mental fatigue. In B. K. S. Iyengar, Yoga: The Path to Holistic Health. London/New York: Dorling Kindersley, 2001, pp. 290-293; 338-340.

Kelly, Alice Lesch. Rest for the weary. Yoga Journal, Mar/Apr 2001. Article available online: http://www.yogajournal.com/health/124_1.cfm. See also follow-up letters to the editor in the Jul/Aug 2001 issue, p. 14.

Khalsa, Shakta Kaur. Get a lift. Body & Soul Holistic Health, Winter 2002, p. 48-53.

Khalsa, Shanti Shanti Kaur. Mind and Movement®: Yoga for Serious Illness workshop. 6th Annual Yoga Journal Convention, 27-30 Sep 2001, Estes Park, Colorado. Author’s email: [email protected].

“Simple, safe, and effective yogic methods re medically sound and helpful to people with specific illnesses including cancer, HIV disease, and chronic fatigue to ease the side effects of medical treatment.” Based on principles present in Dr. Khalsa’s Immune Fitness® workshop.

Kocher, H. C. Influence of yogic practices on mental fatigue. Yoga-Mimamsa, 1976, 18(2):2-13.

Kraftsow, Gary. Working with Chronic Fatigue Syndrome; A practice for Chronic Fatigue Syndrome. In Gary Kraftsow, Yoga for Wellness: Healing with the Timeless Teachings of Viniyoga. New York: Penguin/Arkana, 1999, pp. 253-256.

Lark, Susan M., M.D. Breathing exercises; Yoga for relief of chronic fatigue. In Susan M. Lark, M.D., Chronic Fatigue & Tiredness: A Self-Help Program. Lost Altos, Calif.: Westchester Publishing, 1993, pp. 147-154; 179-194.

Laster, Judith. Relax & Renew: Restful Yoga for Stressful Times. Berkeley, Calif.: Rodmell Press, 1995.

“Restorative yoga and effective breathing techniques to relieve stress and fatigue.”

______. Relax and renew. Yoga Journal, Sep/Oct 1995, pp. 75–83.

Letter to the editor. Yoga & Health, Feb 1997, p. 41. (Recounts writer’s positive experience with Yoga for chronic fatigue.)

Mandlik, Vishwas V., and Ramesh Varkhede. Effect of Omkar chanting on concentration, memory and level of fatigue. In H. R. Nagendra, R. Ragarathna, and S. Telles, Yoga Research & Applications: Proceedings of the 5th International Conference on Frontiers in Yoga Research and Applications. Bangalore, Vivekananda Kendra Yoga Research Foundation, 2000, pp. 269-272. Article available online: http://www.yogapoint.com/info/research.htm#.

6 McManus, Melanie. Life goes on after chronic fatigue. Wisconsin State Journal, 10 Apr 1995, p. 1C. (On Cara Doyle, who mentions that she practices Yoga and meditation for her chronic fatigue.)

McRae, Ken (Sudhakar). Specialized restorative practice for exhaustion and chronic fatigue. Yoga Bulletin of the Kripalu International Network, Spring 1997, p. 9.

Mehta, Silva, Mira Mehta, and Shyam Mehta. Fatigue. In Silva, Mira, and Shyam Mehta, Yoga: The Iyengar Way. New York: Alfred A. Knopf, 1992, p. 186.

Midgow, Jeff, M.D. Chronic Fatigue Syndrome. Yoga Bulletin of the Kripalu International Network, Winter 1996, pp. 8, 11.

“Yoga is one of the most helpful resources for CFS . . . The main thing to know in advising your CFS students is that their yoga practice needs to be gentle and slow . . . “

______. Overcoming fatigue with the revitalizing power of yoga. . Kripalu Yoga Teachers Association Yoga Bulletin, Spring 2001, 10(1):8.

Moon, Laurie. Chronic Fatigue Syndrome: A personal perspective. Yoga Bulletin of the Kripalu International Network, Winter 1996, pp. 9, 11.

Motiwala, Sam N., and Rajvi H. Mehta. Treating ailments with yoga IV: Chronic Fatigue Syndrome. Yoga Rahasya 4(2) (1997): 32-37. (Brief discussion, followed by recommendations for several asanas.)

Murphy, Erin. Therapeutic yoga. Yoga Journal, Nov/Dec 1988, pp. 79-86. (Restorative Yoga for general fatigue and weakness.)

Murtha, Susanne, and Sabine Borchers. Chronic fatigue syndrome [Integrative Yoga Therapy approach]. Spirit of Healing Yoga Therapy Journal. Article available online: http://www.iytyogatherapy.com.

Need a boost? New Age Journal, Mar 1996, 13(2). (On yoga and other natural fatigue fighters.)

O’Reilly, Trish. Step by step. Yoga International, Jun/Jul 2001, pp. 76-84. (Energizing sequence.)

Powell, Belinda. Me and M.E. Yoga Biomed News, Sping 1995, no. 26, pp. 4-5.

Price, J. R., and J. Couper. Cognitive behaviour therapy for adults with chronic fatigue syndrome (Cochrane Review). The Cochrane Library, 2001, no. 2.

From a review by Belleruth Naparstek, HealthJourney News, 17 Jun 2001: “[This] systematic review looked at all randomized controlled trials of cognitive-behavior

7 therapy [CBT includes relaxation training, meditation, imagery, etc.] for adults with chronic fatigue syndrome (CFS).

“Although only 3 relevant trials were deemed worthy of inclusion, these studies demonstrated that CBT significantly benefits physical functioning in adult out-patients with CFS, and performs better than strictly orthodox medical management. In addition, the CFS patients found these treatment tools very much to their liking.

“The study concludes that the medical profession should be more aware of the potential of these therapies for improved functioning in their patients, and that health service managers should increase their availability.”

Prins, J. B., G. Bleijenberg, E. Bazelmans, L. D. Elving, T. M. de Boo., J. L. Severens, G. J. van de Wilt, P. Spinhoven, and J. W. van der Meer. Cognitive Behaviour Therapy for Chronic Fatigue Syndrome: A Multicentre randomised controlled trial. The Lancet, 17 Mar 2001, 357(9259):841-847.

From a review by Belleruth Naparstek, HealthJourney News, 7 Sep 2001: “Prins, Bleijenberg et al. from University Medical Center, Nijmegen, The Netherlands, compared the effects of cognitive-behavioral therapy (relaxation, guided imagery, and other self-regulatory techniques) to professionally facilitated support groups and a control group of standard care only, in the treatment of CFS (chronic fatigue syndrome). Of 278 patients diagnosed with CFS, 93 were randomly assigned to CBT, 94 to support groups and 91 to the control condition. Evaluations were done at the start, after 8 months, and after 14 months, to assess the severity of fatigue and degree of functional impairment.

“At 14 months, the behavioral therapy was found to be significantly more effective than the other 2 conditions, for fatigue and for functional impairment. Support groups were no more effective than the control condition.”

Ranade, Subhash, and Sunanda Ranade. Fatigue. In Subhash Ranade and Sunanda Ranade, Ayurveda and Yoga Therapy. Pune, India: Anmol Prakashan, 1995, p. 60.

Ravishankar, N. S. Exhaustion and fatigue. In N. S. Ravishankar, Yoga for Health: Curative Powers of Yogasanas. New Delhi: Pustak Mahal, 2001, p. 149.

Rawls, Eugene, and Eve Diskin. A yoga program for the fatigue problem. In Eugene Rawls and Eve Diskin, Yoga for Beauty and Health. West Nyack, N.Y.: Parker Publishing, 1967, p. 226.

Rees, Gillian. Dying of perfection: Overcoming Chronic Fatigue Syndrome. Yoga International, Mar/Apr 1995, pp. 13-16.

Richmond, Sonya. Insomnia, neurasthenia, and fatigue. In Sonya Richmond, How to Be Healthy with Yoga. New York: Bell Publishing, 1962, pp. 34-43.

8 Rothenberg, Robin. Therapeutic Yoga 101: A course in self-acceptance. International Journal of Yoga Therapy, 2004, no. 14, pp. 29-34. Author email: [email protected].

Abstract: This article is a personal essay describing the methodology for and orientation to teaching therapeutic Yoga in a mixed milieu. Many of the students have complex conditions such as multiple sclerosis, fibromyalgia, rheumatoid arthritis, cancer, or chronic fatigue. Others have suffered structural trauma from car accidents and are contending with soft tissue injury and disc compression. In spite of the irrefutable challenge of addressing these various conditions simultaneously, years of working in this field has convinced the author that not only is it possible to do so, but it is highly rewarding for both the students and the teacher. It is the author’s hope that by sharing her experience it will encourage other therapists to move beyond the container of a specific pathology and reunite body, mind, and spirit in a healing, communal environment.

Satyananda Saraswati, Swami. [Answers the question: Have you got any exercise that you can draw on at any time during the day, in any circumstances, to produce the energy you need?] Yoga, Jan 1977, pp. 16-17. (He recommends vajrasana and shashankasana.)

Schaeffer, Rachel. The full-energy workout: Revive from the inside out with these vitality-boosting yoga moves. Natural Health, Jan-Feb 1999, pp. 116-121. Available online: http://www.findarticles.com/cf_0/m0NAH/1_29/54062653/p1/article.jhtml?term=yoga.

Shah, J. T. Mental and physical fatigue. In J. T. Shah, Therapeutic Yoga. Mumbai, India: Vakils, Feffer and Simons, 1999, pp. 10-11, 18-19, 26-27, 42-43, 46-47, 50-53, 56-57, 64-65, 84-85, 88-99.

Sheffield Yoga for ME/CFS. URL: http://www.sheffieldyogaforme.org.

This very helpful site provides the following information:

General information on ME/CFS Benefits of Yoga for this condition Frequently asked questions on ME/CFS Book, tape, and CD reviews Evaluation Summary [for participants in Yoga for ME/CFS classes] 2002 Survey Report [for participants in Yoga for ME/CFS classes] 2003/2004 Feedback/experiences from members [of the ME/CFS classes]

Sherry, Vince. Healthy in Houston: Yoga for health . Article available online: http://www.news24houston.com/shared/print/default.asp?ArID=12260.

On how Jennifer Levinson, a chronic fatigue patient, benefited from the practice of Yoga.

9 Sieverling, Carol. “New” breathing technique: No cost, easier, and more effective at increasing oxygen transport than the “rebreather” protocol. Article available online: http://www.cfsresearch.org/cfs/cheney/17nf.htm.

Describes a pranayama technique recommended by Paul Cheney, M.D., for chronic fatigue syndrome. (NOTE: Because it involves breath holding, this technique is contraindicated for anyone with a cardiovascular disorder, such as hypertension, hypotension, heart disease, glaucoma, etc. Anyone with a cardiovascular disorder should not hold their breath.)

Sparrowe, Linda, and Patricia Walden. The women’s energizing sequence; The women’s restorative sequence. In Linda Sparrowe and Patricia Walden, The Woman’s Book of Yoga & Health: A Lifelong Guide to Wellness. Boston: Shambhala Publications, 2002.

Stevens, Angela. Yoga classes for people with ME/CFS: An update of news on the growing network of classes [in Great Britain]. Spectrum, Spring 2000, p. 23.

Thomas, Florence. Asanas for energy. New Straits Times, 8 Oct 1998, Vol. 12-194, Health Section.

“A series of yoga postures aids one in restoring a depleted nervous system and stimulating vital energy currents. These are the Loma-Viloma asanas, or energy- balancing postures, beneficial for newcomers to yoga and for people who are stiff or weak, or recovering from serious injury or illness.”

Varshell, Lanita. A Gentle Way: An Introduction to Very Gentle Yoga. La Mesa, Calif.: A Gentle Way Yoga & Joyful Movement Center. 90 minutes. Available for purchase online at http://www.agentleway.com/agwaudiotape.html, or call 619-483-4748.

For plus-sized people and people with physical or stress-related disabilities. [Lanita Varshell is plus-sized and formerly suffered from chronic fatigue and fibromyalgia.] The entire session is performed in a reclining position, either on the floor or on a bed. Reviewed in Yoga Journal, Nov/Dec 1999, p. 130.

From the website: “Practice yoga at home or on the road with this effective meditation tape. Soft music accompanies Lanita’s soothing voice as you are guided through gentle stretching, breathing, and relaxation techniques. The entire session is done either lying on the floor or your bed. This session is done with your eyes closed, all poses and stretches clearly described. If you have any questions regarding any of the poses in this tape Lanita will be happy to assist you through email.”

Vince, Sally. Journey back to wholeness. Research paper written for IYTA New Zealand, Inc. Coordinator of specialist papers for IYTA: Trish Peters, [email protected].

10 From IYTA News (N.Z.) Inc.: “This research paper . . . is a must for anyone who is teaching. It is important to understand a condition where symptoms and effects are not always highly visible.

“ME . . . has a variety of symptoms which range from feelings of extreme unwellness, persistent exhaustion, digestive problems, muscle aches, tenderness . . . all [of] this affected by physical effort. Because it is written from personal experience, there is a deep understanding of the needs of the individual, and this, coupled with thorough research, provides a full study of the topic.

“Chapters cover aspects of physical, emotional, spiritual well-being, giving exercises, affirmations and visualizations. Allergies and diet are explored along with breathing techniques and easy versions of asana work. Each of the eight limbs of yoga [is] used as [a tool] toward recovery. Using yoga techniques to alleviate the condition has helped to bring sufferers back to almost total well-being. Case histories are given as examples and other therapies are also explored.”

Voelker, Lakshmi. [Mudra for chronic fatigue; Mudra for tiredness]. Was originally available online at the health-care oriented Vicus.com, but the former has been replaced by search engine called Vicus.com.

Weller, Stella. Fatigue; ME (Myalgic Encephalomyelitis). In Stella Weller, Yoga Therapy. London: Thorsons, 1995, pp.105-106; 117-118.

Yee, Rodney. Yoga Journal’s Yoga Practice for Energy video. Available from Yoga Journal’s Catalogue, 1-800-I-Do-Yoga. See also the interview with Rodney Yee regarding this video at: http://www.gaiam.com/gaiam/1,1267,ArticleDetail:learn:12:520,00.html.

______. Yoga Journal’s Yoga Remedies for Natural Healing. Available from Yoga Journal’s Catalogue, 1-800-I-Do-Yoga. (General fatigue.)

Yoga Biomedical Trust. Chronic Fatigue Syndrome (M.E.) classes. URL: http://freespace.virgin.net/yogabio.med/ (click on “Yoga Therapy & How to Try It,” then click on “Index-Alphabetical,” then click on “Chronic Fatigue Syndrome”).

The Yoga for Health Foundation. Yoga for M.E. classes. For more information, contact: The Yoga for Health Foundation, Ickwell Bury, Ickwell Green, Biggleswade, Beds. SG18 9EF, Great Britain, tel: 01767 627261, fax: 627266, URL: http://www.yogaforhealthfoundation.co.uk/remedialyoga.htm#me.

Yoga Sciences Research Foundation. Energizing Series; Energize & Relax video. East Lansing, Mich.: Yoga Sciences Research Foundation. Email: [email protected], URL: http://www.angelfire.com/mi/ysrf/index.html.

Yoga stretches energy and enthusiasm. Spectrum, Jun 1995, no. 42, p. 20.

Results of a study that assessed the effects of three different techniques—relaxation, visualization and yogic exercises—in enhancing an individual’s self-perception of his/her energy level and mood.

Of Related Interest

Afari, Niloofar, David M. Eisenbergb, Richard Herrell, Jack Goldberg, Ellen Kleyman, Suzanne Ashton, and Dedra Buchwald. Use of alternative treatments by chronic fatigue syndrome discordant twins. Integrative Medicine, Spring 2000, 2(2-3):97- 103. PMID: 10882883.

Background: Patients with chronic fatigue syndrome (CFS) have been faced with difficulties in diagnosis and lack of effective treatments. Anecdotal evidence suggests that use of alternative treatments may be common in these patients. Our primary objective was to compare the prevalence and patterns of alternative medicine use among twins who met the Centers for Disease Control and Prevention (CDC) CFS criteria to that of their non-CFS co-twins. Secondary goals were to assess how often alternative medicine use was discussed with physicians and the perceived benefit of these therapies. Methods: Sixty-three twin pairs discordant for CFS completed a survey about their use of 22 alternative therapies. Matched pair odds ratios and 95% confidence intervals were used to examine differences in the use between CFS twins and their non-CFS co-twins. Results: 91% of twins with CFS and 71% of non-CFS twins had used at least 1 alternative treatment in their lifetime. Twins with CFS were more likely to use homeopathy, mega-vitamins, herbal therapies, biofeedback, relaxation/meditation, guided imagery, massage therapy, energy healing, religious healing by others, and self-help groups than their non-CFS counterparts. A large proportion of all twins found alternative therapies helpful; however, only 42% of those with CFS and 23% of those without CFS discussed their use of alternative medicine with a physician. Conclusions: Individuals with CFS frequently used alternative medical treatments yet rarely communicated this use to their medical doctor. Future research should ascertain the usefulness of alternative practices in the management of CFS.

Allen, Lesley A. Psychosocial treatments for multiple unexplained physical symptoms: A review of the literature. Psychosomatic Medicine, Nov/Dec 2002, 64(6):939-950. Author email: [email protected].

Abstract: Patients presenting with multiple medically unexplained physical symptoms, termed polysymptomatic somatizers [specific disorders addressed include somatization disorder, fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome], often incur excessive healthcare charges and fail to respond to standard medical treatment. The present article reviews the literature assessing the efficacy of psychosocial treatments for polysymptomatic somatizers. Relevant articles were identified by scanning Medline and PsychLit. Thirty-four randomized, controlled studies were located. Whenever possible results from each study were transformed into effect sizes. An analysis of the efficacy of

12 the psychotherapeutic approaches is provided. Various psychosocial interventions have been investigated with polysymptomatic somatizers. Although the majority of studies suggest psychosocial treatments benefit this population, the literature is tarnished by methodological shortcomings. Effect sizes are modest at best. Long-term improvement has been demonstrated in fewer than one-quarter of the trials. Although seemingly beneficial, psychosocial treatments have not yet been shown to have a lasting and clinically meaningful influence on the physical complaints of polysymptomatic somatizers.

Deale, Alicia, Kaneez Husain, Trudie Chalder, and Simon Wessely. Long-term outcome of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome: A 5-year follow-up study. American Journal of Psychiatry, Dec 2001, 158(12):2038-2042.

OBJECTIVE: This study evaluated the long-term outcome of cognitive behavior therapy versus relaxation therapy for patients with chronic fatigue syndrome. METHOD: Sixty patients who participated in a randomized controlled trial of cognitive behavior therapy versus relaxation therapy for chronic fatigue syndrome were invited to complete self- rated measures and participate in a 5-year follow-up interview with an assessor who was blind to treatment type. RESULTS: Fifty-three patients (88%) participated in the follow- up study: 25 received cognitive behavior therapy and 28 received relaxation therapy. A total of 68% of the patients who received cognitive behavior therapy and 36% who received relaxation therapy rated themselves as “much improved” or “very much improved” at the 5-year follow-up. Significantly more patients receiving cognitive behavior therapy, in relation to those in relaxation therapy, met criteria for complete recovery, were free of relapse, and experienced symptoms that had steadily improved or were consistently mild or absent since treatment ended. Similar proportions were employed, but patients in the cognitive behavior therapy group worked significantly more mean hours per week. Few patients crossed the threshold for “normal” fatigue, despite achieving a good outcome on other measures. Cognitive behavior therapy was positively evaluated and was still used by over 80% of the patients. CONCLUSIONS: Cognitive behavior therapy for chronic fatigue syndrome can produce some lasting benefits but is not a cure. Once therapy ends, some patients have difficulty making further improvements. In the future, attention should be directed toward ensuring that gains are maintained and extended after regular treatment ends

Ivanhoe Newswire. Treatment for chronic fatigue can be in [changing the way you think]. 19 Feb, 2001. Available online at Ivanhoe.com.

“If you’re one of the 800,000 Americans who suffer from chronic fatigue syndrome, treatment may be as simple as changing the way you think. A study reported in this week’s British Medical Journal shows by receiving an explanation for their symptoms, patients suffering with chronic fatigue were able to find relief from their condition . . . researchers conclude that when given education and physiological explanations for their condition, patients are more encouraged to do exercises that will benefit their condition.”

______. Chronic fatigue linked to [hormonal] stress [response system]. 2 Dec 2002. Available online at Ivanhoe.com.

“A new study . . . indicates chronic fatigue syndrome (CFS) may be linked to subtle changes in the hormonal stress response system called the HPA axis. A stable and functioning hypothalamus-pituitary-adrenal, or HPA axis, helps the body maintain smooth functioning under stress. The process to maintain control is lengthy and problems can occur at any point. The researchers in this new study suggest a problem in the process may be the cause of CFS . . . [They] recruited 40 volunteers (half with CFS and half without) to take psychosocial stress tests, physical stress tests, and undergo other medical tests. The researchers then compared the results of all the tests.

“They report significantly lower response levels of one of the HPA hormones among patients with CFS. The CFS patients had lower levels of the hormone prior to testing and after testing. The doctors say this research is early, but hope it will lead to further understanding of this complex disease.” (Source of Ivanhoe Newswire information: Psychosomatic Medicine, Nov/Dec 2002.)

Lindsay, Jamie. The energetic effects of pranayama. My Yoga Mentor, Nov 2004, no. 12. Article available online: http://www.yogajournal.com/teacher/[email protected]&ctsrc=nlt12.

“You may have noticed that changing the sequencing of your class changes your students’ energetic experience. But there’s another way to create different energetic effects—the careful use of breath control.”

Naschitz, Jochanan E., Michael Rozenbaum, Itzhak Rosner, Edmond Sabo, Renata Musafia Priselac, Naomi Shaviv, Allen Ahdoot, Michael Ahdoot, Luis Gaitini, Samuel Eldar, and Daniel Yeshurun. Cardiovascular response to upright tilt in fibromyalgia differs from that in chronic fatigue syndrome. Journal of Rheumatology, Jun 2001, 28(6). Abstract available online: http://www.jrheum.com/abstracts/abstracts01/1356.html.

Blood pressure and heart rate were recorded during 10 min of recumbence and 30 min of head-up tilt. Values in fibromyalgia (FM) were significantly different from those in chronic fatigue syndrome (CFS), suggesting that homeostatic responses in FM and CFS are dissimilar. This observation challenges the hypothesis that FM and CFS share a common derangement of the stress-response system.

Reuters Health. Exercise might relieve chronic fatigue. Reuters Health, 24 Aug 2000. Available online at HealthCentral.com, www.healthcentral.com/news/newsfulltext.cfm?ID=40217&src=n31.

Solomon, Laura, and William C. Reeves. Factors influencing the diagnosis of chronic fatigue syndrome. Archives of Internal Medicine, 8 Nov 2004, 164(20):2241-2245.

Abstract: Background: Most of what is believed about chronic fatigue syndrome (CFS) is based on clinic-based studies. These studies may not reflect CFS cases in the population. Methods: We used data from a population-based study of CFS to identify factors associated with receiving a CFS diagnosis. Wichita, Kan, residents were screened by random-digit dialing. Eligible individuals completed a telephone interview. Respondents meeting CFS criteria were invited for a clinical evaluation to confirm CFS. We analyzed all persons with confirmed CFS. The main outcomes of this study, prevalence and incidence of CFS, are published elsewhere. Herein, we present an exploratory analysis with previous CFS diagnosis as the outcome, predicted by demographic and symptom characteristics. Results: We confirmed CFS in 90 subjects; 14 (16%) had been previously diagnosed as having CFS. Persons in the middle- vs the higher-income group were more likely to have been diagnosed as having CFS (9 [29%] of 31 subjects vs 3 [8%] of 39 subjects; P = .03), as were those with sudden vs gradual fatigue onset (7 [41%] of 17 subjects vs 4 [6%] of 64 subjects; P < .01), those reporting tender lymph nodes (7 [33%] of 21 subjects vs 7 [10%] of 69 subjects; P = .02), and those reporting a sore throat (6 [35%] of 17 subjects vs 8 [11%] of 73 subjects; P = .02). Only 17 (21%) of 81 subjects had sudden fatigue onset, and tender lymph nodes (reported in 21 [23%] of 90 subjects) and a sore throat (reported in 17 [19%] of 90 subjects) were the least common symptoms. Conclusion: Most cases of CFS in the population are unrecognized by the medical community; persons diagnosed as having CFS may be different from persons with CFS in the general population.

Ongoing Research

Andrea Cione New York City [email protected] 212-408-5189 - Work (Mon-Fri, 3pm - 10pm) Teaches Yoga to the chronic fatigue syndrome patients of an M.D who specializes in chronic illness, and she will collect data via questionnaire on the effects of one year of weekly classes (control group may consist of patients not taking Yoga or those who took one Yoga class but did not continue). Contacted IAYT 04/02.