Chronic fatigue syndrome (CFS) is a complex disorder whose hallmark is extreme fatigue that is unconnected to an identifiable medical condition. The fatigue gets worse with physical or even mental activity, but doesn’t get better with rest.
CFS is also known as myalgic encephalomyelitis (ME), and more recently as systemic exertion intolerance disease (SEID). Although CFS/ME and SEID share the same major symptom—chronic fatigue—there are some differences between these disorders. Chronic fatigue can also result from several underlying conditions.
Signs and symptoms
- Memory loss
- Difficulty concentrating
- Sore throat
- Enlarged lymph nodes in neck or armpits
- Pain that travels across joints, with no swelling or redness
- Muscle pain with no apparent cause
- Headache of a new type, pattern or severity
- Unrefreshing sleep
- Extreme exhaustion for over 24 hours after physical or mental exertion
Chronic fatigue syndrome is a difficult condition to live with, and can prevent you from enjoying life the way you want to. It also affects your relationships, impairing your ability to be the friend, parent, or partner you’d like to be. This can cause stress, depression or anxiety.
One way to help manage and better handle your fatigue is with cognitive-behavioral therapy (healthy thinking). Your thoughts are something you have the power to control, and CBT can teach you techniques to make your thoughts more positive and helpful—negative thoughts can make you feel worse.
CBT is used to treat both the symptoms of chronic fatigue syndrome and the typically related effects of living with a chronic illness (such as depression, anxiety, relationship issues or work problems). To treat CFS symptoms, your therapist will ask you to keep detailed records to help you analyze what makes your symptoms better or worse.
For example, you might be asked to rate the severity of your fatigue hourly throughout the day while also tracking what you’re doing at the time—resting, lying down, sleeping, eating, exercising, working, engaging in a social activity, taking medication, etc. After a while, a pattern may become apparent, leading to a specific treatment. So if tracking shows exhaustion starting in late afternoon, planning a rest period for earlier in the afternoon could improve that symptom. Keeping records also helps to track progress (or lack thereof), and helps you feel like you have some control.
Behavior therapists use well-established techniques when treating the effects of CFS (such as depression, anxiety or relationship problems), but tailor them to the special circumstances of CFS sufferers. So while behavior therapy for depression often recommends increasing your physical activity, you may be depressed because CFS hampers your ability to be active. Your therapist would adapt to your needs, and find some enjoyable, but not overly strenuous, activities you could participate in without aggravating your symptoms.
Healthier thinking can remove barriers, such as pessimistic thoughts, to being physically active. Light aerobic exercise—even just walking—has been shown to be beneficial to people with chronic fatigue syndrome, helping them to feel more energetic and not as tired.
Changing your thinking won’t happen overnight. Be patient with yourself, as it takes time to learn healthy thinking and trying something new can feel strange at first. But once you get used to practicing it on a daily basis, it will get easier and you won’t even realize you’re doing it. Plus, it’s something you can start doing right now!