What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS) is an illness characterised by persistent or relapsing unexplained fatigue, of more than six months duration. Other symptoms of the illness may include muscular and joint pain, headache, tender lymph glands, sore throats, unrefreshing sleep, and difficulty with memory and concentration. The severity of symptoms can vary from day to day, and many people have to give up work or study, and greatly reduce their social, family or leisure activities. There is no blood test for CFS so diagnosis is based on the clinical assessment of symptoms and disability a person describes, and by ruling out all other conditions known to cause fatigue.   

There are no known causes of CFS, but there is some evidence that the condition may be triggered by a viral infection or other infections, high levels of stress, or major life events. Changes in the immune, nervous and hormonal systems have been found in people with CFS, but it is not clear if the changes are the cause or the result of the condition. Some people with CFS also suffer from other health problems, such as irritable bowel syndrome, depression, and anxiety, which can exacerbate symptoms and complicate recovery. 

Overcoming Chronic Fatigue Syndrome

Research has shown that people can recover from CFS and consider themselves as having good or very good health after their recovery (1). Recovery, however, may not mean a return to pre-CFS levels of activity and functioning, as the illness often requires a long-term management approach. Some people can experience ongoing symptoms for many years, and thus recognise the need to continue implementing the skills and strategies learned in therapy.

Unfortunately, there is disagreement amongst patients, researchers and clinicians about which treatments are most effective for CFS.  While different medications (synthetic or natural) have been effective for some people they do not work for everyone. Having a supportive GP and getting specialist medical advice is very important to determine what treatment approach will be best for each person. Put simply, there is no ‘one size fits all’ treatment for CFS, so a tailored approach with the help of several clinicians across different professions can be helpful. 

Rehabilitation approaches, which include activity, rest and sleep management advice can be effective, and work best with the specialist skills of trained health professionals. Several studies have demonstrated that Cognitive Behavioural Therapy (CBT), which incorporates sleep management, graded activity, using appropriate rest, has also been effective in helping people recover from CFS. CBT aims to help people understand their illness, provides empathic support, improve sleep, increase general functioning, improve mood and anxiety related to the illness, and generally helps people cope with the debilitating nature of CFS. CBT can also help improve self-esteem, relationships and work functioning that are commonly affected by CFS.  

Learning mindfulness and self-compassion, through a range of practical exercises and skills training, can also improve resilience to cope with the symptoms of CFS/ME.  Psychologists can offer a tailored treatment program with mindfulness training and CBT, which would complement any medical or physical treatment options someone with CFS  undertakes.

(1) Brown, M., Bell, D.S, Jason, L., Christos, C., and Bell, D.E (2012). J Clin Psychol. 2012 Sep; 68(9): 1028–1035.

Treatment at Avoka Health

Dr Giselle Withers, a Clinical psychologist at Avoka Health, worked for two years at a leading Chronic Fatigue Syndrome Service at St Bartholomew’s Hospital in London. She has been trained by leading practitioners in Cognitive Behavioural Therapy for Chronic Fatigue Syndrome and has helped many people overcome CFS with this approach. She also specialises in sleep management, and treatment of anxiety and depression, which enables her to work very effectively with people faced with this complex combination of symptoms. Please contact Giselle for more information on CFS. Referrals from GP’s are able to access a Medicare rebate for treatment sessions.