How is chronic fatigue syndrome treated?

How is chronic fatigue syndrome treated?

It is generally advised that if one suffers from chronic fatigue syndrome, one should strive to get as much rest as possible and pace oneself when going about daily activities. Attempts to avoid any emotional stress or excessive physical activity should be made as far as possible.

It is vital to remember that the goal for treating CFS is to avoid any pain or fatigue from progressing. It is advised that a CFS sufferer implement a daily routine that can be easily managed and followed in order to avoid the progression of symptoms or a relapse. Any exercise that is performed should be done under the supervision of a PT (physical therapist) or doctor. It is also best to avoid complete rest (i.e. some exercise should still be undertaken) as stopping all physical activity can make one feel more fatigued. Therefore, some physical activity that is conducted at a steady and comfortable pace should be undertaken daily. When seeking to increase physical activity and strength, this should be done at a gradual rate. Decreased amounts of caffeine and alcohol may also help CFS sufferers to sleep better. Social isolation should also be minimised as being around people and taking one's mind off the condition may help to improve overall mood.

A chronic fatigue syndrome treatment plan will be designed according to the symptoms experienced. Being diagnosed early, following a treatment plan, taking medications and controlling certain symptoms are all factors that will aid in recovery. CFS can last for a number of months and even years, yet some people, through treatment and pacing themselves will recover completely and successfully return to the pace of their normal lives. However, other less fortunate cases may have their symptoms aggravated due to lack of treatment and knowledge.

 Psychologist treating a woman

The treatment plans for chronic fatigue syndrome

There are a number of different treatment options for CFS, it is likely that your doctor will choose one tailored to a patient's needs in order for personal symptoms to be effectively managed.

A doctor will first discuss the available treatment options and explain what the side effects and benefits of these are. From this, a personalised plan is likely to be developed. Should one's symptoms be more severe, then a doctor may also refer one to a specialist such as a psychologist to help manage mental health issues such as stress, anxiety and depression associated with CFS. A doctor will regularly review the treatment plan and assess various factors in recovery, making adjustments where necessary for the best results.

Specialist treatments for CFS

The following are the different specialist treatments available for those with CFS:

CBT (cognitive behavioural therapy)

This is a type of vocal (talking) treatment designed to aid in managing the way that one behaves and thinks. This technique may aid in the following ways:

  • Helping one to accept a condition for what it is
  • Allowing one to feel that one has some control over the symptoms experienced
  • Challenging the emotions that may be preventing symptoms from improving
  • Gaining a thorough understanding of the cause and effect relationship between one's behaviour and condition, for example, learning that stress, when experienced over the long term, causes the body to produce hormones that can lead to illness.

The CBT therapist is likely to have some experience in dealing with those who have CFS and will offer the treatment on a personal basis.

The use of CBT as a psychological method of treatment does not mean that chronic fatigue syndrome is a mental condition or 'all in your head', rather cognitive behavioural therapy is part of a broader scope of treatment for several long-term disorders.

GET (graded exercise therapy)

This treatment technique is conducted through an exercise programme that is structured to gradually increase the amount of time one performs physical activity. GET typically involves raising one's heart rate through walking or swimming and the programme is tailored to a person's personal physical capabilities.

GET will be conducted by a specialist who has hopefully had some experience with CFS patients, and is normally done on a personal, one-on-one basis.

Once finding out what one's capabilities are, the length and intensity of the exercise will be increased gradually. One will also set goals to reach. These goals may take a number of weeks or even years to achieve, but it is vital to try to reach these as this will help with the improvement of one's condition.

Activity management

This technique ties in with GET and will involve a CFS sufferer setting their own personal goals in daily life and recording rest periods and current activity in a diary. Activities are then gradually increase tover time, bearing in mind that overexertion should be avoided as this may result in the worsening of symptoms. Instead it is advisable to perform physical exercise and activities in a way that is manageable and proceeds without any adverse after effects.

Medication for chronic fatigue syndrome

Currently, there is no specific drug or medication for the treatment of chronic fatigue syndrome, but there are a number of medications available to aid in the improvement and relief of symptoms.

Medication

OTC (over-the-counter) pain relievers may help in easing headaches and any joint and muscle pain that one suffers from. A doctor may also prescribe some stronger medications, although these should only be used short-term.

Antidepressants and sleeping tablets are often prescribed to those who suffer from depression as a result of chronic fatigue syndrome. These often aid in improving sleeping issues and relieving pain. Some of these include:

  • Amitriptyline – This is a low-dose antidepressant drug and also aids in easing muscle pain
  • Sertraline (Zoloft) and Bupropion (Wellbutrin) – These are used to treat any issues regarding sleep or pain and can also aid in the improvement of psychological issues.

Lifestyle changes in treating chronic fatigue syndrom

Supplements and diet

These lifestyle changes should be an additional form of treatment to medications and the aforementioned techniques.

Supplements and diet may play a vital role in the improvement of CFS symptoms. A number of doctors will suggest that one sticks to a healthy, balanced diet. One may be referred to a dietitian who will be able to design a meal plan that ensures that sufficient nutrients and energy are obtained from the food consumed.

Supplements also have several benefits, some of these include:

  • Vitamin C – Aids in boosting the immune system
  • Vitamin B12 – Prevents anaemia and keeps the body’s blood and nerve cells healthy
  • Coenzyme Q10 – Promotes energy and cell growth
  • Magnesium – Aids in keeping blood pressure normal, increases energy and calms anxiety and nerves, as well as offering a number of other health benefits.

Rest, relaxation and sleep

If one suffers from chronic fatigue syndrome  it may be difficult to:

  • Fall asleep and achieve a deep sleep state
  • Wake up feeling refreshed
  • Get enough sleep as one feels more is required
  • Sleep during the night as one may sleep more during the day

A doctor may be able to help  in establishing a healthy sleeping pattern. One may find that it is necessary to sleep during the day, if this is the case, and it is possible to do so, then a doctor is likely to suggest that one has naps that are no longer that 30 minutes so that a good night’s sleep is still possible.

There are also a number of breathing and relaxation techniques such as meditation and deep breathing that may be able to help one feel refreshed during the day as opposed to having a nap.

Other lifestyle changes to help manage CFS

Some with severe CFS may need to have a special badge to enable them to park their car in the disabled parking area as walking far distances is extremely difficult to do. They may even need a stairlift to be fitted in their homes, and in the most severe cases, wheelchair use will need to be implemented.

Counselling and support groups

There are some community support groups for those who suffer from CFS, however, not every sufferer will find these to be useful and a number of people do not get their symptoms diagnosed or recognise this as a real condition. It is vital to see chronic fatigue syndrome as a very real and, in some cases, severe condition that can have a vast and complicated impact on one’s life.

Relapses or setbacks in chronic fatigue syndrome

Relapses are a common experience in those suffering from chronic fatigue syndrome, when these occur symptoms feel significantly worse for a period of time. The condition will usually follow cycles or patterns of remission and relapses. Relapses are often the result of several factors such as unplanned mental or physical activity or infection. In some cases, there is no clear or specific cause. A specialist or doctor can help one to manage these relapses by:

  • Prescribing any medication necessary to help alleviate symptoms
  • Teaching one breathing and relaxation techniques
  • Including more rest periods in activities
  • Encouraging one to be positive regarding the outlook and recovery of your condition

What is the follow-up care for CFS?

A doctor and/or specialist is likely to ensure that regular check-ins and follow-up appointments are scheduled so that he or she can ensure that one's condition is improving and modify treatment if need be.

PREVIOUS How is chronic fatigue syndrome diagnosed?
NEXT Prevention and outlook for chronic fatigue syndrome