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Chronic Fatigue Syndrome (CFS / ME)

What is Chronic Fatigue Syndrome?

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME) or Post-Viral Fatigue, is a complex, long-term condition characterised by persistent and debilitating fatigue.

 

This fatigue is:

  • Not the same as everyday tiredness

  • Not caused by ongoing exertion

  • Not significantly relieved by rest

  • Severe enough to impact daily functioning

 

Symptoms may develop suddenly (e.g. after illness) or more gradually over time. Many people notice a clear change from their previous level of health and activity.

 

A key feature of CFS/ME is post-exertional malaise (PEM)—a worsening of symptoms following physical or mental effort, often delayed and disproportionate to the activity.

Common Symptoms

In addition to fatigue, people may experience a range of symptoms. These vary between individuals and can fluctuate over time.

Cognitive (“brain fog”) symptoms

  • Difficulty concentrating

  • Poor short-term memory

  • Reduced attention span

  • Difficulty planning, organising, or finding words

Feeling mentally “slowed” or disoriented

Physical symptoms

  • Unrefreshing or disrupted sleep

  • Muscle or joint pain

  • Headaches

  • Dizziness or light-headedness

  • Sensitivity to light, sound, or smell

  • Digestive issues (e.g. nausea, IBS-type symptoms)

  • Sore throat or tender glands

  • Heart palpitations

Emotional impact

  • Frustration, grief, or loss related to reduced functioning

  • Anxiety or low mood

  • Feelings of isolation or being misunderstood

 

CFS/ME can significantly affect work, education, relationships, and day-to-day life.

How Common is CFS/ME? (UK Statistics)

  • Around 250,000 people in the UK are estimated to be living with CFS/ME

  • It affects both adults and young people

  • Most commonly develops between ages 20–45, and also in adolescence

  • It is more common in women than men

  • Many cases develop following a viral illness, though not always

Understanding CFS/ME

  • There is no single known cause of CFS/ME. Current understanding suggests it involves a combination of factors, including:

  • Immune and nervous system dysregulation

  • Post-viral responses

  • Energy production and regulation difficulties

  • Stress and physiological sensitivity

 

Importantly, CFS/ME is a genuine and complex medical condition, not “just tiredness” or purely psychological.

What Treatment do we offer?

There is currently no single cure for CFS/ME. Treatment focuses on managing symptoms, improving quality of life, and supporting individuals to live within their energy limits.

 

Therapy plays an important role in helping people adapt, cope, and regain a sense of control.

Energy Management (Pacing)

  • Current best practice emphasises pacing, which involves:

  • Understanding your personal energy limits

  • Balancing activity and rest

  • Avoiding “boom and bust” cycles

  • Gradually building consistency rather than pushing through fatigue

 

(This approach is now recommended over fixed graded exercise programmes.)

Cognitive Behavioural Therapy (CBT)

  • CBT can support individuals to:

  • Adjust to living with a long-term condition

  • Manage the emotional impact (e.g. frustration, anxiety, low mood)

  • Address unhelpful thought patterns that may increase distress

  • Develop practical coping strategies

 

CBT is not a cure but can be helpful in improving quality of life.

Acceptance and Commitment Therapy (ACT)

ACT has a growing evidence base for CFS/ME. It helps:

  • Reduce the struggle with symptoms

  • Increase psychological flexibility

  • Support engagement in meaningful activities within limits

  • Build a sense of purpose despite ongoing symptoms

Compassion-Focused Therapy (CFT)

  • Particularly helpful where individuals experience:

  • Self-criticism (“I should be able to do more”)

  • Guilt or shame about reduced capacity

 

CFT supports a more compassionate and realistic relationship with your body and limits.

Sleep and Nervous System Regulation

Therapy may also include:

  • Improving sleep routines and patterns

  • Relaxation and grounding techniques

  • Reducing physiological stress and overexertion

How Therapy Can Help

Therapy offers a space to:

  • Make sense of your experience

  • Adjust to changes in identity and lifestyle

  • Manage uncertainty and setbacks

  • Reduce emotional distress

  • Develop a sustainable way of living

 

It can also help you communicate your needs more effectively with family, employers, or healthcare professionals.

Living with CFS/ME

Living with CFS/ME often involves learning to work with your body, rather than against it.

 

With the right support, many people find ways to:

  • Stabilise their energy levels

  • Reduce symptom flare-ups

  • Improve emotional wellbeing

  • Rebuild a sense of identity and purpose

 

While progress may be gradual and non-linear, meaningful improvement in quality of life is possible.

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