Chronic Fatigue Syndrome – Treatment Overview

Treatment for chronic fatigue syndrome (CFS) focuses on making you feel better so that you can resume a normal life. Simple measures you can take at home—such as improving your sleep habits and getting gentle exercise—are important parts of treatment. Talking with a counselor or psychologist has been proven to be helpful for people with CFS.6, 7
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Although there is no cure for CFS, many of its symptoms do respond to treatment.
Initial treatment

Pain relievers that you can buy without a prescription, such as acetaminophen, ibuprofen, or aspirin, may help relieve headaches, muscle and joint pain, and other physical symptoms. Narcotic pain relievers, which require a prescription from a health professional, may become addictive if they are used frequently, so they are generally prescribed in the most severe cases on a short-term basis.

Taking antidepressants and getting counseling can help relieve your other symptoms, whether you have depression or not. Antidepressants are used to improve your mood, control your pain, and help you sleep. With CFS, treating both physical and psychological factors is important.

There are many unproven remedies, such as special diets or mineral supplements, that some people recommend for treating CFS. There is no evidence that any of these are effective.1, 6
Ongoing treatment

Home treatment is very important. Adjusting your daily schedule, improving your sleep habits, and getting regular, gentle exercise can often help you feel better. Beginning a graded exercise program, in which the level of exercise starts out easy and gradually grows more challenging, should be part of your treatment. Studies have shown that a carefully planned exercise program can help people with CFS regain their strength and energy and feel better.6 Remember that if you have CFS, you will be able to do only light exercise. Doing too much or increasing your level of exercise too quickly can make your symptoms worse. For information about starting an exercise program, see:

Graded exercise for chronic fatigue syndrome.

A type of counseling called cognitive-behavioral therapy has been shown to help people with CFS function better on a day-to-day basis.6, 7 It is counseling that teaches people how to change the way they think and behave to cope more successfully with their fatigue and other symptoms.

Even though it’s not easy, keeping a good attitude is a great benefit for people with CFS.1 Your mind and body are connected and influence each other. Physical illnesses can be made worse—or better—by your feelings and attitudes, and vice versa. Learn as much as you can about your disease and work with your doctor to learn ways to cope with your symptoms. Get emotional support from your health professionals as well as from your family and friends. It’s easy to get caught in a cycle of frustration, anger, and depression. Learning to cope with your symptoms will help you avoid that cycle. For more information, see:

Cognitive-behavioral therapy for chronic fatigue syndrome.

Regular visits to your doctor every few months can help track your progress and evaluate any changes in your symptoms that might indicate that your fatigue is caused by something other than CFS.
Treatment if the condition gets worse

The good news about CFS is that it rarely gets worse over time. In some people, it goes away in 1 or 2 years. Others have periods of relatively good health followed by periods of severe symptoms and great difficulty. Relapses are not unusual. Continue to see your doctor periodically to monitor changes in your condition.
What To Think About

Although the cause of chronic fatigue syndrome (CFS) is not well understood, the fatigue is real and can make day-to-day activities difficult. As you work toward regaining your strength and energy, don’t go too fast. Aim for a gradual return to your previous level of activity.

Doctors focus on giving support, information, and counseling, and on treating any problems that arise as a result of symptoms of CFS. If you are depressed, your doctor may prescribe an antidepressant. Medicines are also prescribed to help you sleep, relieve your pain, and treat blood-pressure problems. Blood pressure problems may include orthostatic hypotension in which your heart beats faster and your blood pressure drops when you stand or sit up quickly.

Joining a support group can reassure you that there are others who share your experience, that you are not alone. Talking to others who have CFS can help you maintain a good attitude, which is critically important to feeling better.
Author: Robin Parks, MS
Medical Review: Anne C. Poinier, MD – Internal Medicine
Karin M. Lindholm, DO – Neurology

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