Chronic fatigue syndrome (CFS) is a much maligned and poorly understood condition. One thing is certain about it though, it can be deeply disabling. With this condition, perhaps more than any other, is the need for the patient to vigorously invest in self care. This is how to do it:
1. Build yourself a ‘concertina’ lifestyle.
CFS varies, often unpredictably. It’s important to have a lifestyle that can easily be contracted when you’re feeling less well, and expanded when you are feeling a bit better. This means making tough structural decisions about your life. Work, perhaps, needs to be flexible, but so do social commitments. If you are to feel good about your life you need to be free to participate as much as you are able without feeling guilty that you ‘should’ be doing more.
2. Pace yourself evenly throughout your day, week and months.
It’s easy whe you are feeling relatively well to attempt ‘catch up’. This is only going to result in a rebound bout of exhaustion. The cognitive behavioural therapist’s advice is to pace your activities sensibly. Do some activities, rest, then do some more, then rest again. Getting this balance right is an art in itself, and will depend on your energy levels from day to day. The alternative, the push yourself solidly then collapse into fatigue will create a hectic and unstable lifestyle characterised by huge peaks and troughs. It is better to live your life steadily which will maintain your well-being over the long term.
I once read that one day’s bed rest results in a loss of body strength of 4%. I don’t know if it is true, but it surely makes a valid point. If you don’t use your body it will ‘de-condition’, that is to say, get weaker. For someone who is exhausted a lot of the time, this can cause a vicious cycle. Exhaustion leads to muscle loss which leads to more exhaustion.
Try and exercise regularly, even if for just 5 minutes a day. Try to build the strength of your heart and lungs with walking or jogging. But don’t forget to build the strength of your skeletal muscles too. Start with really light weights if you have to, like a tin of beans. Aim to make slow regular improvements.
It is really important not to overdo exercise as it can rebound into more fatigue. Again, learning to get the balance right is the key.
4. Eat Small Regular Meals.
Nutrition is important to maintain your body in as healthy a state as possible. In terms of delivering energy it is best if you eat small regular meals throughout the day. Try eating more complex carbohydrates like brown rice and brown bread which will deliver energy slowly and steadily. Avoid sugary foods which boost energy in the short run but then result in a rebound collapse of energy.
5. Challenge Your Thinking.
It’s easy when you’re exhausted to become the victim of your own negative thinking. Try to think of this bout of exhaustion as temporary. Thoughts like ‘I’m always fatigued’ or ‘this will never end’, are not only inaccurate, they are demoralising. If you find yourself ruminating on negative thoughts … stop. Switch your attention to something different instead. Listen to (uplifting) music, make a phone call or make a list of what you have to be grateful for. Chronic fatigue is just one part of you.
I understand that coping with chronic fatigue is difficult, not least because it is so poorly understood by health professionals. In searching for a therapist to help it’s as important to find someone who can work with you physically as well as psychologically. Ideally the therapist should have sports and nutrition qualifications as well as therapy qualifications … and there aren’t many of us about!
Dr Phil Tyson is a Men's Psychotherapist based in Manchester in the UK. He offers: