Why Treatment for Chronic Fatigue Syndrome is so Difficult
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Chronic Fatigue Syndrome

Why Is Chronic Fatigue Difficult To Treat?

May 12, 2017

The treatment for chronic fatigue syndrome (CFS) is difficult, because the illness is difficult to diagnose. There is no test to ascertain whether one has CFS or not. The diagnosis of CFS involves a process of elimination to rule out other disorders. This elimination process includes:

  1. An ongoing medical condition, such as untreated hypothyroidism, sleep apnea or narcolepsy, among others.
  2. A previously diagnosed medical condition whose resolution (termination) has not been documented satisfactorily, such as cancer and hepatitis B or C.
  3. A previously diagnosed major depressive disorder such as eating disorders, dementia, schizophrenia, bipolar disorder, etc.

Even if all these conditions have been ruled out, fatigue presents as an important symptom of several other illnesses such as:

  1. Fibromyalgia (characterized by chronic pain, tiredness that doesn’t improve when you sleep, pain in the joints, etc.)
  2. Somatoform disorders (disorders that are physical manifestations of psychological disorders). These make it very hard for patients with CFS to convince doctors that their illness is not entirely in their head.
  3. Non-melancholic depression (primarily psychological, not biological depression).
  4. Neurasthenia (a weakness of the nerves).
  5. Multiple Chemical Sensitivity disorder (a heightened sensitivity to low doses of environmental chemicals).

If an individual is be diagnosed with CFS, their treatment options primarily involve management of symptoms. Options include:

Cognitive Behavioral Therapy (CBT): A number of patients of CFS don’t believe their condition is psychosomatic (involving both mind and the body.) However, studies have shown that patients who undergo CBT show significant improvement in the severity of their symptoms. This is because CBT changes their patterns of thinking through a conscious evaluation of their thought processes.

Graded Exercise Therapy (GET): Slowly introducing patients to some form of physical activity that gradually increases over time has shown to be beneficial. These activities are completely patient-led. However, it isn’t a cure for patients with CFS.

To conclude, treatment for chronic fatigue is difficult but not impossible. It is possible to reverse chronic fatigue naturally through a combination of lifestyle changes.


Fukuda, K., Straus, S. E., Hickie, I., Sharpe, M. C., Dobbins, J. G., Komaroff, A., & Group, I. C. (1994). The Chronic Fatigue Syndrome; A Comprehensive Approach to its Definition and Study. Annals of Internal Medicine, 121(12): 53-59.

White, P. D., Goldsmith, K., Johnson, A. L., Chalder, T., Sharpe, M., & Group, P. T. (2013). Recovery from chronic fatigue syndrome after treatments given in the PACE trial. Psychological Medicine, 2227-2235.