Chronic Fatigue Syndrome
The treatment for Chronic Fatigue Syndrome (CFS) or Myalgic Encephalomyelitis (ME) is complex and requires a multi-pronged approach. It includes counselling, exercise, meditation, yoga, dietary changes, inclusion of nutritional supplements and sometimes medication (to cope with pain or sleep deprivation). This is because the symptoms of the illness are very diverse. Also the pathophysiology (disordered physiological changes occurring due to an illness) of CFS/ME remains unknown. Hence, dealing with the illness on a whole is difficult. Medical practitioners resort to treating individual symptoms in the hope that something or the other will help in the long run.
A vast range of treatment options have been shown to benefit patients with CFS/ME (although it’s a small percentage of patients who gain the benefits). As a result, no treatment can be ruled out completely.
A survey was conducted with CFS/ ME patients by the UK-based advocacy group, The ME Association. It was found that when it comes to treatment for CFS/ME, there’s very little that doesn’t work at all. Thus, deciding on the right treatment could feel like searching for a needle in a haystack. One may have to try different forms of treatment before they find something that works for them.
One way to decide on a treatment option is to decide on which symptom of CFS/ME do you want to address first:
The World Health Organization classifies CFS/ME as a neurological condition, implying that it is caused by an unexplained dysfunction in the neurochemistry of the brain. But, many medical practitioners think of CFS/ME as a neuropsychiatric condition. The latter belief was strengthened by the publication of the results of a study termed the PACE Trial, in 2013. It stated that Cognitive Behavioural Therapy (CBT) and Gradual Exercise Therapy (GET) were more effective in treating CFS/ME than specialist medical care. The implication that CFS is more of a psychiatric disorder than a physiological one left patients coping with the condition feeling disgruntled. Until the pathogenesis of this disorder is better understood, this question will remain an unanswered one.
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.
The ME Association. (2008). RCGP refuses to change their classification of CFS as a mental health disorder. Retrieved from The ME Association: http://www.meassociation.org.uk/2008/05/rcgp-refuses-to-change-their-classification-of-cfs-as-a-mental-health-disorder/
The ME Association. (2010, May). Uploads: Managing my ME: What people with ME/CFS and their carers want from the UK’s health and social services. Retrieved from The ME Association: http://www.meassociation.org.uk/wp-content/uploads/2010/09/2010-survey-report-lo-res10.pdf
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.