Treatment for Chronic Fatigue Syndrome

Chronic Fatigue Syndrome (CFS), also known as Myalgic Encephalomyelitis (ME), is a complex ‘medically unexplained’ condition in that there are currently no reliable or valid tests for its diagnosis. Diagnosis is therefore based on ruling out serious pathology that could otherwise explain the symptoms that patients experience which are usually extreme fatigue, widespread pain and stiffness and ensuing problems with mental wellbeing. Having a doctor ruling out serious pathology is clearly reassuring but at this point patients still have lots of unanswered questions and this is where many of our own patients tell us that they have been left without adequate help.

The process of coming to a diagnosis is a sensitive one. Patients often complain that they are not listened to adequately or taken seriously enough. Some even sense that healthcare practitioners think that they are making their symptoms up. It is possible that patients may exaggerate symptoms in an attempt to be taken more seriously but this is not a criticism of them, it is a failure of the medical community to provide good care for them in the first place. If we challenge our patient’s ideas about their condition, it is only ever done with sincerity and empathy and always with the intention of helping them improve their symptoms and quality of life.

Some patients find the label of a formal diagnosis helpful because, finally, it means that they are being taken seriously and there is hope that someone will be able to help. However, other patients tell us that a label is all well and good but see little point in it unless help is forthcoming and effective. Essentially, they have been given a medical diagnosis for a medically unexplained problem.

We understand this condition because we understand the individual symptom characteristics (with or without a label) and fully appreciate the profound effect it has on quality of life and ability to function normally in society. Patients with CFS, as well as other similar conditions like fibromyalgia, require in-depth assessment and treatment from a multidisciplinary team (MDT). This is ideally not just a loose referral network but a team really working together, with the patient involved in the decision making processes surrounding their care at all times. It is also a long term therapeutic relationship; there are no quick fixes and we aim to be as thorough as possible and get it right from the start rather than cut corners or dilute patient care.