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  • Writer's pictureAmy Smith

M.E./CFS: Its Challenges and Tips on How to Manage

Updated: Feb 11, 2023

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (M.E./CFS) is a physical health condition that affects many people. There are many aspects of this condition that are challenging for those experiencing it, here are some examples:

-It can affect many bodily systems leading to a constellation of nasty symptoms (e.g. fatigue, pain, achiness, brain fog, stomach problems)

-For some individuals the symptoms of M.E./CFS can be severe and debilitating

-It can be unpredictable. There are times a specific activity may seemingly trigger symptoms but at other times the same activity does not exacerbate symptoms

-As there is no one physical marker, the condition is physically complex and it is not a well understood condition (even among medical professionals), therefore, it can take a long time (often years) to receive a diagnosis

-Not many people in the general public understand the condition which can lead to comments that are frustrating!

Unfortunately, compared to many other chronic physical health conditions, medical research on M.E./CFS is far behind. Understandably, those who experience M.E./CFS long for a cure. However, without known clear physical markers/causes a cure is difficult to achieve. Moreover, as mentioned above, it is very likely that what occurs in the body with those with M.E./CFS is highly complex, involving several bodily systems, therefore developing physical treatments is difficult. However, there is potential to improve the regulation of the systems involved which, in time, can help to reduce symptoms. Some people notice improvements early on once they begin to make changes. However, do not be disheartened if you do not notice immediate improvements as changes in the body often takes time (even several months).

As several systems in the body are involved in M.E./CFS this calls for a holistic approach to manage the condition. This involves taking care of both your physical and emotional wellbeing. The fact that I believe it is important for you also to attend to your emotional wellbeing and not just your physical wellbeing does not mean for one moment I think your symptoms are not real and are “all in your head”, which is a message you may have received elsewhere from friends, family and even healthcare professionals. Hopefully in the explanation of the physiology underlying M.E./CFS on the M.E./CFS page on this website (click here to view the M.E./CFS page), it makes sense why it is also important to attend to your emotional wellbeing and not just physical wellbeing.

In therapy that I can offer, I can collaboratively work with you to find ways to make improvements to your physical and emotional wellbeing. Therapy is very much individualised. However, here is a list of some of the key things that you may be introduced to:

Pacing: balancing your activity levels. This involves not doing too much nor too little, taking regular breaks, alternating the type of activity you engage in, making time not just for things that need to get done but also time for things that you want to do that are enjoyable and relaxing. Pacing helps to regulate the systems in the body and helps them to re-set.

Socialise: This releases a hormone called oxytocin which improves our emotional wellbeing and also improves the functioning of the autonomic nervous system (ANS).

Valued Activities: Do things that give you a sense of achievement/add value to your life (this can increase dopamine levels which not only helps us to feel good emotionally but helps to improve the functioning of the ANS, reduces brain fog and improves pain tolerance).

Regulating your sleep: go to bed and wake at a similar time, try to avoid/minimise sleeping in the day.

Regular eating: eat three meals per day and snacks in between, eat at regular times each day, eat fresh food

Drink enough fluids

Mindfulness/Meditation and Relaxation Exercises: These help to boost the parasympathetic nervous system (relaxation system) to counter the sympathetic nervous system (stress system) which is in over-drive for those suffering from M.E./CFS.

Manage emotions e.g. stress/anxiety/depression: For example, address unhelpful thinking patterns. This boosts our parasympathetic nervous system.

Monitor your steps: Work out what your tolerance levels are and try not to go over this even on good days.

Gentle stretching: This helps to activate the parasympathetic nervous system and improves blood flow which reduces anxiety and symptoms associated with M.E./CFS, such as brain fog.

If you would like support in managing your M.E./CFS, including learning in more details about the above tips, feel free to contact me, a M.E./CFS specialist Psychologist, at or kindly complete the webform. I can offer therapy in-person in St Albans/Hertfordshire or online.

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