Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is a type of therapy that can help you manage CFS by changing the way you think and behave. It's often used as a treatment for a range of health conditions.
CBT aims to help reduce the severity of your symptoms and the distress associated with CFS. It works by breaking down overwhelming problems into smaller parts, and by breaking the negative cycle of interconnected thoughts, feelings, physical sensations and actions.
Ideally, your CBT therapist will have experience of dealing with CFS and treatment will be offered on a one-to-one basis. The treatment will be tailored to your needs and may include some of the following:
- Helping you accept your diagnosis.
- Challenging feelings that could prevent your symptoms improving.
- Trying to increase your sense of control over your symptoms.
The use of CBT doesn't mean CFS is considered to be a psychological condition. It's often used as a treatment for a variety of long-term conditions, such as cancer and rheumatoid arthritis.
Graded Exercise Therapy (GET)
Graded Exercise Therapy (GET) is a structured exercise programme that aims to gradually increase how long you can carry out a physical activity.
This usually involves exercise that raises your heart rate, such as swimming or walking. You'll have your own exercise programme adapted to your own physical capabilities.
GET should only be carried out by a trained specialist with experience of treating CFS and, if possible, should be offered on a one-to-one basis. After finding out what you can comfortably do already in the exercise (the baseline), you will gradually increase:
- The length of time you do the exercise.
- The intensity of the exercise.
As part of your exercise programme, you and your therapist will set goals, such as being able to walk to the shops or carry out some gardening. It may take weeks, months or even years for you to achieve these goals, but it's very important not to exceed the exercise duration and intensity set for you.
Activity management is another aspect of your treatment programme. It involves setting individual goals and gradually increasing your activity levels.
You may be asked to keep a diary of your current activity and rest periods to establish your baseline. Activities can then be gradually increased in a way you find manageable.
There's no medication available to treat CFS specifically, but different medicines may be used to relieve some of the symptoms of the condition.
Over-the-counter painkillers can help ease any muscle pain, joint pain and headaches you may have. Stronger painkillers can also be prescribed by your GP, although they should only be used on a short-term basis.
If you have chronic (long-term) pain, you may be referred to a pain management clinic. There are about 300 of these across the UK, mostly located in hospitals.
Antidepressants can be useful for people with CFS who are in pain or having trouble sleeping. Amitriptyline is a low-dose tricyclic antidepressant that may be prescribed.
It is not suitable for everyone – for example, it may not be suitable if you have a history of heart problems. It can also cause side effects such as a dry mouth, blurred vision, dizziness and drowsiness.
If you experience severe nausea as a result of CFS, you may benefit from a type of medication called an antiemetic.