Chronic Fatigue Syndrome - Treatment

Treatment

There is no proven or reliable cure for CFS, and no drug has been developed specifically for this disorder. Because CFS remains poorly understood, many patients have problems finding good care. Overall, the recommended strategy for treatment includes a combination of the following:

• A healthy diet
• Antidepressant drugs (in some cases), usually low-dose tricyclics
• Cognitive-behavioral therapy (CBT) and graded exercise (for certain patients)
• Other medications
• Sleep management techniques

Patients who stay as active as possible and try to have some control over the course of the disorder have the best chance for improvement. It is important for patients to choose physicians who are willing to consider the problem a medical condition with psychiatric components. They should be very wary, however, if the physician recommends excessive and expensive treatments that may have serious side effects and that have no proven benefits. For patients with severe CFS that cannot be managed with lifestyle changes and standard medications, asking the physician about enrolling in any available clinical trials may be helpful.

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Cognitive-Behavioral Therapy

CBT is designed to help CFS patients regain a sense of control, and is proving to have substantial benefits for some patients. Some experts believe that patients who are diagnosed with CFS should be referred to therapists who are trained in cognitive-behavioral therapy. (Psychoanalysis and other interpersonal psychological therapies, which are concerned with subconscious thoughts and early childhood memories, are not generally helpful for CFS patients.)

The Goals of Cognitive-Behavioral Therapy. The primary goals of cognitive-behavioral therapy (referred to below as just cognitive therapy) are to change any distorted perceptions that individuals have of the world and of themselves, and to change their behavior accordingly. For CFS patients, this means learning to think differently about their fatigue, improving their ability to deal with stressful situations, and managing their disorder. CBT can also help people manage their sleep problems and find the appropriate activity levels for them. Cognitive therapy is particularly helpful for defining and setting limits, behaviors that are extremely important for CFS patients.