Managing chronic fatigue syndrome can be as complex as the illness itself. There is no cure yet, no prescription drugs have been developed specifically for CFS, and symptoms vary considerably over time. These factors complicate the treatment picture and require you and your health care team to constantly monitor and frequently revise treatment strategies.

It may take some time to find a combination of traditional and alternative therapies that works for you, but it’s important not to delay symptom management. For instance, untreated sleep problems can actually make other symptoms—like pain and memory problems—worse.

One key to managing CFS is working with your doctor and other health care practitioners to create an individualized treatment program for you. This program should be based on a combination of therapies that address coping techniques, symptoms and activity management.

A multidisciplinary team of health care professionals working together to develop this individualized care plan is ideal. This team might include physicians and other primary care professionals, mental health professionals, rehabilitation specialists and physical or exercise therapists. Other professionals, like a sleep therapist or dietician, can be added as needed, and you may only need one or two consultations with such specialists.

If you live in an area where you don’t have access to specialists, or if your insurance professional doesn’t cover such consultations, you can still work with your primary care professionals to develop an effective treatment plan.

Coping with CFS
Living with chronic fatigue syndrome can be difficult. Like other debilitating chronic illnesses, CFS can have a profound impact on daily life, requiring patients to make significant lifestyle changes and adapt to a series of new limitations.

Common Difficulties
Common difficulties for CFS patients include problems coping with:

• the severe, changing and unpredictable symptoms of varying severity
• a decrease in stamina that interferes with activities of daily living
• memory and concentration problems that seriously impact work or school performance
• an uncertain prognosis that makes it hard to plan for the future
• loss of independence, livelihood and economic security
• alterations in relationships with family and friends
• worries raising children
• concerns about the potential impact of decreased sexual activity on intimate relationships
• skepticism and misconceptions about the illness

Feelings of anger, guilt, anxiety, isolation and abandonment are common in CFS patients. While it's normal to have such feelings, unresolved emotions and stress can make symptoms worse, interfere with pharmacological therapies and make recovery harder. It's important for patients to acknowledge the life-altering changes imposed by their illness and to develop effective coping strategies to deal with these changes.

Professional Counseling
Consulting a trained professional will help most patients build effective coping skills. A supportive counselor can help you cope with the prospects of long-term illness, as well as the anxiety, depression, grief, anger and guilt that often accompany chronic illness. A competent therapist, using problem-solving techniques and standard psychotherapy and counseling methods, can help you work through these issues. In some cases, a therapist may recommend a combination of medication and psychotherapy. Because chronic illnesses like CFS impact the entire family, not just the patient, you may want to consider family education and counseling. Consulting a behavioral health professional may be helpful to address changes in family dynamics related to living with CFS.

Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy, or CBT, is often prescribed to help chronically ill patients cope with illness and develop behaviors and strategies that help alleviate symptoms. It has been successful in helping patients with cardiovascular disease, diabetes and cancer, and recent studies indicate that CBT can be useful in treating some CFS patients.
CBT is frequently prescribed as part of therapeutic process; it help patients learn to manage activity levels, stress and symptoms. Optimally, CBT can help you better adapt to the impact of CFS and improve your level of function and quality of life.

Symptomatic Treatment
People with CFS present with different patterns of primary symptoms. Symptom severity can also vary considerably. Clinicians should query patients about which symptoms are most disruptive or disabling and tailor the management plan accordingly. Treatment can be directed toward the most problematic symptoms as prioritized by the patient, but only after underlying conditions applicable to those symptoms have been investigated and excluded.
Primary symptoms may include sleep problems, muscle and joint pain, cognitive dysfunction, fatigue, headaches and sore throat. Gastrointestinal complaints, orthostatic instability, depression and allergies are also seen in many patients. Aggressive symptom management for these and other disruptive symptoms is indicated.

Alternative Therapies Deep breathing and muscle relaxation techniques, massage and healing touch, and movement therapies like stretching, yoga and tai chi can be beneficial for some CFS patients in reducing anxiety and promoting a sense of well-being.
Be sure to discuss all potential alternative therapies with your health care professional since many so-called cures and treatments for CFS that are promoted on the Internet are unproven and could be dangerous.

Support Groups Many people with CFS find it therapeutic to meet with other people who have this illness. Support groups can provide patients with useful, current information, and they can provide a sense of community with people who understand what you're going through.