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Fatigue

Chronic Fatigue Syndrome (CFS) / Myalgic Encephalomyelitis (ME) is characterized by extreme fatigue, post-exertional malaise, and feeling generally unwell. The causes for CFS/ME are not fully understood and possible causes include viral infections, immune disturbances, or disturbances to the central nervous system. As with any human experience, CFS has a psychological component, which means that psychological approaches can form part of a support or treatment package for CFS/ME.

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What Is Chronic Fatigue Syndrome / Myalgic Encephalomyelitis?

Signs and Symptoms of CFS/​ME

CFS/​ME is characterized by disabling tiredness (fatigue) that lasts a long time and cannot be explained by other causes. CFS/ME should be considered if the fatigue prevents the individual from doing things that they used to be able to, if the fatigue gets worse after activity or gentle exercise, or if the following symptoms are present:

  • sleep problems

  • pain in the muscles or joints

  • headaches

  • sore throat or sore glands that aren’t swollen

  • problems thinking, remembering, concentrating, or planning

  • flu-like symptoms

  • feeling dizzy or sick or having palpitations

  • exercising or concentrating on something makes your symptoms worse

Psychological Models and Theory of CFS/​ME

Understanding of the causes and maintenance of CFS/​ME is incomplete. Biomedical factors likely play a role. Like any physical illness it is normal to have thoughts and feelings about symptoms and what they mean, and so psychological approaches also have potential clinical value. Models of CFS/​ME including psychological factors include:

  • Browne and Chalder (2006)

  • Burgess and Chalder (2004)

  • Vercoulen et al. (1998)

  • Harvey and Wessely (2009)

  • Roche, Dawson, Moghaddam, Abey, and Gresswell (2017)

  • Wiborg, Knoop, Frank, and Bleijenberg (2012)

References

  • Browne, T., & Chalder, T. (2006). Chronic fatigue syndrome. Psychiatry, 5(2), 48–51.

  • Burgess, M., & Chalder, T. (2004). Cognitive behaviourtherapy for CFS/​ME: PACE manual for participants. MREC v. 2. Retrieved from: https://me-pedia.org/images/7/7a/PACE-cbt-participant-manual.pdf

  • Harvey, S. B., & Wessely, S. (2009). Chronic fatigue syndrome: Identifying zebras amongst the horses. BMC Medicine, 7(1), 58. https://doi.org/10.1186/1741-7015-7-58

  • Roche, L., Dawson, D. L., Moghaddam, N. G., Abey, A., & Gresswell, D. M. (2017). An Acceptance and Commitment Therapy (ACT) intervention for Chronic Fatigue Syndrome (CFS): A case series approach. Journal of Contextual Behavioral Science, 6(2), 178–186.

  • Science Media Centre (2018). Science Media Centre Factsheet: CFS/​ME—The illness and the controversy. Retrieved from: http://www.sciencemediacentre.org/wp-content/uploads/2018/03/Science-Media-Centre-Factsheet-CFS-ME.pdf

  • Vercoulen, J. H. M. M., Swanink, C. M. A., Galama, J. M. D., Fennis, J. F. M., Jongen, P. J. H., Hommes, O. R., van der Meer, J. W., & Bleijenberg, G. (1998). The persistence of fatigue in chronic fatigue syndrome and multiple sclerosis: Development of a model. Journal of Psychosomatic Research, 45(6), 507–517.

  • Wiborg, J. F., Knoop, H., Frank, L. E., & Bleijenberg, G. (2012). Towards an evidence-based treatment model for cognitive behavioral interventions focusing on chronic fatigue syndrome. Journal of Psychosomatic Research, 72(5), 399–404.

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