Scientific Overview
Stress and Stress Tolerance
HPA Axis
Circadian Rhythms
Immune System
Placebo Effect
Chronic Fatigue Syndrome
Chronic Pain
Psychiatric vs Organic Debate
Irritable Bowel Syndrome
Chronic Lyme Disease
Search Site

Recovery from CFS/ME/Burnout

Once you know the cause of the illness, it is easy (at least in theory) to fully recover and lead a normal life without having any relapses. In practice, however, it is not always that easy, due to the difficulty (or unwillingness) in recognising the causes of the illness, and the hard decisions that sometimes need to be made in order to recover.

1. Remove the causes of the illness. The cause is usually one or more stressors, such as work stress, relationship problems, excessive responsibilities, or a combination of different stressors. The first step is to recognise the causes of the illness, and then remove them. This can sometimes involve making difficult decisions—such as giving up a job, moving to a different location, or ending a relationship. Usually the illness is triggered by a combination of multiple stressors, such as work, personal or viral. In many cases the cause is an unsatisfying, emotionally draining, or stressful job, and recovery involves changing to a different career (after a recuperation period).

Note that even after the initial stressors have disappeared, other factors can perpetuate the illness, such as a belief that you will never recover, not being able to work or earn money, or hostility at doctors or family members who you think are telling you the illness is "all in your head".

2. Gradually increase physical and mental activities. In many cases, simply removing the stresses that caused the illness does not result in full recovery. Doing too little is as bad as doing too much, and will result in continued illness. Try to have a routine/structure in your daily activities, and gradually build up mental and physical activity. Listen to your body and rest when you are tired, to avoid relapses.

3. Build up your life again. After long-term stress, changes occur in the physical structure and function of the brain which results in the symptoms of CFS. Reversing these changes requires having positive, motivating goals, participating in physical and mental activities, and changing your life so that you wake up each day looking forward to the things you are going to do. The pursuit of important goals, along with the perception that these goals are being reached, is known to be an important factor in maintaining happiness, and it also appears to be the most important factor in recovering from CFS. It may be that this gives the prefrontal cortex a "kick" out of it's negative feedback state. Also important is having pleasurable/joyful experiences each day. It is important not to try to do too much too soon, otherwise a relapse is likely. Instead, build things up gradually over a period of months or years, and at some point in the future you will eventually be completely symptom free.

4. Address sleep issues. Many studies show that poor sleep contributes to CFS symptoms, and therefore it is important to try to improve sleep as much as possible. Try to have the same bedtime each day and avoid long naps during the day. Activities and structure during the day help to promote sleep. Sunlight during the day (and especially in the morning) helps to reset the body clock. Don't lie awake for a long time if you are not sleepy — try reading until you feel sleepy (using a dim light).

5. Avoid the triggers in future. You can live a normal life after recovering from CFS, and if you do the right things you can avoid ever having a relapse. You don't need to remove all of the stresses and difficulties from your life, but you do need to avoid getting into long-term emotional sinks, jobs with excessive pressure, and similar traps. Anger is one of the worst negative emotions for triggering CFS relapses, and should be avoided if possible. Avoid having a negative perception of perception of stress (i.e. feelings of anger/defeat), as this may contribute to the negative feedback of the HPA axis in response to stress. Techniques such as mindfulness meditation may be useful in avoiding emotional overengagement.

6. Be in control. Always try to feel in control of your destiny, and the tasks you are doing. Lack of control and being submissive in the face of stress may also result in negative feedback to the HPA axis. Lack of control has also been shown to be a factor in stress related health issues.

7. Increase flow and creativity. The concept of flow is the mental state of being totally immersed in performing a motivating, creative, enjoyable activity, resulting in a feeling of spontaneous joy or rapture, and feeling energized. The concept of flow most closely corresponds to the factors such as goals, enjoyment and motivation that are important in recovery from CFS.

8. Therapy/counselling. While it is possible to recover without any outside help, many patients find counselling, therapy or coaching useful in helping them find the path to recovery. Cognitive behavioural therapy (along with graded exercise therapy) is the only official treatment for CFS. While some people find it helpful, research shows that only a small percentage of patients actually recover using CBT. If you do use CBT, it is important to find a therapist who understands CFS.

Copyright (c), All Rights Reserved

DISCLAIMER: is an educational resource and is not giving medical advice. Seek advice from a medical practitioner before making any changes to your life, or if you experience worsening symptoms.