Living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can be hard. It can keep you from living life the way you want. It may strain your relationships with loved ones too, making it hard to be the kind of friend, parent, or partner you want to be. You may feel stressed or get depressed or anxious.
Your doctor may recommend cognitive-behavioural therapy, or healthy thinking, as part of your treatment plan. This therapy may help you cope with your fatigue. But more research is needed to better understand how well this treatment works for ME/CFS.
Some studies show that this type of therapy can help people with ME/CFS feel better.footnote 1, footnote 2 But people vary in how much they are helped by this kind of program.
Many people work with a therapist or a counsellor to learn healthy thinking techniques. Therapy can be expensive and may not be covered by your provincial health plan or private insurance. But the fact that it is usually short-term helps keep the cost down. And after you learn the techniques, this is something you can do on your own.
Working on your own or with a counsellor, you can practice these three steps:
The goal is to have encouraging thoughts come naturally. It may take some time to change the way you think. You will need to practice healthy thinking every day.
The first step is to notice and stop your negative thoughts or "self-talk." Self-talk is what you think and believe about yourself and your experiences. It's like a running commentary in your head. Your self-talk may be rational and helpful. Or it may be negative and not helpful.
The next step is to ask yourself whether your thoughts are helpful or unhelpful. Does the evidence support your negative thought? Some of your self-talk may be true. Or it may be partly true but exaggerated. Here are a few types of unhelpful thoughts to look for:
The next step is to choose a more helpful thought to replace the unhelpful one.
Keeping a journal of your thoughts is one of the best ways to practice stopping, asking, and choosing your thoughts. It makes you aware of your self-talk. Write down any negative or unhelpful thoughts you had during the day. If you think you might not remember at the end of your day, keep a notepad with you so you can write down any unhelpful thoughts as they happen. Then write down a helpful message to correct the unhelpful thought.
With daily practice, more accurate and helpful thoughts will soon come naturally to you.
But there may be some truth in some of your negative thoughts. You may have some things you want to work on. If you didn't perform as well as you would like on something, write that down. You can work on a plan to correct or improve that area.
If you want, you also could write down what kind of unhelpful thought you had. Journal entries might look something like this:
Stop your negative thought
Ask what type of negative thought you had
Choose an accurate, helpful thought
"I have had more energy today, but I know that won't last for long."
Focusing on negative
"Sure, all days will be different. But I've had some days where I surprisingly felt less tired. So I know that not every day will be hard."
"I should be able to handle this by now. I'm not trying hard enough."
"Sometimes the standards that I set for myself are very high and hard to reach. But I'm learning new and more helpful ways to cope with my fatigue."
"There's really nothing I can do to feel less tired."
"On days when I haven't slept well, managed my stress well, or done my scheduled activities, it's easy to think that there's nothing I can do. But on days when I do these things, I feel better. There are things in my control that I can do to manage my chronic fatigue."
"Working for more than 2 hours is very hard, so there's no way I can ever go back to my job."
All or nothing
"I may not be able to return to my exact job, but I can be open to other arrangements that will allow me to continue to work in a similar way."
Cleare A, et al. (2015). Chronic fatigue syndrome. BMJ Clinical Evidence, published online September 28, 2015. http://clinicalevidence.bmj.com/x/pdf/clinical-evidence/en-gb/systematic-review/1101.pdf. Accessed February 23, 2016.
Sharpe M, et al. (2015). Rehabilitative treatments for chronic fatigue syndrome: Long-term follow-up from the PACE trial. Lancet Psychiatry, 2(12): 1067-1074. DOI: 10.1016/S2215-0366(15)00317-X. Accessed February 26, 2016.
Other Works Consulted
White PD, et al. (2011). Comparison of adaptive pacing therapy, cognitive behaviour therapy, graded exercise therapy, and specialist medical care for chronic fatigue syndrome (PACE): A randomised trial. Lancet, 377(9768): 823-826.
ByHealthwise StaffPrimary Medical ReviewerKathleen Romito, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineMartin J. Gabica, MD - Family MedicineSpecialist Medical ReviewerAdam Husney, MD - Family MedicineMartin J. Gabica, MD - Family Medicine
Current as ofMarch 24, 2017
Current as of: March 24, 2017
Kathleen Romito, MD - Family Medicine
& E. Gregory Thompson, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & Adam Husney, MD - Family Medicine & Martin J. Gabica, MD - Family Medicine
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