Overview

There is no doubt that opinions from countries around the world that have been studying C.F.S. are drawing to a consensus on a working definition of what we should all be looking at when we talk about C.F.S.. It is however interesting that the countries that appear to be complaining more of this disorder are those of westernised or ‘advanced’ countries, Australia, New Zealand, South Africa, North America, Canada, Great Britain, Europe. I will draw your attention to the fact that these countries suffer more mental stressor factors than maybe elsewhere. It is a syndrome, which means it probably includes different illness processes with similar symptoms but in all of them the principal complaint is one of persistent chronic fatigue without any other reasonable explanation for its cause. One can see that there must be a number of possibilities for the cause of this type of complaint, but if you have come to this stage I would have  assumed that all other medical explanations would have been excluded. There seem to be two major types; the slow onset and the acute onset variety. Within the latter, and to some lesser extent the former, the major complaint is that of chronic fatigue which then would draw the attention of the diagnosis of C.F.S., but occasionally muscle pain appears to be the principal complaint in which case the diagnosis would be that of Fibromyalgia Syndrome. In all of these conditions I will argue that the predominant pre-morbid  factor is that of negative mental stress.

One of the major sub-groups of C.F.S. is that of the acute onset where the fatigue disorder has been apparently precipitated by some kind of infective agent. There are many sorts of infective agents but it appears that the majority are brought on by some kind of ‘virus’ infection.

I have looked at several thousand cases of C.F.S. over the last twenty years and have seen many patients that appear to have predictable factors that make them worse and that also make them better. By analysing these various markers I have developed strategies for patients to help them feel better. To optimise their chances of recovery by preventing them from making themselves worse you can encourage their ability to make themselves better. The majority of patients realise that by doing too much either mentally or physically they make themselves worse, but what they don’t realise is that by making themselves worse they actually perpetuate the illness process itself – chasing rainbows. There are now some recognised effective remedies namely those of Cognitive Behavioural Therapy (C.B.T.) and Graduated Exercise Treatment regimes (G.E.T.). I will also suggest that  antidepressants help the recovery.

There are many worldwide centres studying C.F.S. and most have independently adopted various types of management programmes that have similar treatment styles and they amount to those of management programmes, C.B.T. and G.E.T.. I too have found that this type of approach is the most effective treatment presently available. I also make use of antidepressants, these medications are used here as neurotransmitter regulators to try and help correct the biochemical disturbances within the central nervous system and act as post-synaptic membrane support systems; these medications are not only safe but non-addictive. They have problems and side effects but the prescription is designed and tailor made to treat the patients themselves, and nothing should be taken that makes the symptoms worse or the patient feel unwell. They need to be taken for quite considerable lengths of time, usually years and typically two to four years. They are, however, highly efficient not only in relieving the symptoms but I believe in actually treating the illness process itself. Success of this type of regime is high and  a ‘Dr Smith’s Get Well Supporters Club’ exists to offer group support for patients with C.F.S., all of whom I am happy to say have a positive and optimistic approach to their illness process, and as they have one source of information the approach is the same. C.F.S. is not only treatable but potentially curable.

I trust that you will find this approach thoughtful and well worked out. I am a middle of the road Clinician and offer evidence based medicine. There is nothing here that would be not recognised by all practising Physicians as being reasonable and acceptable. I hope you find the contents of this website educational, enlightening and an answer to your problem.