From the Guidelines
Non-medical treatments for Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) should prioritize cognitive-behavioral therapy and mindfulness-based therapies to manage symptoms and improve quality of life, as recommended by the 2021 US Department of Veterans Affairs and US Department of Defense clinical practice guideline 1.
Key Recommendations
- Cognitive-behavioral therapy is recommended for patients with CFS/ME to improve physical functioning and health-related quality of life 1.
- Mindfulness-based therapies, such as mindfulness-based stress reduction and meditation awareness training, can also be effective in reducing functional impairment and improving quality of life 1.
- Gentle, gradual physical activity, such as tai chi or yoga, may be beneficial for some patients, but should be approached cautiously to avoid symptom flares 1.
Rationale
The 2021 US Department of Veterans Affairs and US Department of Defense clinical practice guideline provides evidence-based recommendations for the management of CFS/ME, including the use of cognitive-behavioral therapy and mindfulness-based therapies 1. These therapies have been shown to improve physical functioning, health-related quality of life, and reduce functional impairment in patients with CFS/ME 1.
Considerations
- Individualized treatment plans should be developed for each patient, taking into account their unique needs and preferences 1.
- Pacing and stress management techniques, such as meditation and deep breathing exercises, can also be helpful in managing symptoms and improving quality of life 1.
- Nutritional approaches, such as eating small, frequent meals and staying well-hydrated, may also be beneficial in managing symptoms and improving quality of life 1.
From the Research
Non-Medical Treatments for Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME)
- Mind-body interventions (MBIs) have been shown to improve fatigue severity, anxiety/depression, and quality of life in patients with ME/CFS 2
- MBIs include mindfulness-based stress reduction, mindfulness-based cognitive therapy, relaxation, Qigong, cognitive-behavioral stress management, acceptance and commitment therapy, and isometric yoga 2
- Pacing of activities with strategic rest periods is considered an important coping strategy for patients with ME/CFS to manage their illness and prevent post-exertional fatigue and malaise 3
- Cognitive behavior therapy (CBT) and graded exercise therapy (GET) are sometimes recommended as rehabilitative treatments for ME/CFS, but their effectiveness and safety are debated 4, 5
- Adaptive pacing and nutritional supplements may also be beneficial for some patients with ME/CFS, but more research is needed to confirm their effectiveness 6
- A patient-centered care approach that takes into account the individual's symptoms and needs is recommended for managing ME/CFS 3, 4
- The use of counseling, behavioral, and rehabilitation therapy programs may be of benefit for ME/CFS, but the evidence is still limited 6