Treatment
There is no proven or reliable cure for CFS, and no drug has been developed specifically for this disorder. Because CFS remains poorly understood, many patients have problems finding good care. Overall, the recommended strategy for treatment includes a combination of the following:
- Cognitive-behavioral therapy (CBT) and graded exercise may be helpful for certain patients
- Antidepressant drugs in some cases, usually low-dose tricyclic
- A healthy diet
- Sleep management techniques
- Medication
Patients with the best chance for improvement are those who remain as active as possible and who seek to have some control over the course of the disorder. Patients should seek physicians who are willing to consider the problem as a medical condition with psychiatric components. They should be very wary, however, if the physician recommends excessive and expensive treatments that may have serious adverse effects and that have no proven benefits. For patients with severe CFS that cannot be managed with lifestyle changes and standard medications, asking the physician about enrolling in any available clinical trials may be helpful.
Cognitive-Behavioral Therapy
CBT is designed to help patients regain a sense of control and is proving to have substantial benefits for some patients. Some experts believe that patients who are diagnosed with CFS should immediately be referred to therapists trained in cognitive-behavioral therapy. (Psychoanalysis and other interpersonal psychological therapies, which are concerned with subconscious thoughts and early childhood memories, are not generally helpful for the CFS patient.)
The Goals of Cognitive-Behavioral Therapy. The primary goals of cognitive-behavioral therapy (referred to below as just cognitive therapy) are to change any distorted perceptions that individuals have of the world and of themselves and to change their behavior accordingly. For CFS patients, this means learning to think differently about their fatigue and to improve their ability to deal with stressful situations and manage their disorder. Cognitive therapy is particularly helpful in defining and setting limits, behaviors that are extremely important for these patients.
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