Fatigue service

The extreme fatigue brought about by CFS is persistent, often overwhelming, and is associated with other symptoms, such as aching muscles, sore throats, deteriorated short-term memory and an increased sensitivity to noise and light. 

Why do fatigue symptoms persist?

We do not know the cause of ME/CFS, but our fatigue service can address the factors that cause fatigue symptoms to persist and reduce their impact on everyday life.

Some of the factors that might make fatigue symptoms feel worse are:

• Relapse brought about by excessive activity, also known as ‘boom-bust’.
• A disturbed sleep pattern.
• Difficult emotions, such as stress, anxiety and depression.

ME/CFS can itself cause frustration, a sense of being isolated or feeling misunderstood, difficulty in relationships and an experience of stigma.

What chronic fatigue treatment do we provide?

Our specialist fatigue team provides a range of treatment options for ME/CFS. We offer face-to-face, virtual and telephone contact options to improve the access to our service for all.

Fatigue specialist psychology 

Our clinical and counselling psychologists use various techniques (such as mindfulness, cognitive behavioural therapy, acceptance and commitment therapy, and compassion-focused therapy) to help you better align with your personal values and live a meaningful life, in spite of fatigue’s challenges. They can also help you to:

• set and achieve goals
• manage sleep difficulties
• unhook from difficult thoughts and emotions
• improve relationships
• overcome the experience of stigma

Fatigue specialist physiotherapy

Our specialist physiotherapists have extensive experience in helping people overcome the challenges of living with ME/CFS. They can help you to:

• improve your energy management skills
• better manage pain (which is a commonly associated symptom of ME/CFS)
• assist with re-engaging with your values and goals
• prepare/adjust for the physical challenges of employment and activities of daily living

Medical care for chronic fatigue symptoms

Our fatigue team may provide medical care reviews to discuss new or altered fatigue symptoms, and the impact of other conditions you may have with your ME/CFS. 

Relaxation techniques can help when you are having trouble sleeping. Most relaxation techniques combine breathing more deeply with relaxing the muscles.

Some people find that learning a technique and getting into a routine is useful. It can take a bit of time to learn the techniques and for them to start to work, but keep practising. Here are two audio files that our patients have found useful.

Relaxation tapes

These two recordings, one lasting 10 minutes and one lasting 20 minutes, teach relaxation techniques to help you relax and unwind and aid sleep

"Your help, encouragement and advice have been extremely helpful, getting me back to my old self and doing the things that I want to do."

"Thank you for your support and for providing me with the tools to help understand and manage my ME/CFS."

"When I first came to you I could barely walk for 20 minutes, now I can cycle for an hour and run a mile again. Thank you for giving me my life back."

"Thank you so much for your support over the last year, I look forward to keeping you updated and telling you about my return to full health in the not too distant future.!

Here are websites that you may find useful when looking for further information.

Reading

Fatigue

• Overcoming chronic fatigue: a self-help guide using cognitive behavioural techniques (Mary Burgess and Trudie Chalder).
• Coping better with chronic fatigue syndrome/myalgic encephalomyelitis: cognitive behaviour therapy for CFS/ME (The self-help series) (Bruce Fernie and Gabrielle Murphy).

Pain

• Overcoming chronic pain (Cole, Howden-Leach, Macdonald, Carus, 2005).
• The explain pain handbook protectometer (Butler and Moseley, 2015).
• Understanding long term pain – taster version. The full publication can be purchased for £1 by contacting the British Pain Society on 020 7269 7840 or publications@britishpainsociety.org.

General

• Mindfulness: a practical guide to finding peace in a frantic world (Mark Williams and Danny Penman).
• Mindfulness for health: a practical guide to relieving pain, reducing stress and restoring wellbeing (Vidyamala Burch and Danny Penman).
• The compassionate mind (Paul Gilbert).

Audio books/CDs

• Mindfulness meditation for pain relief: guided practices for reclaiming your body and your life (John Kabat-Zinn).
• Mindfulness for beginners (John Kabat-Zinn).

Websites

Pain

• Arthritis research UK
• Arthritis information: back pain
• Arthritis information: neck pain
• Arthritis information: fibromyalgia
• British pain society

Cognitive behavioural therapy resources

• Get self help
• Mood cafe – relaxation exercises

Mindfulness resources

• Breathworks
• The free mindfulness project

Pain video

Yoga videos

White cloud wellness
Yoga for energy

Apps

• The mindfulness app
• BellyBio: Interactive breathing (by Relaxline)
• Get some headspace (free 14-day trial)
• ActiveME – activity diary 
• Sleepcycle alarm clock
• Sleepbot
• Relax and sleep by Glenn Harrold
• Sleepmaker rain
• Nature sounds relax and sleep (Android)

Please note we are not responsible for the content of external websites.

The referral process

You might be aware that there is no test that confirms the diagnosis of ME/CFS, and therefore we have to exclude any other causes for your symptoms.

In order to do this, you will need to have blood tests arranged via your GP. These blood tests will need to have taken place since the onset of your symptoms. Your GP will be aware of what these blood tests are and will arrange them for you if you have not had them already.

Your referral will have to be made by your GP. Unfortunately, we are not able to accept self-referrals. 

We will assess the information your GP has given and, if necessary, discuss your case with them. We will then either accept the referral or make suggestions for a referral to other services if we feel this is more appropriate (for example, to a sleep clinic if a primary sleep disorder is the most likely diagnosis). 

We have a detailed transition protocol to ensure that if you are referred from children or adolescent services, the transfer is as seamless as possible.

Once your referral has been accepted

You will be sent an appointment for an initial introduction to our service, which will most likely be delivered online. 

This introduction session will help orientate you to our service and explain the different treatment approaches that we offer. 

If you wish to work with us, you will then be offered an initial one-to-one assessment before engaging with our therapy team. 

Our appointments are made by a member of our administration team. If you have any queries you can call them directly on 020 7794 0500, extension 31717.

Information for health professionals

If you wish to refer a patient to our fatigue service, please use our referral form. Before referring a patient, please read through the guide for referrers.