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How I Treated Fatigue
Bruce Campbell

I began my recovery program by developing my strategies for fatigue, my most persistent and disruptive symptom. 


I remembered from my previous experience that fatigue could have multiple causes, each of which might be addressed by different strategies. I identified eight possible causes for my fatigue besides my illness.

Activity Level
Being active beyond my limits
De-conditioning from having a lower activity level
Poor Sleep  
Sleep was not restorative, leaving me feeling tired
Pain can lead to muscle tension, which is fatiguing
Stress produces worry and muscle tension
Low spirits produce sense of listlessness
Poor Nutrition           
Lose energy if don’t get enough food or lack right foods
Drugs can cause fatigue as a side effect


Activity level seemed the most crucial to me. There was an obvious relationship between the number of hours a day I was active and my fatigue, though the effects were sometimes delayed a day or two. If I was active for more than about four hours in a day, I later experienced elevated fatigue. Rest produced a reduction in my exhaustion. 

Ironically, I found hope in my discovery that I created some of my own suffering. If the connection between activity and fatigue was so direct, then I might be able to gain some control if I found a level of activity that my body could tolerate. Finding an amount of activity I could sustain was one of the foundations of my recovery.

The other factor that seemed especially promising was inactivity. I knew that highly-trained athletes become deconditioned if they stop exercising for even a brief time, so I was sure that part of my fatigue was due to my lower activity level. If my aerobic capacity had diminished, then I would become fatigued more easily by activity. I thought the way to fight this was through exercise. 

Through experimenting, I found I could recondition myself without increasing my symptoms if I walked about 20 minutes a day at a pace that raised my heart rate to 90 to 95 beats per minute. As I improved, I was able to increase the length of my walks gradually and eventually returned to hiking. 

Improving my sleep also seemed worth pursuing. I knew from other patients that sleep was often nonrestorative for people with CFS, but I thought I could help myself to some degree by maintaining good sleep-related habits. 

I thought I could reduce my morning sluggishness if I maintained regular hours and avoided things like late nights on the computer. So I made it a rule to turn off the TV and stop using the computer at 9 p.m. Those strategies, too, were helpful. 

Once I developed my approach for fatigue, I asked myself if I needed additional strategies for poor sleep and pain, my other major symptoms. After some experimentation, I concluded that all three symptoms were responsive to the same strategies and, by and large, I didn't need separate strategies for each symptom.

Limiting my activity level, taking regular rests, and reducing stress reduced all three symptoms and helped improve my mood as well.

When diagnosed in 1997, I functioned at about 25% of normal. Using a self-help approach, I improved step by step and over a period of about four years, gradually returned to my pre-CFS life. 

(Adapted from RecoveryFromCFS.org)