I began my CFS journey with a recognition that the illness had changed my life. Rather than a temporary interruption, CFS had become the central fact around which my life revolved. Its effects were comprehensive, limiting my energy level and my ability to work, changing my emotions and relationships, and creating great uncertainty. So the beginning of my journey was the brute fact that CFS had imposed severe limits on me, changing my life perhaps permanently and certainty for an extended period of time. My focus would have to be on adapting to those limits.

Given the limited medical resources available to me, I concluded that to get better I would have to accept responsibility for finding things that would help me. I tried to combine two elements which may seem in conflict: acceptance and hope. Acceptance did not mean resignation, but rather a recognition that my illness forced me to live a different and more limited life. I believed that listening to my body and responding to its needs gave me the best chance for improvement. I also recognized the limits of my power. I believed that I could exercise some control over my symptoms, but whether I recovered was out of my hands.

In addition to acceptance, I had hope. I was confident that through changing my daily habits and routines I could find things to help me feel better. I believed that I could reduce my discomfort, regain some control over my life and reduce uncertainty. I did not expect a quick solution; rather, I recognized that self-management was a way of life.

Looking back, I see an approach built on six strategies.

1) Using Multiple Techniques: Because I had several symptoms and because CFS affected so many parts of my life, I needed a variety of coping strategies. Rather than thinking I could cope by using a single solution, I realized I would have to think comprehensively about my life and use many strategies.

2) Experimentation: I believed I could learn from my experience, gradually becoming more skillful in managing my illness by trying things to find what worked for me. I assumed that this approach would require discipline and patience, and that some of my experiments would fail. But I felt confident that I could improve my skills over time and that, in any case, there was no better alternative than experimentation.

3) Pacing: I came to believe that defining my limits in detail and living consistently within them offered the best chance of controlling my symptoms and improving my quality of life. This meant finding a sustainable level of activity and making appropriate use of rest on a daily basis.

4) Controlling Stress: Because my illness both increased the stress in my life and magnified the effects of stress, I made managing stress a major focus. I used relaxation and other techniques to reduce stress and also learned how to control stress by avoiding stressful situations.

5) Addressing Emotions and Relationships: I had to acknowledge the powerful feelings triggered by being ill and adopt strategies to combat them. Also, I found that support, especially the support offered by fellow patients, was crucial to living well with illness.

6) Building a New Life: Another central challenge was coming to terms with loss, finding a way to bring new meaning to my life when so much had been taken away. After much struggle, I decided that while I was unlikely to restore my old life, I could build a new one in its place.

My approach of using self-help exclusively was different from that taken by most patients. Under different circumstances, I might have combined a self-management approach with a medical one. But self-help served me well, enabling me to regain my health gradually over a period of four years, using techniques I believed were safe, prudent and effective, focusing as they did on living within limits and extending those limits very gradually, as allowed by the illness.

Recovery from illness often occurs in one of two ways. Many illnesses are self-limiting. They resolve themselves over time. In other cases, medical treatment brings relief. Taking an anti-biotic cures an infection or a surgery repairs a broken bone. I followed a third path in response to CFS, neither assuming that my illness would disappear with the passage of time nor treating it with medications or supplements. I believed that changing my habits and routines offered the best chance for improvement. I saw my role as listening to my body and doing those things that would help it find a way to re-establish good health. For me, that was sufficient to produce recovery. I realize that most patients will use medications to treat CFS. But, if you are a patient, I hope you will also explore how you can help yourself by changing how you live with your illness.

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