@colleenyoung An antiviral (Valtrex) and low dose Naltrexone have been helpful in reducing symptoms. I'm very fortunate to have a primary care doctor who was willing to try and support these treatments.

But "pacing", that is not exerting beyond my available energy, has been the most helpful "treatment" of all.

Still, I remain mostly housebound and at times bedbound. While my quality of life has improved, my physical functioning has not.

My health deteriorated significantly 5 years ago on a prescription of a stimulant combined with increased exercise given by doctors who did not understand ME/CFS. I went from mild/moderate ME/CFS to moderate/severe ME/CFS. Even after 5 years, I have not recovered my previous functioning.

I've also had very bad reactions to several psychiatric medications prescribed by doctors who did not recognize neurological symptoms typical of ME/CFS. It's unfortunate how very many years it took to find a doctor who understands ME/CFS and could offer appropriate treatment.

My overall experience interacting with the healthcare system is very well described by the 2015 National Academy of Medicine report, "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness", which writes:

"Diagnosing the disease remains a challenge, and patients often struggle with their illness for years before an identification is made. Some health care providers have been skeptical about the serious physiological — rather than psychological — nature of the illness. Once diagnosed, patients often complain of receiving hostility from their health care provider as well as being subjected to treatment strategies that exacerbate their symptoms."
https://www.ncbi.nlm.nih.gov/books/NBK274235/

@webdog, I really appreciate this discussion. My mother suffers from a life-limiting chronic fatigue. In her case, however, we do not believe that it would be classified as ME. Having said that, I’m going to read the above references to get better educated.

Her fatigue is related to myelodysplasia and sjrogren’s. Fatigue is such a common symptom of so many conditions, I don’t find it surprising that it takes a long time to diagnose ME. The part that is harmful is when patient reports of continued and debilitating fatigue are met with skepticism.

It sounds like you have a healthy and helpful relationship with your doctor. Thank goodness. I can’t help but wonder how much you’ve been able to educate other health care professionals about ME? When encountering other providers, have you found a successful way of getting beyond the doubt and misbelief? What might you recommend to others who haven’t yet found an understanding doctor?

@colleenyoung Chronic Fatigue Syndrome is quite the unfortunate name, as it implies "fatigue" is the main symptom. Yet fatigue is a symptom of nearly every chronic disease. Not helpful at all. Particularly when for many patients, fatigue isn't the most disabling symptom of a "serious, debilitating, chronic disease that affects multiple body systems, including the nervous system, the immune system, and the body's production of energy."

For now, the US government calls it "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" or just ME/CFS. The New York State Department of Health calls it "Myalgic Encephalomyelitis" or just ME. No US government health agency calls it "Chronic Fatigue Syndrome" anymore. However, in the UK, the term "CFS/ME" is commonly used. No one, except a few clinicians, use the term "Systemic Exertion Intolerance Disease" or SEID, which was a name proposed in 2015 by the Institute of Medicine.

Likely a new name or names will be introduced once we know the etiology of ME/CFS. Much has been written elsewhere about the many names for this disease, how this mess arose and who might be at fault... but I think everyone agrees the numerous names for this disease is an absolute confusing mess.

As you say, I do have a healthy relationship with my doctor. He's all "evidence based", but I've had to convince him to throw some of that out the window. The lack of research over the past 30 years has meant there is little known about ME/CFS and there is no FDA approved treatment. But that doesn't mean patients shouldn't be treated. ( see https://www.medscape.com/viewarticle/893766 ).

What turned my primary care doctor around was the 2015 National Academy of Medicine report, which you can find at these links:
Summary documents: http://nationalacademies.org/hmd/reports/2015/me-cfs.aspx
Full report: https://www.ncbi.nlm.nih.gov/books/NBK274235/

This authoritative report makes it absolutely clear that ME/CFS "is a medical — not a psychiatric or psychological — illness". And that ME/CFS patients are more disabled than patients with other severe disabling chronic diseases, "including type 2 diabetes mellitus, congestive heart failure, hypertension, depression, multiple sclerosis, and end-stage renal disease."

My personal process for choosing a doctor:
1) Present ME/CFS information from authoritative sources, such as the CDC, National Academy of Medicine, NY State Dept of Health, ME/CFS conferences, NIH, Stanford, etc.
2) After being shown the evidence, if the doctor accepts ME/CFS is a serious biomedical disease and is willing to learn more, keep them.
3) If the doctor maintains ME/CFS is wholly or partly psychological and should be treated with psych or behavioral interventions, get rid of them. Don't bother trying to convince a doctor that won't look at the current scientific evidence or accept government reports.

Convincing doctors that ME/CFS patients should be treated with the same care and understanding as patients with any other serious chronic illness hopefully will become easier sometime this summer, when the CDC releases its "Information for Healthcare Providers". In this document will also be recommended treatment guidelines. GET and CBT will not be listed as recommended treatments.
https://www.cdc.gov/me-cfs/healthcare-providers/index.html
After 30 years of complete neglect, the CDC seems to be slowly, slowly recognizing the severity and prevalence of ME/CFS. It's not just "tired people"; patients suffer horrifically with little medical or social support, and those with severe ME/CFS can and do sometimes die from this disease.

@colleenyoung , Hi Colleen, Up-to-Date also recently stopped recommending GET and CBT.