Long time no hear.

The good news is that my depression and accompanying anxiety appear to be under control and much improved after changing my medication for Fluoxetine to Venlafaxine.

The bad news is that after another frustrating five weeks fluctuating from tired to exhausted and back again, my Psychologist is now treating me for M.E, more commonly known as Chronic Fatigue Syndrome (CFS). Although he cannot make a formal diagnosis, only my GP/specialist can do that, he has studied my history of cyclical depressive episodes of depression and fatigue and I am symptomatic of M.E. I have researched this illness and my symptoms certainly fit the bill especially as M.E can only be diagnosed by elimination. In other words, on the basis that my GP has found nothing else wrong with me, my Psychologist is probably right.

I trust Doc Fraser implicitly and after a chat about the illness, how it manifests itself, the probable causes in my case and the treatment plan, I am comfortable that I am on the right track for managing the symptoms better in the short, medium and long-term. Looking back, I have been symptomatic for many, many years but it is one of those illnesses that can sneak up on you time and time again just when you start to feel better. In fact, it is when recovery begins and the fatigue lessens that you are at your most vulnerable to a relapse and therefore simply being aware of this will help me to keep the triggers to a minimum and hopefully avoid a catastrophic  relapse like the one I have just come through.

After my weekly therapy sessions with the Doc, I am sent home with homework and action plan and last week was no different. However, the approach is different and involves a lot more rest than previously and a number of other lifestyle changes in addition to continuing with the CBT to help improve my underlying mood whilst putting the new approach into action.

I will report on my progress as I go along but briefly here’s a list of what’s in and what’s out!

What’s in?

• Rest
• Moderation
• “Pacing”
• New eating patterns
• Shorter periods of activity interspersed by regular interludes during the day
• Conserving energy
• Drink more water
• Gentle activity (gardening, walking, golf-3-4 holes to start with and swimming)
• Asking for help

What’s out?

• Manic activity
• Wasting energy
• Long periods of work with no breaks
• Demanding physical exercise such as running, aerobics
• Working long hours/weekends
• Stress
• Doing everything myself

Unfortunately, my personality dictates that I naturally follow the “What’s out” list rather than the “What’s in” list and therefore these changes are going to be hard for me to make.

Doc Fraser was, in no uncertain terms, adamant that I should want to get better not just in the short-term but in the long-term so that these cycles do not recur and I must put his recommendations into practice if I am to succeed. I took this as a clear warning that unless I take on this challenge and do my best to change the habits of a lifetime my mental and physical health with deteriorate and one day there may not be a way back.

Time to get serious methinks.

Any hints and tips for managing this illness are gratefully received and I will try to reciprocate as and when I get to grips with it myself.

In the meantime, I will continue with my holiday on the very sunny and hot South Coast.