1. Understand the potential causes of this condition.

There is no clear answer but common issues currently being investigated include inflammation, immune system activation, disruption to the autonomic nervous system affecting breathing and blood pressure ,microclots, inflammation and reduced blood flow in the brain.

  1. Learn what lifestyle circumstances aggravate and/or relieve symptoms.

  2. Understand the stress response and the impact that chronic stress has on symptoms.

  3. Observe the effects of physical, cognitive and emotional exertion.

  4. Set realistic goals to manage each day.

  5. Understand the principles of pacing in order to remain below the threshold of activity that leads to exacerbations.

  6. Practice strategies to control sympathetic and parasympathetic nervous system responses.

  7. Adopt the 12 Pathways To Wellbeing lifestyle principles.
  8. Develop a comprehensive toolbox of rest and restorative practices.

  9. Aim to achieve high-quality sleep using as many tools and strategies as required.

  10. Plan how to manage setbacks.

  11. Maintain involvement in life including social engagement, work and hobbies.
  12. Keep accurate records of all tests, consultations and treatments and have this at hand to be able to communicate with any therapist. An example