Chronic fatigue syndrome
Chronic fatigue syndrome (CFS) is a debilitating disorder of unknown cause. It's not known if it is even a single condition, and some sufferers resist the term CFS, preferring the alternative myalgic encephalomyelitis or ME. The same initials may also stand for myalgic encephalopathy.
This much is uncontentious.
Some researchers emphasise the importance of psychosocial factors and believe that CFS should be lumped with other diagnoses given to patients suffering from symptoms whose cause is not well understood or else believed to be psychological, such as Fibromyalgia and Multiple Chemical Sensitivity. They have argued that the way that "these syndromes finally go is when the word gets out that they are really 'all in the mind' and not to be taken seriously." This approach has caused problems for patients, and led to a degree of animosity. As of 2019, there have been strides in the understanding the pathophysiology of the disease, with numerous studies suggesting that there are various biological abnormalities involving many organ systems in those with CFS as compared with controls, but that standard laboratory tests have not been updated to catch those differences. These findings suggest a physical and not a psychological origin for the CFS disorder, as evidenced by impaired cellular energy generation .
On the lunatic fringe of activists spectrum are some world class crackpots, known to more moderate groups as "the cult", mainly clustered around "the One Click Group". These delightful people have run a years-long hate campaign against those who do not follow their hard-line advocacy of a solely physical mechanism for
CFSME, especially their perceived antichrist Professor Simon Wessely, a respected psychiatrist who has reported good results with cognitive behavioural therapy (CBT).
Professor Wessley's view that the ongoing symptoms of CFS/ME are a result of abnormal illness beliefs on the part of the patient, reinforced by such things as patient support groups, has been highly influential in shaping UK policy on the management of CFS/ME. He takes much the same stance on Gulf War Syndrome.  While there are those who seem to believe that there is a combination of factors at work, and that CBT may be helpful for some patients if only as a palliative measure, the One Click Group consider that any suggestion of any positive effect from psychological treatments is a stigma, that to accept any such effect is to assert that the condition is imaginary and is therefore a direct personal attack on every single patient.
These crackpots, supported by some eccentric input from Professor Malcolm Hooper and the Countess of Mar, to name but two, have wound themselves up to the point that other groups have felt the need to make public statements distancing themselves from One Click and at least one person has been convicted of harassment and subject to a restraining order, curfew and tagging.
Having exhausted the limited options available to them in mainstream medicine, many patients look to alternative medicine for a solution. You name it and someone's claiming it "cures" CFS/ME. Acupuncture, neuro-linguistic training, candida-control, herbs, homeopathy, diets and faith-healing are just a selection of the alternative therapies listed by one UK patient advocacy group — with a reminder that there's little proof to back up any of them.
That said, recent research is showing signs that there may be subtle physical factors in play that might have been overlooked in the past. Most notably, a 2017 study discovered that various types of white blood cells in CFS patients had significantly worse mitochondrial function than white blood cells from a control group, both in a resting state and while stressed. As these mitochondrial defects would then cause the immune system to expend far more energy than it usually would, the resulting energy deficit would logically result in the symptoms of CFS, especially when it is further stressed. Unfortunately, mitochondrial diseases cannot be treated by current medicine and so CFS patients will likely remain afflicted for the near future.
- http://www.sciencedirect.com/science/article/pii/S0163834397803155 - General Hospital Psychiatry, "Chronic fatigue syndrome: A practical guide to assessment and management", May 1997
- Chronic fatigue syndrome researchers face death threats from militants, The Guardian, 21 August 2011
- http://www.publications.parliament.uk/pa/ld200304/ldhansrd/vo040122/text/40122-13.htm House of Lords, Daily Hansard (debate)
- One Click Too Far, ME Action
- http://www.simonwessely.com/index.php/cfs-personal-story/ CFS Personal Story - Professor Simon Wessley (web site)
- 2012 John Maddox Prize, Sense About Science