I live with Chronic Fatigue Syndrome (CFS), also referred to as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). I name that openly because silence and misunderstanding have surrounded this illness for too long. CFS is real, complex, and often life-altering. While the physical symptoms are severe, the emotional and psychological impact of living with this condition is equally significant and deserves
honest conversation.
CFS is characterized by persistent, profound fatigue lasting at least six months that is not alleviated by rest, along with unrefreshing sleep, cognitive impairment, and post-exertional malaise (PEM)—a worsening of symptoms following physical or mental exertion (Institute of Medicine [IOM], 2015). PEM is especially disruptive, as it makes daily functioning unpredictable and often forces individuals to live within narrow and constantly shifting limits. Estimates suggest that up to 0.9% of the population may be affected, though underdiagnosis and misdiagnosis remain common (Johnston et al., 2013).
Given these realities, it is not surprising that mental health concerns frequently co-occur with CFS. Research consistently shows elevated rates of depression and anxiety among individuals with CFS compared to the general population (Hvidberg et al., 2015).
Importantly, these findings do not support the notion that CFS is “caused” by mental illness. Rather, studies suggest that psychological distress often develops as a consequence of chronic symptoms, functional loss, social isolation, stigma, and the absence of definitive treatment options (Afari & Buchwald, 2003). In other words, emotional suffering in CFS is better understood as a human response to prolonged illness than as evidence that symptoms are imagined.
As a pastor and counselor, I believe faith invites honesty, not denial. Scripture does not minimize suffering or rush people toward easy explanations. “The Lord is near to the brokenhearted and saves the crushed in spirit” (Psalm 34:18, English Standard Version). The nearness of God is often emphasized before answers or relief. Likewise, the apostle Paul names weakness without shame, reminding us that “My grace is sufficient for you, for My power is made perfect in weakness” (2 Corinthians 12:9, ESV).
Lament, grief, and weariness are not spiritual failures; they are faithful responses to real pain.
Psychotherapy can play an important supportive role for individuals living with CFS. While therapy does not cure the underlying condition, it can help address the emotional burden of chronic illness, including grief, shame, identity disruption, and nervous system dysregulation. Approaches such as Acceptance and Commitment Therapy (ACT) and other supportive, non-curative models have been shown to improve
psychological flexibility and quality of life in individuals with chronic health conditions, including CFS (Brooks et al., 2018). Faith, medical care, and mental health support are not competing paths; they are complementary aspects of whole-person care (1 Thessalonians 5:23).
If you are living with CFS, hear this clearly: you are not lazy, broken, or failing. It is appropriate to keep asking questions, to bring concerns and research to your healthcare providers, and to seek counseling as a source of support. While much about CFS remains uncertain, bringing this illness into the light—with truth, compassion, and humility—matters. You are seen. You are heard. And you do not have to walk this road
alone.
By: Pastor Tommy Luster, Graduate Level Counseling Intern
References
Afari, N., & Buchwald, D. (2003). Chronic fatigue syndrome: A review. American Journal of Psychiatry, 160(2), 221–236.
https://doi.org/10.1176/appi.ajp.160.2.221
Brooks, S. K., Rimes, K. A., & Chalder, T. (2018). The role of acceptance in chronic fatigue syndrome. Journal of Psychosomatic Research, 104, 14–20.
https://doi.org/10.1016/j.jpsychores.2017.11.005
Hvidberg, M. F., Brinth, L. S., Olesen, A. V., Petersen, K. D., & Ehlers, L. (2015). The health-related quality of life for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). PLoS ONE, 10(7), e0132421.
https://doi.org/10.1371/journal.pone.0132421
Institute of Medicine. (2015). Beyond myalgic encephalomyelitis/chronic fatigue syndrome: Redefining an illness. National Academies Press.
https://doi.org/10.17226/19012
Johnston, S., Brenu, E. W., Staines, D., & Marshall-Gradisnik, S. (2013). The prevalence of chronic fatigue syndrome/myalgic encephalomyelitis: A meta-analysis. Clinical Epidemiology, 5, 105–110. https://doi.org/10.2147/CLEP.S39876