Chronic fatigue living in children

Overview

Chronic fatigue in children is a condition where a child feels extreme, persistent tiredness that does not go away with rest. It lasts for at least three months and can interfere with school, play, and daily activities. It is also known as paediatric chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME).

Yes, chronic fatigue is seen in children and teenagers, though it is not as common as in adults. It affects around 0.5% to 1% of children and young people.

It can affect any child, but it is most often diagnosed in teenagers. Girls are affected more often than boys, and children who have had a viral infection or a stressful event may be more at risk.

Symptoms

Common symptoms

• Severe tiredness that does not improve with sleep or rest
• Feeling worse after physical or mental activity (called post-exertional malaise)
• Sleep problems – trouble falling asleep, waking up often, or not feeling refreshed
• Pain in muscles or joints without swelling
• Headaches
• Sore throat and tender lymph nodes
• Problems with thinking, memory, or concentration (often called 'brain fog')
• Dizziness or feeling lightheaded when standing up

Symptoms in children

• Fatigue that last for months and limits their ability to attend school or play with friends
• Irritability or mood changes because of constant tiredness
• Difficulty concentrating in class or doing homework
• More frequent headaches and stomach aches
• Lack of energy that makes even small tasks feel draining

Causes

Main causes

• The exact cause is unknown, but it is believed to involve a combination of factors.
• It often starts after a viral infection, such as glandular fever (Epstein-Barr virus), flu, or COVID-19.
• Changes in the immune system and nervous system may play a role.
• Stress, both physical and emotional, can be a trigger.

Risk factors

• Being a teenager – the condition is most common in this age group
• Being female – girls are affected more often than boys
• Having a family history of chronic fatigue or similar conditions
• Recent infection with a virus
• High levels of stress at home or school

When to see a doctor

See a doctor urgently if:

• If your child has extreme fatigue that comes on very suddenly
• If your child has difficulty breathing or chest pain along with fatigue
• If your child shows signs of severe confusion or disorientation

Book a routine appointment if:

• If your child has been feeling very tired for more than three months and it is affecting their daily life
• If your child is missing school or social activities because of tiredness
• If your child has other symptoms like pain, sleep problems, or brain fog

Diagnosis

There is no single test for chronic fatigue. Doctors diagnose it by asking about symptoms, medical history, and ruling out other conditions that could cause tiredness. The main symptom is fatigue lasting at least three months that is not helped by rest and gets worse after activity.

Tests that may be done

• Blood tests to check for anemia, infection, thyroid problems, and other conditions
• Urine tests
• Sometimes a sleep study if sleep disorders are suspected
• Tests for heart or lung function if needed

What to expect at your appointment

The doctor will ask many questions about your child's symptoms, daily routines, and any recent illnesses. They may also ask about school, mood, and family stress. It can take time to reach a diagnosis because other conditions need to be ruled out. The doctor will work closely with you and your child to understand what is happening.

Treatment

There is no cure for chronic fatigue, but treatment focuses on managing symptoms and helping your child live as normal a life as possible. Treatment is tailored to each child and may involve a team of healthcare providers including doctors, physiotherapists, and psychologists. The goal is to improve energy, reduce symptoms, and support school and social life.

Self-care at home

• Pacing – balancing activity and rest to avoid overdoing it
• Keeping a consistent sleep schedule and practicing good sleep hygiene
• Eating a balanced diet with small, frequent meals
• Gentle stretching or light activity on good days
• Reducing stress through relaxation techniques or talking with someone

Medical treatments

Doctors may recommend treatments like cognitive behavioral therapy (CBT) to help your child cope with the condition and manage activity levels. Graded exercise therapy (GET) – a carefully planned increase in activity – may be offered under close supervision. Medicines for pain, sleep, or mood may be considered, but only after a careful discussion with a specialist. No specific drugs are approved for treating chronic fatigue itself.

When is surgery considered?

Surgery is not a treatment for chronic fatigue.

Living with this condition

Living with chronic fatigue can be challenging for both your child and your family. It's important to adjust daily routines to save energy. Your child may need to rest during the day, take breaks from school, and limit activities. Work with the school to create a plan that supports your child's learning without overwhelming them. Celebrate small achievements and focus on what your child can do, not just what they cannot.

Lifestyle tips

• Create a calm and consistent daily routine
• Encourage gentle movement like short walks or yoga when energy allows
• Set realistic goals for each day
• Make time for enjoyable hobbies that are not tiring
• Get support from family, friends, and professionals

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, whole grains, and proteins. Avoid large meals that can cause tiredness. Stay hydrated. For exercise, start very slowly – even a few minutes of gentle movement can help. The key is not to push too hard; listen to your child's body and rest when needed.

Mental health and emotional wellbeing

Chronic fatigue can cause frustration, sadness, anxiety, and feelings of isolation. Your child may worry about falling behind at school or missing out on social events. It is important to acknowledge these feelings and seek help if needed. Talking to a counsellor or joining a support group can make a big difference. If you or your child are having thoughts of self-harm or suicide, contact a crisis service immediately.

Prevention

There is no known way to prevent chronic fatigue. However, recognizing symptoms early and getting appropriate support may help reduce the impact on your child's life. Teaching your child healthy sleep and stress management habits may also be helpful.

Vaccines

Ensuring your child is up to date on vaccinations may help prevent some infections that could trigger chronic fatigue, but there is no vaccine for the condition itself.

Screening programmes

There is no routine screening for chronic fatigue in children. Diagnosis is made based on symptoms and after other conditions are ruled out.

Complications

If left untreated

• Missed school and falling behind academically
• Social isolation from friends and activities
• Increased risk of depression and anxiety
• Long-term tiredness that can last into adulthood

Long-term outlook

With the right support, many children with chronic fatigue get better over time. Some recover completely, while others continue to have mild symptoms. Treatment helps manage the condition so your child can still enjoy many aspects of life. Staying hopeful and working closely with healthcare providers is key.

Find support

International organisations

• ME Association ↗
• Action for ME ↗
• The MEA (UK-based, international reach) ↗

Local organisations

• NHS - Chronic fatigue syndrome (CFS/ME) ↗ · United Kingdom

Helplines

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