Chronic fatigue living in teenagers

Overview

Chronic fatigue syndrome (also called M.E., which stands for myalgic encephalomyelitis) is a long-term illness that causes extreme tiredness. This tiredness is not relieved by rest and gets worse after physical or mental activity. In teenagers, it can interfere with school, social life, and everyday activities.

Chronic fatigue syndrome is not extremely common, but it does occur in teenagers. Estimates suggest it affects about 1 in every 1,000 children and teenagers.

It can affect any teenager, but it is more common in girls than boys. It often starts between ages 11 and 19.

Symptoms

Common symptoms

• Persistent, disabling tiredness that does not go away with rest.
• Sleep that is unrefreshing – waking up feeling just as tired.
• Muscle or joint aches without swelling.
• Headaches of a new type or pattern.
• Difficulty concentrating, memory problems, or 'brain fog'.
• Feeling much worse after physical or mental activity (post-exertional malaise).
• Sore throat or swollen glands that come and go.

Symptoms in children

• Same as common symptoms, but children may also miss a lot of school and feel irritable or withdrawn.
• They might have trouble staying awake during the day or have very irregular sleep patterns.
• Complaints of stomach aches or dizziness are more common in younger teenagers.

Symptoms in older adults

• This condition primarily affects teenagers and younger adults, but if it occurs in older teenagers, symptoms are similar to adults: chronic fatigue, pain, and cognitive problems.
• Older teenagers may also experience more stress about their future (college, work) which can worsen symptoms.

Causes

Main causes

• The exact cause is unknown, but it often starts after an infection like flu, glandular fever, or a chest infection.
• Problems with the immune system, hormones, or how the brain processes energy may play a role.
• Stressful events (like exams, family problems, or injury) can sometimes trigger or worsen symptoms.

Risk factors

• Being female – girls are affected more often than boys.
• Having a previous infection, especially with the Epstein-Barr virus (which causes glandular fever).
• A family history of chronic fatigue syndrome or similar conditions.
• High levels of stress or perfectionism.

When to see a doctor

See a doctor urgently if:

• Call 999 (or your local emergency number) if your teenager has severe chest pain, confusion, or says they want to harm themselves.
• Go to the emergency department if they are unable to move or swallow due to fatigue.

Book a routine appointment if:

• Make an appointment with your family doctor if your teenager has had extreme tiredness for more than 3 months.
• Also see the doctor if tiredness is affecting school attendance, friendships, or mood.

Diagnosis

There is no single test for chronic fatigue syndrome. A doctor will diagnose it based on your teenager's symptoms and by ruling out other conditions that cause fatigue. They will ask about medical history, activity levels, sleep, and how symptoms affect daily life.

Tests that may be done

• Blood tests to check for anaemia, thyroid problems, infections, and other conditions.
• Urine tests if needed.
• Sometimes a sleep study or heart tests if symptoms suggest another issue.

What to expect at your appointment

The doctor may refer your teenager to a specialist (like a paediatrician or a chronic fatigue clinic). The diagnosis can take time, but it is important to be patient. Keeping a diary of symptoms and activities can help.

Treatment

There is no cure for chronic fatigue syndrome, but treatment focuses on managing symptoms and helping your teenager live as normally as possible. Each treatment plan is individual and often involves a team of healthcare professionals. The goal is to improve energy, reduce symptoms, and support mental wellbeing.

Self-care at home

• Pacing – balancing activity and rest to avoid 'boom and bust' cycles. Learn to recognize energy limits and take breaks before getting exhausted.
• Establishing a regular sleep routine – going to bed and waking up at similar times each day, avoiding long daytime naps.
• Eating small, regular meals with a balanced diet. Stay hydrated.
• Managing stress with relaxation techniques, gentle activities like yoga or mindfulness.

Medical treatments

Depending on symptoms, a doctor may recommend pain relief (such as simple painkillers) or sleep aids. They may also suggest talking therapies like cognitive behavioural therapy (CBT) to help cope with the impact of the illness. In the UK, graded exercise therapy (GET) is no longer recommended for M.E./CFS, but a physiotherapist can help design a safe, gradual activity plan. Always follow a healthcare professional's advice.

When is surgery considered?

Surgery is not a treatment for chronic fatigue syndrome.

Living with this condition

Living with chronic fatigue syndrome means adapting daily routines. Help your teenager find a balance between rest and activity. School may need to be flexible – part-time attendance, rest breaks, or home tuition. Encourage hobbies that can be done without overexertion, like reading, drawing, or listening to music.

Lifestyle tips

• Keep a daily routine for sleep, meals, and activity.
• Use energy wisely – plan important tasks for times of the day when energy is better.
• Stay connected with friends, even if it's through messaging or short visits.
• Avoid pushing through fatigue – listen to the body and rest when needed.

Diet and exercise

Eat a well-balanced diet with plenty of fruits, vegetables, and protein. Avoid skipping meals. For exercise, avoid intense workouts. Gentle, non-strenuous movement like stretching or short walks may be helpful but always start slowly and stop if symptoms worsen. A physiotherapist can guide safe activity.

Mental health and emotional wellbeing

Chronic fatigue can lead to frustration, sadness, anxiety, and feeling isolated. It is normal to grieve for lost activities. Encourage talking about feelings. Professional support from a counsellor or therapist (like CBT) can help. If your teenager has thoughts of self-harm, get help immediately.

Prevention

Since the cause is not fully understood, there is no guaranteed way to prevent chronic fatigue syndrome. However, maintaining a healthy lifestyle – good sleep, balanced diet, regular gentle exercise, and managing stress – may help reduce the risk or severity.

Vaccines

There is no vaccine to prevent chronic fatigue syndrome.

Screening programmes

There is no routine screening for this condition. If your teenager has persistent fatigue, see a doctor for evaluation.

Complications

If left untreated

• Long-term disability – missing school and social activities for months or years.
• Increased risk of depression and anxiety.
• Difficulty returning to normal activities due to worsening symptoms.
• Strained family relationships due to lack of understanding.

Long-term outlook

The outlook for teenagers with chronic fatigue syndrome is generally positive. Many improve significantly within a few years, especially with early diagnosis, good support, and careful management. Some may have long-term symptoms, but most learn to adapt and live fulfilling lives. Recovery looks different for everyone – the goal is to improve quality of life.

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