Chronic fatigue syndrome is a disorder that makes one feel very tired all the time. Sometimes the disorder is so bad that it makes it hard for someone to do their normal activities. Although it is not likely to shorten one’s life, chronic fatigue syndrome can have a profound effect on one’s quality of life. The causes of chronic fatigue syndrome aren’t well-understood. Some theories include viral infection, psychological stress, or a combination of factors. Because no single cause has been identified, and because many other illnesses produce similar symptoms, chronic fatigue syndrome can be difficult to diagnose and manage. There are no tests for this condition, so the health-care providers will have to rule out other possible medical causes for one’s fatigue. While chronic fatigue syndrome has in the past been a controversial diagnosis, it’s now widely accepted as a real medical condition. Chronic fatigue syndrome can affect anyone, though it’s more common among; young and middle-aged adults than in children or older adults, women in their 40s and 50s, and it is more likely to be diagnosed in white (non-Hispanic) people compared to other ethnic groups. The symptoms of chronic fatigue syndrome vary based on the individual affected and the severity of the condition. The most common symptom is fatigue that’s severe enough to interfere with your daily activities. For this condition to be diagnosed, fatigue should last for at least six months and not be curable with bed rest. Additionally, one should have at least four other associated symptoms such as; loss of memory or concentration, feeling unrefreshed after a night’s sleep, chronic insomnia (sleep disturbances), muscle pains, frequent headaches, multi-joint pain without redness or swelling, frequent sore throat, tender and swollen lymph nodes in the neck or armpits One may also experience extreme fatigue after physical or mental activities. This can last for more than 24 hours after the activity. People are sometimes affected by this condition in cycles, with periods of feeling worse and then better again. Symptoms may sometimes even disappear completely (remission). However, it’s still possible for them to come back again later (relapse). The cycle of remission and relapse can make it difficult to manage ones symptoms. Chronic fatigue syndrome is usually diagnosed based upon a medical history and physical examination. Blood or urine testing may be done to rule out other conditions, but are not needed to diagnose this condition. There is no cure for chronic fatigue syndrome currently; the goal of treatment is to reduce symptoms of fatigue and help one to cope. Many therapies have been tried in this condition but none has been consistently successful. Cognitive behavioural therapy (CBT) is a type of “talk” therapy that is known to ease with one’s symptoms of chronic fatigue syndrome. During CBT, the patient shares with a psychologist or counsellor about the things that they think and do. Then he or she helps them to change how they see their situation and how they react to these situations. This trains one to cope better with their condition. Exercise sometimes makes chronic fatigue syndrome symptoms worse, but not exercising at all can also make symptoms worse. People with chronic fatigue syndrome are recommended to do gentle exercises. As one gets used to that, they can slowly increase the amount of exercise they do. Sometimes it helps to work with a trainer who understands chronic fatigue syndrome whenever possible. Making some changes to one’s lifestyle can help reduce on the severity of one’s symptoms. Limiting or eliminating caffeine intake, alcohol consumption, avoiding day naps and creating a daily sleep routine can improve one’s quality of sleep Dr. Ian Shyaka Resident in Surgery, Rwanda Military Hospital, iangashugi@gmail.com