IBS, Chronic Fatigue Syndrome, and Mental Health: The Common Link- Part 3
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IBS, Chronic Fatigue Syndrome, and Mental Health: The Common Link- Part 3

Published on Thursday, December 07, 2023
by
Keydella Fuller

Health & Wellness

Beyond the Symptoms: The Role of Holistic Therapies in Wellness

In parts one and two, we discussed the complex nature of Irritable Bowel Syndrome (IBS) and Chronic Fatigue Syndrome (CFS), their difficulty in diagnosing, and the toll they can take on our mental health, increasing the risk of anxiety and depression. This article explores holistic measures for managing IBS and CFS symptoms while nurturing our mental well-being.

Mental Health: Breaking the Stigma

I would be remiss not to discuss this very important topic first. I tell all my clients, it is okay to not be okay. The stigma surrounding therapy and mental health counseling is not as it was before, and it is now widely accessible. There are many different therapies, from group therapy, cognitive behavior therapy, and 1:1 therapy, that are beneficial in reducing depression and anxiety if dealing with IBS and CFS. Seek guidance from a qualified mental health professional to help manage the emotional toll of these conditions.  Additionally, seek out support groups or online forums that you may relate with, as it is helpful to communicate with others who ‘get it.’

Stress Management: Techniques for Tranquility

Another key area of focus is stress management. Stress can come in many different forms. Physical, mental, and emotional are common types of stress that people dealing with IBS/CFS frequently experience. Some techniques to try for stress reduction include meditation, mindfulness, and gratitude (try keeping a gratitude journal). Therapies like massage, breathwork or breathing exercises, yoga, or tai chi may also assist. If you tried some of these in the past, just remember it may take some trial and error to figure out which techniques work best for you. 

For those with CFS/ME- pacing can be utilized to assist with some of these therapies as well, as too much mental focus can worsen the fatigue. We will discuss more on pacing below. 

Sleep: The Key to Restoration

Restorative sleep is important for both IBS and CFS/ME, but especially for chronic fatigue individuals. Many people with CFS suffer from difficulty falling asleep or the familiar “wired and tired” description of where they want to sleep. Still, they cannot as they may get a second wind of energy from not expending enough energy during the day. 

Sleep apnea is a commonly missed condition affecting our ability to obtain restorative sleep. Waking up with headaches, sleeping 6-8 hours a night, and still not feeling rested or falling asleep easily can be signs of sleep apnea. And no, it is not a weight problem because even thin people can suffer from sleep apnea. If sleep apnea is a significant cause of fatigue, treating this underlying cause can profoundly impact energy levels. 

A sleep-conductive environment is crucial if you are dealing with any sleep issues. I encourage my clients to establish a bedtime routine where they do roughly the same things at the same time. Reduce exposure to bright light (including overhead light) in the 2 hours before you intend to go to bed. Limit TV and phone; put them away 2 hours before bed as the blue light alters our melatonin production

Make sure your bedroom is comfortable and has a cool temperature. The use of earplugs or an eye mask may also help. Waking up at the same time in the morning and getting exposed to bright light as soon as you wake up (within the first hour) also helps to resync the body’s natural circadian rhythm. This can be done through natural sunlight exposure or the use of light therapy or a light box that provides 10,000 lux of light

Nutrition and Diet: Fueling Your Well-Being

There are many things that we can discuss here. Nutrition and diet (what we eat daily) can hinder or help how we feel every day. Frequently, people with CFS may not have the energy to eat and may suffer from many nutritional deficiencies. People with IBS may find it unpleasant to eat regularly as, for some, it causes immediate diarrhea. 

Key areas to focus on with nutrition:

  1. Identify where nutritional/vitamin deficiencies are and supplement them (either food or supplement replacements as needed)
  2. Consider Low FODMAP or an elimination diet to identify food sensitivities
  3. Avoiding excess sugars, caffeine, alcohol, and fried foods may be beneficial
  4. Stay hydrated, especially if experiencing diarrhea from IBS or orthostatic intolerance (positional dizziness or drop in blood pressure while standing) that commonly occurs with CFS. Aim to drink ½ your body weight in ounces - start where you are now and work your way up to it. 
  5. Gut health supplements, probiotics, immune supplements like Zinc, and anti-inflammatory fatty acids like omega-3 may also be beneficial. As well as Co-q 10 for mitochondrial health to aid your cells' energy. As always, be sure to purchase reputable supplements that are 3rd party tested and free of common allergens such as wheat, soy, etc. 

Be sure to consult a healthcare provider before any significant dietary adjustments. 

Exercise and Physical Activity: Moving with Purpose 

It may sound wild to say exercise when you have no energy. For some dealing with CFS, just taking a shower can be exercise. Exercise helps with mental health and releases positive brain chemicals that help us feel good. Physical activity, especially for those with CFS, will defer based on the individual's severity of symptoms. Some have less energy than others; thus, activities must be personalized and prioritized. Any form of movement is beneficial, no matter how small or insignificant it may seem. 

Pacing: Balancing Energy Reserves

You need to check in with your body and mind to determine your energy levels and how long you can attempt to do activities. It is essential to pace yourself. For example, if you decide on a 5-minute walk, go out for 1 minute, come back home and rest for 5, then go out another minute and rest for 1, etc. It's important not to drain yourself of your energy reserve as this may cause you to be in bed for the following 2-3 days. 

For some, it may seem like pacing activities either take too long or you feel unaccomplished. In that instance, I recommend keeping an activity log to write down all the tasks you have accomplished while pacing yourself.

Keep Hope Alive: Concluding the Journey

In the journey through Irritable Bowel Syndrome (IBS) and Chronic Fatigue Syndrome (CFS), we've navigated the complexities and learned how these conditions intertwine with mental health challenges. Remember, every small positive step is a victory.

Seeking mental health shows strength, and reaching out to those who understand can make a significant impact. As we conclude this series, know that although you may feel alone, you are not. Find a support group to share and explore your thoughts and feelings. Incorporating these holistic tips

Incorporating some of the alternative therapies discussed here will help to manage IBS and CFS better. Prioritizing self-care, seeking guidance from healthcare practitioners experienced in IBS and CFS. Progress may be gradual, but every effort counts. Journal your positive experiences, stay patient, and keep hope alive for a brighter, healthier future.


  1. Bested, A. & Marshall, L. (2015). Review of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: an evidence-based approach to diagnosis and management by clinicians. Reviews on Environmental Health, 30(4), 223-249. https://doi.org/10.1515/reveh-2015-0026
  2. Howland, J. (2022, December 7). Mayo Clinic Minute: Light therapy can help with seasonal affective disorder. Mayo Clinic News Network. Retrieved November 13, 2023, from https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-minute-light-therapy-can-help-with-seasonal-affective-disorder/
  3. Institute of Medicine. (2015). Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness. National Academies Press.
  4. Staudacher, H. M., Black, C. J., Teasdale, S. B., Mikocka-Walus,, A., & Keefer, L. (2023, June). Irritable bowel syndrome and mental health comorbidity — approach to multidisciplinary management. Nature Reviews Gastroenterology & Hepatology, 1-15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237074/

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Keydella Fuller

MSN, APRN, FNP-C

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