Before anything else: persistent fatigue needs a medical assessment. Your GP should exclude iron deficiency, thyroid problems, sleep apnoea, diabetes, coeliac disease and medication effects with blood tests and a proper history. ME/CFS is a clinical diagnosis made after that, not instead of it.
What a whole-picture appointment adds is the map. People arrive able to say they are exhausted and unable to say when, which makes it impossible to change anything usefully. So the first task is two weeks of very simple notes: what time you woke, how you felt on waking, what you did, and how you felt two hours and two days later. Almost everyone finds a pattern they did not know was there. Sometimes it is a delayed crash after exertion, which points at ME/CFS. Sometimes it is a mid-afternoon collapse that tracks with what happened at lunch. Sometimes it is every third day, which usually turns out to be a push-and-crash cycle the person was running without noticing.
Those three patterns need completely different responses, and that is why the mapping comes before the plan. Where there is post-exertional worsening, the plan is pacing and nothing that builds up quickly. Where it is a blood sugar and meal-timing pattern, it is a food conversation. Where it is push-and-crash, the work is on the pushing.
Sleep, daylight, hydration and what a realistic week contains all come into it. Treatment here is gentle and spaced, and if a session is followed by a bad two days we change the dose of treatment, not your effort. The clinic is in Lane Cove, five minutes from the village.
