What is Chronic Fatigue Syndrome

What is Chronic Fatigue Syndrome (CFS)?

CFS (also known as ME, myalgic encephalomyelitis) is an illness which affects as many as 4 per 1000 of the UK population.  Sufferers experience a disabling tiredness, as well as potential other symptoms, which may include headaches, an inability to concentrate and musculoskeletal pain.  On occasion, people suffering from CFS might also experience depression or anxiety.

Although symptoms can be recognised early, CFS is not diagnosed unless a person has been suffering from its symptoms for at least 6 months.  Prior to a diagnosis, a person can have been perfectly healthy, with no history to suggest a diagnosis of CFS.  At this time, little is known as to what triggers the illness.

Managing CFS

Each individual suffering CFS will have a different experience.  In some cases they may be able to manage on their own, with maybe an occasional day off work.  In more severe cases their ability to concentrate might be so significantly reduced, which may make simple tasks more challenging to undertake in the workplace.

Research suggests that around 40% of sufferers will return and can function in the workplace.  It is therefore important to have a tailored strategy in place to aid an employee suffering from CFS.  This may even help further with their recovery.  It is also important to note that  those with CFS can have good and bad days. On a good day they can undertake their daily activities and appear capable and focused, and then on bad days they may have difficiutly getting out of bed in the morning.

The National Institute for Health and Care Excellence (NICE) advises that a treatment programme should aim to maintain and/or increase a CFS sufferer’s emotional and physical abilities, and that this programme should be devised by a healthcare professional, tailored specifically for an individual sufferer.  It is important to highlight that the World Health Organisation (WHO) considers CFS a chronic (long-term) neurological condition. 

As an employer, some symptoms to watch out for in an employee are possible self-medication, working longer hours, and increased sickness absence.  If a work-environment is seeking to actively educate employees about early warning signs of potential health issues, this can have a positive lasting effect for both the company and its employees, especially for those already suffering from a long-term illness, and those who might experience an illness later on.  It reasures an employee with CFS, or any long-term illness, knowing that their employer is supportive in helping them manage their illness.   

Further reading and resources:

ME Association

Chronic Fatigue Syndrome – Diagnosis | NHS

Book: How to Look After Yourself When Your Feeling Depressed

A Little Book of Encouragement by Alice Rosewell


Over recent years great strides have been made to increase awareness of mental health issues, including anxiety and depression, which are two of the most common.  In Britain alone, 9% of people meet the criteria for a diagnosis of anxiety and depression, with it being estimated that between 4 and 10% of people will experience some form of the illnesses during their lifetime [1].

Despite this awareness, however, depression is a very individualised experience, which can often leave a person feeling alone and isolated in their suffering.  It is during these seemingly endless hard moments, when talking and being around others all seems a little too much, that books can often offer an unexpected solace.

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  • Copyright © 2016 Alice Rosewell

How to Look After Yourself When You’re Feeling Depressed is a short, unintimidating book that offers readers a little encouragement as a reminder to take care of themselves, even when depression is stacking all the odds against them.

It’s a guide to quietly get you through the day, written in small accessible chapters, each often accompanied by a simple and cheerful illustration.  Alice Rosewell, the author, who has suffered from spells of depression throughout her adult life, writes from a place of understanding and compassion.  Recognising that whilst self-care on its own isn’t sufficient to treat severe depression, having someone show an interest and kindness toward you, and that someone being you, can be a positive step in the right direction.

How to Look After Yourself When You’re Feeling Depressed is currently available in paperback or as an ebook from Amazon.

[1] Mental Health Statistics | mentalhealth.org.uk

Tips for reducing the risk of developing Type 2 Diabetes

The NHS estimates that around 5 million people in England are currently at risk of developing Type 2 diabetes.  It’s a huge contributor to preventable sight loss in people of working age, heart attacks, strokes and kidney failure, as well as leading to around 100 amputations a week and 20,000 early deaths a year.  But unlike Type 1 Diabetes, the development of Type 2 can be avoided through preventative measures, of which there are many little ones that can be incorporated into everyday life.

Eating consciously

  • about 10 mins before a meal drink a glass of water, this will help you to feel less hungry whilst eating
  • use smaller plates to dish up a meal, encouraging smaller portion sizes
  • enjoy your meals away from distractions, such as television which can distract from being conscious of how much you’ve eaten
  • keep the serving dishes away from the table, you will be less likely to reach for seconds, and more aware of the fact if you get up for them
  • eat more slowly and give your stomach time to feel full. It often takes the body around 20 minutes to feel full after having eaten
  • try to ensure that at least half of your meal is made up of vegetables
  • half a dessert with a partner or friend
  • keep a water bottle on you throughout the day. Water is great for curing hunger pangs and will also keep you hydrated, helping you to stay feeling fresh
  • make a list of the things you need from the supermarket before you go and stick to it
  • eat a handful of nuts or some fruit before heading out for the weekly shop, to avoid feeling hungry and tempted in the supermarket
  • read the nutritional labels on food packaging, you may become aware of a higher salt content for example than you had imagined, which might influence your purchasing decisions in the future
  • read a book instead of unwinding with television, if you’ve seen a trailer for a film coming out that you think looks good, see if it’s based on a book. You’re much less likely to snack whilst holding a book and hopefully if you’re enjoying the story, you’ll be distracted from thinking about snacking
  • if you find yourself mindlessly opening the fridge or snack cupboards, pause and consider if you’re actually hungry or just grazing

Moving around

  • listen to upbeat music whilst doing chores and cooking dinner, you’ll likely find yourself dancing along, and feel good songs are great mood boosters
  • try some YouTube workouts and/or yoga, there are many for all ages and stages. They’re free, varying lengths, and often presented by professionals, who will talk you through particular moves and their benefits
  • walk about whilst your on the phone. A 20 minute phone call can lead to over 1000 steps, a 1/10 of the daily recommendation (10,000 steps)
  • whilst waiting for the kettle to boil or the toaster to pop, strengthen your muscles by doing some squats or arm stretches

Further resources and reading:

Can you reduce the risk of diabetes? | Diabetes UK

Diabetes: Reduce Your Risk of Getting It | NHS


Line Managers role vital in the return-to-work process

A recent poll conducted by XpertHR of 339 employers found that the most effective means of reducing long- and short-term absences is to have line managers take a more active role in engaging with the return-to-work process.

Here we look at some of the ways in which line managers can be effective in doing so.

Research funded by the British Occupational Health Research Foundation concluded that line managers attitude and behaviour towards employees returning to work is a key component to ensuring that their return is successful.

During an employee’s absence, especially if it’s long-term (4 or more weeks of continued absence) it’s important to communicate regularly with them either via telephone or email, allowing for the general focus of the conversation to be centred around their wellbeing, but also offering work updates so as to make sure they still feel a part of things.

It’s important to reiterate that the company will support an employee during their absence, and offer reassurance that their job is there for them when they return, and that they shouldn’t feel pressured to return before they are ready and well enough to do so.

Before an employee returns to work talk them through the return-to-work process, which may initially include assigning lighter duties and/or a phased return.

When an employee returns to work, make sure to meet with them on their first day back, to check in with them and make sure they are comfortable with any procedures and/or adaptations that have been made to their role in facilitating their return; and also to assure them that as their line manager you are there for them if they need to talk – it’s important to encourage an open line of communication.  Be proactive, and arrange further meetings, which while remaining objective, don’t have to be in the format of a formal sit-down.

As a line manager you should feel comfortable in seeking further information and/or advice, either from HR or occupational health about an illness affecting an employee, and what practical adjustments can be made to help facilitate their return to work.  Although it’s good to keep in mind that the most important role you can have as a line manager in an employee’s return to work is not to be all knowing regarding their condition, but to be approachable, sensitive and accessible.

Further reading and resources:

Manager support for return to work following long-term sickness absence: Guidance

Managing rehabilitation: A competency framework for managers to support return to work

How to be, and why you should be, more active in the workplace


Do you spend most of your working day sitting?  If the answer is yes, then you may be prone to “sitting disease”. 

Sitting for long hours in the office has been identified as a key cause behind most of our sedentary behaviour during the working week, which is a cause for concern as The World Health Organisation ranks physical inactivity as the 4th leading factor in global mortality, behind tobacco and high blood pressure.

Sitting at our desks for prolonged periods of time can lead to bad posture, poor circulation, tiredness and stiffness among other symptoms, which can all be precursors to more serious health risks including obesity and musculoskeletal disease.

NOTE: It is important to note that being physically inactive in your daily life is not the same as being sedentary.  Even if you regularly exercise, you may still be prone to sedentary behaviour.  Katy Bowman, who runs the site nutritiousmovement explains that “Actively sedentary is a new category of people who are fit for one hour but sitting around the rest of the day… You can’t offset 10 hours of stillness with one hour of exercise.”

If you are able to stand for some of your working day, do.  Even though you may feel that you are standing still, you are in fact far less likely to be sedentary.  Often when you’re standing, you will shift weight from foot to foot.  You’re also more likely to move about when you’re on the telephone, for example.  If a standing desk is not a suitable option, every 90 minutes or so, try and stand up for a couple of minutes, maybe to make a photocopy or collect something from the printer, or even to walk across the office to talk with a colleague as opposed to sending an email.  And if you are having a meeting with only a couple of you, why not walk and talk?

As well, try changing up how you sit.  Swap out your chair for an exercise ball or a chair with no armrests, both of which will encourage you to sit straighter.  And whether sitting or standing it’s important that your computer screen should be level with your eyesight, otherwise your head will be tilted down, which can lead to neck and back pain.

During your lunch hour go for a walk, alone or with a colleague, even it’s only around the carpark.  Walking helps stimulate circulation, which is reduced when seated for long periods of time.  It also acts as a natural energiser.

Overall, remember to keep moving.  A great visual reminder, is to keep a pedometer on you.  Nowadays, many smartphones have apps built in, or are available for download.  The daily recommendation is 10,000 steps, which doesn’t necessarily mean you have to walk that distance, but more so generally move that amount.

New Year’s Resolutions to Help Improve Concentration

Sometimes we forget that making the simplest and smallest of changes can have the greatest of positive affects in our lives.  Entering into the new year, we don’t need to make sweeping changes, but maybe encourage ourselves to have just a bit little extra.

A Good Night’s Rest

Research suggests that between 7 and 8 hours of sleep each night is optimal for feeling refreshed and revitalised throughout the day, which is, of course, key to concentration.  A great commitment would be to aim to have a full night’s rest, but understandably it’s not always possible.  Instead, why not encourage yourself to go to bed each night just 15 – 20 minutes earlier than your usual time?  Over the course of a week that would be roughly an extra 2 hours of sleep, or rest. 

For advice on how to wind down for the day, and have the best sleep, see our Top Tips for a Restful Night’s Sleep.

A Brisk Walk

It takes the average person 17 to 20 minutes to walk a mile, a small window of time, for example, that might be available to you during your lunch break?  A brisk walk encourages you to spend some time out of doors, and acts as a natural energiser, stimulating circulation and increasing the oxygen supply to your cells, which in turn can help you to feel more alert heading into the afternoon. 

For many the simplest form of exercise, walking also offers a whole host of other health benefits, including strengthening your heart, and boosting your vitamin D intake.

A Balanced Diet

Eating healthily does not have to mean cutting out on all of your favourite foods and drink.  For example, Natalie Stephens, a clinical dietician at The Ohio State University Wexner Medical Center says, “Dark chocolate boosts serotonin and endorphin levels, which are associated with concentration.” 

And, consuming a moderate amount of caffeine can be a great motivational boost.  A study in 2005 undertaken by Florian Koppelstätter showed that caffeine stimulated the area of your brain connected with attention, concentration and planning.

Blueberries and bananas are also great snacks to have on hand when you need to focus.  Research has found that both help to improve memory, and blueberries are especially tasty and juicy!

All of the above are things we know we should be doing, but can sometimes find ourselves dismissing with the pressures of our daily working lives and the pace of modern living.  The irony, however, is that sleep, exercise and a balanced diet actually help alleviate the symptoms and reasons behind why we don’t spend more time looking after ourselves.  The more alert and fresh you feel during the day, the easier it will be to focus and accomplish tasks, leading to greater productivity through concentration.

Top Tips for a Restful Night’s Sleep

We spend almost a third of our lives asleep.  This time is considered just as crucial to our wellbeing as eating, drinking and breathing.  Sleep helps us maintain better mental and physical health.  Whilst we sleep we process information and our emotions.  Not having enough sleep can affect our ability to communicate, pay attention and digest information, which in turn can lead to irritability and forgetfulness, and mistakes and accidents in the workplace.  Sleep allows our brains to recover and recuperate, which is why it is important to get a full and good night’s rest.

In the short term, medication can be a useful tool in tackling sleep issues, however in the long term it is much more beneficial to develop a healthy psychological approach to sleeping.  The following brief guide offers some advice on how to do so.


Establish a Sleeping Pattern

Going to bed and getting up at roughly the same time each day helps programme your body into a natural sleeping routine, which will not only help you to fall asleep, but will also help in making you feel less tired on waking.

Create a Peaceful Environment

It is important to be able to associate your bedroom with rest.  Whilst sleeping your room should ideally be warm, without being too hot; as dark as possible; and quiet.

Less Stimulants

Consuming less caffeine, especially in the evenings, helps induce a deeper sleep.  If you do regularly consume caffeinated drinks, try switching one or two out for a herbal tea, lemon verbena is a great alternative, particularly in the evenings when you are winding down from the day. 


Regular exercise, even if only moderate, helps to relieve stress.  However it is important to keep in mind that exercising too strenuously in the couple of hours before bed can in fact act as a stimulant and keep you awake.

If you have time during your lunch break, take half an hour to stroll through your local park, or take a short walk around the block.  This will also help refreshen your mind for the afternoon.

Avoid Late Night Indulgences

Too much food and/or alcohol before bed can disrupt your sleep.  If possible try to refrain from consuming either for at least 2 hours prior to going to sleep.  The same is also true of cigarettes.

Relax Before Bed

Take some time to wind down from your day.  If you have worries weighing on your mind, it can be helpful to write a productive list of them to work through the following day when you are feeling more refreshed.

If you find yourself lying awake, unable to fall asleep, avoid becoming anxious by clock watching.  Turn your clock to face away from you, and trust your in your alarm. You can also get up and spend some quiet time listening to relaxing music or reading.  When you feel naturally sleepy return to bed for a more restful night’s sleep.

Avoid Napping

Napping during the day can disrupt your sleeping pattern, as it encourages lots of shorter periods of light rest, as opposed to a longer and more restorative deeper sleep.


Whilst the above advice should help in creating a more restful sleeping schedule, it is important to find out what works for you as an individual.  Try to identify the reasons and/or factors that play a role in disrupting your sleep, and work on overcoming them individually.

Advice for Working Outdoors in Warm Weather

There are many positive benefits to working out of doors, from enjoying a sense of calm, to feeling more grounded and revitalised. However it is important to keep in mind the affects that weather can have on our health and productivity.

So as spring fast becomes summer, we would like to share our top tips for maintaining your wellbeing during warmer weather.

This brief guide offers advice for individuals, including if you are self-employed, as well as controls that as an employer you can administer.


Potential risks:

If not sufficiently hydrated our bodies are susceptible to heat stress. The symptoms of which can include an inability to concentrate, muscle cramps, exhaustion, as well fainting and heatstroke.

Advice to employees:

Warmer temperatures can lead to increased rates of perspiration, which means your body will be losing more water than usual. It is therefore important to counteract that loss by making sure to drink plenty of water throughout the course of the day, and not waiting necessarily until you feel thirsty. As thirst is an indication that you may already be feeling the effects of dehydration.

Advice for employers:

  • Offer free access to cool drinking water

Sun Protection

Potential risks:

In the short term, without protection, sun can damage the skin so that it blisters and peels, and in the long term it can advance the ageing of skin, as well increase the risk of developing skin cancer.

Advice for employees:

Wearing a brimmed hat will protect your face, neck and ears.  If possible, it is best to keep your arms and legs covered by clothing, as no sunscreen is 100% effective in protecting our skin from harmful UV rays. However for any exposed skin we would recommend a high factor sunscreen of at least SPF15, but more suitably SPF30, especially around midday when the sun is at its highest peak.

Individuals who are more suseptible to the risk of sun exposure are those who are fairskinned of freckled; have red or fair hair and light eyes; or have a number of moles.

Advice for employers:

  • If possible, schedule work to cooler times of the day
  • Provide shading over areas where employees are working
  • Educate employees about the symptoms of heat stress and how to recognise them.


Changing how you breathe can make a difference.

Your nose is designed to filter air breathed in, and so inhaling through your nose, as opposed to your mouth, can help keep allergens out.

If possible, wear natural fibres. Working in synthetic clothing can create an electrical charge that can attract pollen.

Pollen levels are usually at their highest between 5.00am and 10.00am and early evening, and at their lowest during the afternoon.

Washing your hands often and occasionally rinsing your eyes with water can help reduce irritation to your skin and eyes.


During periods of rest try to remain in the shade; drink plenty of cool water; and if possible remove any personal protective equipment to help further heat loss.


Further reading and resources:

HSE | Health Risks from Working in the Sun

HSE | Advice for Employers of Outdoor Workers

SunSmart | Sun Protection Advice

NetDoctor | Avoid Heatstroke this Summer