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It is incredibly challenging living with a disabling chronic illness like ME/CFS as it significantly reduces our options and the quality of our life. It is natural that we would grieve the losses and find it difficult to cope with at times, especially if we are very unwell and not receiving much support. There are services and strategies that will help you to cope. Mental Wellbeing It is incredibly challenging living with a disabling chronic illness like ME/CFS as it significantly reduces our options and the quality of our life. It is natural that we would grieve the losses and find it difficult to cope with at times, especially if we are very unwell and not receiving much support. Find and develop strategies that help you cope: Schedule in activities that you enjoy or that help you feel connected to others. Stress will worsen any illness, and ME/CFS is no exception, so look for ways to minimise stressors. Allocate time for friendships with people who understand and care. Explore practices like mindfulness and self-compassion (see Strategies section below). Talk to your doctor about accessing counselling or other mental health services (see section below). Consider coming along to our in-person and online meetings , or joining our Facebook support group , to connect you with people who understand about life with chronic illness. We offer some suggestions for accessing counselling and developing strategies below. There are a range of mental health helplines and support services available in New Zealand and many of them are free. Give yourself permission to use them if you need to. The Mental Health Foundation of NZ provides a list of support options here . Need to talk? Free call or text 1737 any time for support from a trained counsellor. The Health Info website provides information about 'Getting help for a mental health issue' from Health NZ. This describes some of the mental health supports available in the South Island, including those available through your GP. To see a counsellor privately, you may be eligible for financial support to cover the fees from Work and Income, even if you are already receiving a Disability Allowance (see section below). Accessing mental wellbeing support Questions to ask a prospective therapist It is appropriate to ask a prospective service or therapist some questions before you start working with them, or during the first session. Consider asking: Ask what they understand about ME/CFS, or the chronic illnesses you have, to confirm that it matches current international guidance e.g. are they aware of the ME/CFS guidance on Health Info , from NICE (UK) or CDC (USA)? Are they familiar with the impacts of living with an invisible chronic illness which changes daily life and has no approved treatment? Describe what you are wanting support with and ask them to confirm they have relevant experience and interest in supporting you. You may have identified that you want support with issues, such as stress and uncertainty, adjustment, stigma, hopelessness, sleep problems, relationship challenges, grief and loss, identity, parenting, anxiety, and other mental health problems. Confirm what the funding arrangements are for the therapy. Confirm that the therapy can be offered in a format that meets the severity of your illness e.g. telehealth, phone, their office, your home, text. Wellbeing services through your medical centre Many General Practice clinics now have Health Improvement Practitioners (HIPs), Health Coaches and Support Workers through the Access and Choice programme . These team members are available to deliver a wide range of mental wellbeing support and tools, without long waits and often on the same day, and the services are free. Health Improvement Practitioners (HIPs) are experienced mental health clinicians who work with people of all ages and their whānau. They may have a degree in psychology, psychotherapy, mental health nursing, social work, occupational therapy or be a DAPAANZ registered counsellor. HIPs help people with any issues impacting on their health and wellbeing. Sessions are brief (15-30 minutes), normally in-person, and focus on what is important to you, today. At your first session you will get some strategies and a plan. There are no limits to how often you can see the HIP. Talk to your GP or ring your medical centre to find out the best way to get seen by a HIP who has an understanding of ME/CFS and life with chronic illness. View the Map of practices in Canterbury that have a HIP available. Other Brief Intervention Talking Therapy (BITT) options are also usually available. Ask your medical centre to refer you for free short-term support with your mental wellbeing. BITT therapists are registered mental health professionals and telehealth options may be available. Counselling by telehealth with Pūawaitanga If you are wanting to try some talk therapy, you may want to consider the short-term counselling offered via telehealth by Pūawaitanga. It is free for people over 18 who are on a Work & Income benefit or who hold a Community Services Card. If you don’t meet the criteria for free services, you can also pay to access the service. The sessions are offered through phone or video call between 9am-9pm, 7 days a week. There is no waitlist and first appointment is usually within five days. The number of sessions is flexible, depending on need. Pūawaitanga have confirmed they have counsellors who have experience offering support for long term health concerns, and that this can be requested in the referral. Self-refer through their website www.puawaitanga.nz or call 0800 782 999. Ask to be assigned with one of their trained professionals who is familiar with the impacts and grief of chronic illness. Counselling for under 25s with Gumboot Friday Gumboot Friday provides two free counselling sessions for anyone aged 25 and under who needs the support of a qualified practitioner, including counsellors, psychologists, psychotherapists, and art therapists. You can search their directory and select up to three counsellors who you’d be willing to talk to and then send them a message. Sessions can be face to face, online or by phone. “Remember, there’s no shame in asking for help – it’s just a conversation.” Aoake te Rā Aoake te Rā , also known as the Bereaved by Suicide Service, is a free service that gives 6 to 10 free sessions to support individuals and whānau to navigate life after suicide loss, whether recent or a long time ago. If you have lost someone to suicide, it may be impacting your physical health as well. Experienced therapists can support you to honour the grief and to explore finding a place for it. Private Counselling and Psychologists You can find a counsellor through the directory from the New Zealand Association of Counsellors (NZAC ). You can search for counsellors in your region and what they specialise in e.g. chronic illness, chronic fatigue syndrome. Most counsellors can offer telehealth sessions. You may have to pay part or all the cost. Health Psychologists seek to help people cope with the emotional and psychological impacts of adjusting to living with chronic physical health problems, and to foster hope for the future. Search the NZ Psychological Society directory or use a search engine to find the websites of psychologists. Employee Assistance Programmes (EAP) Some employers offer employee assistance programmes (EAP) to their employees and this may also be available to family members. An EAP is a confidential service that your employer pays for to give employees access to qualified, registered and experienced professionals. An EAP therapist can help you talk through issues affecting your wellbeing. Talk to your manager or human resources representative about whether your employer offers an EAP. Funding from Work and Income You may be eligible to apply to have the costs of ongoing mental health support covered by the Disability Allowance (DA) or the Temporary Additional Support (TAS) allowance from Work and Income. You don’t have to be on a benefit to qualify for the DA, but you and your partner cannot earn more than set income limits. The TAS has both income and asset tests and needs to be applied for every 3 months. Further Information About Services The Family Services Directory from MSD also lists a range of mental health services. Additional resources from the Mental Health Foundation of NZ include: Support for Myself is a list of resources including strategies for recovery. Accessing Mental Health Services covers finding a GP, community mental health services, how to find a therapist or professional, and finding a therapist privately, and community support groups. Developing strategies for mental wellbeing Reasons for prioritising self-care strategies Looking after our mental wellbeing often helps our symptoms to stablise and our health to improve. Low mood can sometimes be part of post-exertional malaise (PEM), so if the PEM episodes can be reduced, your mood may improve as your symptoms become more stable. Use our guidance for Activity Management to pace as well as possible given your circumstances. With ME/CFS and Long Covid, our autonomic nervous system might become dysfunctional, or dysregulated. This autonomic system includes our sympathetic nervous system (fight or flight) and parasympathetic nervous system (calm/rest/digest). Your body may have trouble moving into the rest state, which can make your body feel that it is in danger or anxious. Along with our tips at the top of this page, it can be really helpful using mindfulness, breathing, gentle stretches or relaxation techniques during each day to calm down your nervous system. Self-directed Online Courses and Resources There are many courses and online resources that you can explore at your own pace. A selection of courses... Free courses and resources for New Zealanders covering anxiety, depression, and more www.justathought.co.nz/courses Free and paid content from Breathworks, including mindfulness for chronic illness www.breathworks-mindfulness.org.uk/listing/category/self-guided-courses Other resources... The NZ Health App library from Healthify , highlights apps for mental health and wellbeing, mindfulness, and more. Some apps are free, others have a cost. Search our library catalogue for books that might support your mental wellbeing. We can post books out to you at not cost. Self-Compassion Self-compassion is a vital practice that can help us to reduce stress and increase our ability to enjoy what we can in difficult circumstances. Self-compassion is treating ourselves with the same care, kindness and concern that we would give a friend, when they are in pain or difficulty. It involves exploring soothing touch and soft vocalisation which release oxytocin and endorphins and help to reduce cortisol and relieve pain. Self-compassion also involves setting appropriate boundaries to protect our property, our time, or our emotional, mental and physical well-being. Kate Brandram-Adams, from Mindfulness North Canterbury, presented a workshop for us on this topic. Watch the recording here . For more information: Dr Kristin Neff website: www.self-compassion.org/self-compassion-practices Mindfulness Mindfulness is a practice that can help us to cope with the impacts of living with a chronic illness such as ME/CFS. It may enable us to notice changes to our symptoms sooner and give us an opportunity to bring a more compassionate response, rather than pushing through. It can also be useful for taking our attention away from our symptoms and may help to calm our autonomic nervous system (ANS). Di Robertson, a mindfulness mentor, has previously led a presentation and practice session for us. Watch this on YouTube. For more information: Mindfulness on Healthify healthify.nz/hauora-wellbeing/m/mindfulness Mindfulness Apps: www.headspace.com www.insighttimer.com Mindfulness Training App: www.themindfulnessapp.com Courses: MBSR (Mindfulness Based Stress Reduction ) Finding Resilience Elizabeth Hamilton, a social worker and counsellor, has talked to us about finding resilience when debilitating illness brings many changes to our lives, along with loss, and grief. Being aware of our circle of control and approaches for living through and with loss and grief can make a difference. We invite you to watch the recording of Elizabeth's session on YouTube. Te Whare Tapa Whā Te Whare Tapa Whā is a wellbeing model developed by leading Māori health advocate Sir Mason Durie in 1984. The model describes health and wellbeing as a wharenui/meeting house with four walls. These walls represent taha wairua/spiritual wellbeing, taha hinengaro/mental and emotional wellbeing, taha tinana/physical wellbeing and taha whānau/family and social wellbeing. Our connection with the whenua/land forms the foundation. When all these areas are in balance, we thrive. When one or more of these is out of balance our wellbeing is impacted. Occupational Therapist Sarah Phipps led a presentation and workshop for us and highlighted some specific strategies for people with ME/CFS, including finding ways to live with loss. You can watch the presentation on our YouTube channel.

Complaint Process We are committed to providing appropriate and considerate support and advocacy for people affected by ME/CFS and to providing a positive working environment for our staff. We encourage anyone to get in touch with us to let us know if anything has not gone well so that we can put things right and improve for the future. We welcome this feedback in the form of a formal complaint, or as informal comments. Our definition of a complaint: An expression of dissatisfaction from an individual or a group with the standard of support, service, actions, policy, or position of MECFS Canterbury, or our employees or volunteers. How to complain: In the first instance, please contact the person that the complaint relates to. If the matter cannot be resolved, or if you would prefer, please prepare a written description of your complaint, and send to the Manager, or if the complaint relates to the Manager, send to the Chairperson. You will find our email and postal addresses on the Contact Section of our website. What to include in your complaint: What went wrong When and where it happened Who was involved What you want from your complaint Your name, address, and contact details (telephone and/or email). Unless you wish to remain anonymous and accept that this will result in limitations on our investigation and response. You have the right to expect that: Complaints will be treated with appropriate confidentiality. Information will only be shared with people necessary to complete the investigation into the complaint and to determine our response. You will always be treated with respect. At any point, all parties have the right to have their whānau support and/or supervisors and/or advocate present in any meetings related to the complaint. What happens when you complain? The person you have raised the complaint with will discuss the complaint with you within two working days of them receiving the complaint. Please be aware that the majority of our team work part time, so there may be a delay in your complaint being received. All complaints are reported to the Manager within 24 hours of receipt. For matters involving the Manager, the complaint will be reported to the Chairperson. A formal investigation and response process will be initiated if you or the person contacted require it: We may be in touch again to ascertain further information or facts and are likely to contact any other people involved. We will tell you when we plan to come back to you with a response. An independent mediator will be engaged if needed. We will provide a full and formal response in person and/or by letter if this is appropriate or requested. Our response will detail findings of our investigation and state what actions and changes have been put in place. If the matter is significant, the complaint and response will be tabled at the next Committee meeting in a confidential manner. What happens if I am not satisfied? If we are unable to resolve your complaint, you may take your complaint to the Health and Disability Commissioner or Charities Services .

Any advice, either explicit or implied, is not intended to replace the qualified medical advice that is necessary for each individual. Disclaimer Statement ME/CFS Canterbury / West Coast does not provide recommendations for any treatments for your particular situation on this website, on our social media, or in our handouts. Any advice, either explicit or implied, is not intended to replace the qualified medical advice that is necessary for each individual. Please discuss any lifestyle and treatment changes with your doctor first. ME/CFS Canterbury / West Coast does not accept any responsibility for any treatment undertaken by readers of any content, or for any error or omission in connection with an article or content, published on this website, or in our other material. We have no formal relationship with the activities and organisations that we link to. Links to these activities and information are included for convenience only. The inclusion of such links does not imply endorsement by ME/CFS Canterbury / West Coast of the linked website, or its provider, products and services offered. Readers are advised to take their own appropriate due diligence steps prior to engaging with the organisations, businesses and individuals listed. ME/CFS Canterbury / West Coast is not responsible for the currency or accuracy of content on information we link to.

Connect with Us Join Us Online Community Social Media Want to help? We invite you to join us as a member to access our full range of services , to receive our news in your inbox, and to support our advocacy and education work. It is free* to become a member of MECFS Canterbury. (*We do welcome donations if that is an option for you) Please complete our membership form, either: Join online or Print PDF and post Join Us: Our Events: You are warmly invited to join us at our various events. We have regular group meetings that may have an educational, support or social focus for people affected by ME/CFS. We are also involved in hosting education events for health professionals. For information about our upcoming events, including our support and education meetings, please visit our event calendar. Check our Events Our online peer support groups are private Facebook groups that proivde an online community space for people living with ME/CFS and related conditions. They are a great place to connect, share experiences and information, and organise local social catchups. The South Island online Facebook group... The West Coast online Facebook group... Many of the people in our ME/CFS community live in isolation, with financial hardship, disability, and without appropriate support from the health and welfare systems. We need community-wide support to improve the quality of life of people affected by ME/CFS. There are a variety of ways that you can help or join our team to make a difference. Check out our list of ways to help on our website: EXPLORE WAYS TO HELP Follow and connect with us on various platforms! Facebook Instagram Linked In MeetUp We invite you to check out recordings of our educational sessions on our YouTube channel. Have a question? Get in touch with us! CONTACT US

Help a friend with ME/CFS If you know someone who lives with ME/CFS, your help and support can make an important difference to their lives. Ask them what would make things easier for them, and what support they would like. Perhaps prepare a meal, provide quiet company, help with housework or maintenance, or pay a bill. If you invite them to an event, consider how to reduce the energy required of them, provide a quiet space to rest, and be aware that they may need to cancel on the day if they are too unwell. Believe them. Learn about their experience and the illness. Remember to manage the support you give around your own needs. Possible next steps: Support your friend to join us so that they can receive our services. FILL OUT OUR MEMBERSHIP FORM Have any questions? Please reach out to us. CONTACT US Guidance for hosting and gifts:

Volunteer Our volunteer team makes a huge difference to the support and services that we can offer people impacted by ME/CFS. We have volunteers who visit clients to provide practical supports such as housework and gardening tasks, walking dogs, assisting with filling forms and IT issues. Other people write articles for our newsletter or assist with our events and services in other ways. To sign up as a volunteer: We often have specific vacancies listed on the Volunteer Canterbury website for you to browse through. VIEW OUR VOLUNTEER VACANCIES ON VOLCAN Alternatively, please fill out our ‘Volunteer Expression of Interest’ form. We will be able to match you with people in need based on your location and the tasks you are willing to help with. FILL OUT OUR VOLUNTEER FORM For existing volunteers: After each client visit, please use the Outreach Event Form linked to below, to let us know what support was provided and when. There is also space to indicate future plans and to provide feedback. Remember to bookmark the website address so it can be found easily after each visit. Thank you for being involved in such a practical way with our community! COMPLETE OUTREACH EVENT FORM

Resources and Links Take your time going through this information list. Just read or visit the content that is of interest to you. We only share the best clinically accepted and verified guidelines and information for ME/CFS and Long Covid. Be aware that a lot of content online or in books is not evidence-based, and that more research is needed to fully understand the causes and best treatments for Myalgic Encephalomyelitis / Chronic Fatigue Syndrome. What helps one person, will not necessarily help someone else. Please refer to our ‘Living with ME/CFS ’ content for practical advice on pacing and supports that may make a difference to your wellbeing and quality of life. For Patients and Whanau READ MORE For Long Covid READ MORE For Young People READ MORE For Health Professionals READ MORE For Parents READ MORE Connecting online with others READ MORE For Health Professionals Refer to your HealthPathways for regional clinical advice for ME/CFS. M.E. Awareness NZ has curated a list of information and resources for health professionals, including Continuing Medical Education that is endorsed by RNZCGP. NICE in the UK published updated guidelines for ME/CFS in 2021. CDC in the USA maintains advice and handouts about ME/CFS. Mayo Clinic in the USA have also published guidance for ME/CFS – Consensus Recommendations and Concise Review for Clinicians . Dialogues for a neglected illness project (UK) has produced a series of 15 minute videos covering different aspects of ME/CFS including Post-Exertional Malaise and the issues involved that have lead to poor care and insufficient research. For Patients and Whānau Subscribe to our channel! Te Whatu Ora has provided online information about ME/CFS on HealthInfo. TAKE ME THERE The ‘What is ME/CFS? ’ video from the Bateman Horne Center (ME/CFS specialist centre), USA, is under 6 minutes long and provides a basic introduction into the IOM 2015 diagnostic criteria for ME/CFS. It is intended as education for medical providers but is also a good introduction for patients and the public. M.E. Awareness NZ has curated a list of resources for people affected by ME/CFS TAKE ME THERE Join ANZMES , the national advisory and support organisation for ME/CFS in New Zealand, to support their advocacy efforts. TAKE ME THERE The Unrest film tells the story of Jennifer Brea and others and what ME/CFS looks like behind the scenes. It also includes a history of the disease including contributions from Dr Nancy Klimas and Dr Ron Davis. Our Youtube channel has a range of recorded presentations on a variety of topics from past education meetings. E.g. Gut Health, Orthostatic Intolerance. TAKE ME THERE For Long COVID The Long Covid Support Tool , published by ME Support – NZ, is an excellent series of videos and resources. Useful for people with ME/CFS as well. TAKE ME THERE Long Covid Support Aotearoa provides information and community. TAKE ME THERE Self-guided online courses for Long COVID recovery developed by physiotherapists at Breathability, New Zealand. TAKE ME THERE Information from the Long Covid Physio , an international association. TAKE ME THERE 'What is Long COVID? (and ME/CFS?)' from the ME Association UK. TAKE ME THERE For Parents Join the private Facebook group NZ Carers for Young People with ME and related illnesses TAKE ME THERE Listening to Families , who are based in Christchurch, have produced a series of short videos designed to support and answer questions for families exploring a diagnosis of ME/CFS and management for their child or teenager. 80 minutes in total, with 19 videos from 1 to 8 minutes long, covering a range of relevant topics. TAKE ME THERE For Young People ME Support, based in Auckland, facilitate a free online Discord community for teens living with ME/CFS. Our nurses can refer you. Connecting online with others ME/CFS is a chronic complex condition that makes daily life difficult and causes social isolation. Online peer support groups can be helpful for people with ME/CFS as they can connect people who share similar experiences. People can come together online to socialise, share information and offer support to one another. It is okay to take a break from them as well, and shift our focus to other things. New Zealand based online forums: Join our online peer support community in a private Facebook group for people affected by ME/CFS or related illness who live in Canterbury or the West Coast of New Zealand (or elsewhere in the South Island). Join the friendly Canterbury Fibromyalgia and CFS/ME Group to connect and find out about informal local social catchups. Join the national online community facilitated by ME Support – NZ, who are based in Auckland. Other groups you may wish to check out: NZ M.E/CFS Catch ups for a holistic approach; For parents, join NZCare4ME for carers of young people with ME/CFS and other similar chronic illnesses (such as POTS, MCAD, EDS, and Fibromyalgia). For young people, join a Facebook community for NZ Teens/Early 20's with ME/CFS and Related Illnesses, or CFS / Fibro: Young Adults Group for people aged 18 to 35 (not very active at present). For young people (aged 12-20) living with any illness or disability in NZ and Australia, and their siblings, the Livewire community provides safe social connection and positive distraction. If you are severely unwell with ME/CFS, join the NZ Severe Facebook community. For long COVID, join the Long Covid Support Aotearoa and Long Covid Kids New Zealand Facebook communities. For fibromyalgia, join Fibromyalgia NZ Support and the Fibromyalgia & CFS NZ Support Facebook communities. For Ehlers-Dahlos Syndrome, join the national Loosely speaking - Ehlers Danlos NZ support group, the South Island support hub , or other affinity support groups . For Mast Cell Activation Syndrome, join Mast Cell NZ . International online forums: Phoenix Rising is the largest and oldest international online forum for complex chronic illnesses such as ME/CFS, fibromyalgia, long COVID, postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), and allied diseases. It uses XenForo community platform, rather than Facebook. Science for ME focuses on scientific discussion but is also a useful place for support and advocacy. There are public and member-only areas within the forum. It uses the XenForo community platform, rather than Facebook. #MEAction, a global movement fighting for recognition, education and research for people with ME/CFS, has several international affinity groups on Facebook for people, such as pregnancy and parenting, seniors, and caregivers. For teens and young adults up to mid 20's, check out the Teens with ME/CFS and Related Illnesses, and Teens With Chronic Illnesses Facebook communities. If you have severe ME/CFS, join the international online support group. For parents of young people with ME/CFS, join the large Parents of Kids & Teens with ME/CFS and Related Illnesses Facebook community. For parents of adults with ME/CFS, join Parents of adult children with ME/CFS Facebook community. For long COVID, join COVID-19 Long Haulers Support Facebook community, and search for others.

Many people living with ME/CFS live in permanent lockdown. When you move out of lockdown - and get back into a fulfilling life with a variety of choices and activities - we ask you to remember those that will stay in lockdown because they have ME/CFS. < Back ‘Years in Lockdown’ video for International ME Awareness Day, 12th May 2020 11 May 2020 Many people living with ME/CFS live in permanent lockdown. When you move out of lockdown - and get back into a fulfilling life with a variety of choices and activities - we ask you to remember those that will stay in lockdown because they have ME/CFS. For ME Awareness Day 2020 we prepared a short 2.5 minute video to highlight that many people living with ME/CFS live in permanent lockdown. When you move out of lockdown - and get back into a fulfilling life with a variety of choices and activities - we ask you to remember those who will stay in lockdown because they have ME/CFS.” https://youtu.be/vuRrh7NiknQ Previous Next

Volunteer Outreach Services We have a growing team of wonderful volunteers in our Outreach Service who provide one-off or regular practical support for people affected by ME/CFS. Our kind volunteers help with tasks such as housework, dog-walking, gardening, friendly company, and technical support. This support can help clients to stabilise symptoms, manage obligations and domestic activities, and reduce isolation. We won’t always have a volunteer to match with you in your area, but if you let us know what your needs are, we can certainly try to find someone. All our volunteers have a clean result from a Police Check, are given information about ME/CFS, and sign confidentiality and other volunteer agreements. A quick note to set expectations of our Outreach Service... T here are some factors affecting the capacity of this service currently: It is coordinated by a part time volunteer, and sometimes the coordinator position itself is vacant. It takes time to onboard volunteers and then to match them with clients that need the help offered in the suburb needed. Volunteers do not always stay for long, as they may move onto employment or further study. However, please do put your name on the list if you are interested in this support. We can't guarantee we will find a volunteer for you, but it makes it possible if we know what your needs are. To access this service: To refer yourself to the Volunteer Outreach Service, sign up as a member and note on the form what help would be beneficial, and one of our team will be in touch. FILL OUT OUR MEMBERSHIP FORM CONTACT US If you are already a member, send us an email about the help you are needing.

The Bateman Horne Centre based in Utah, USA, is one of the leading ME/CFS clinical education organisations in the world. In May they released an excellent 96 page ‘Clinical Care Guide: Managing ME/CFS, Long COVID...' < Back BHC publishes Clinical Care Guide 6 May 2025 The Bateman Horne Centre based in Utah, USA, is one of the leading ME/CFS clinical education organisations in the world. In May they released an excellent 96 page ‘Clinical Care Guide: Managing ME/CFS, Long COVID...' The Bateman Horne Centre based in Utah, USA, is one of the leading ME/CFS clinical education organisations in the world. In May they released an excellent 96 page ‘Clinical Care Guide: Managing ME/CFS, Long COVID… You can view the guide online, https://batemanhornecenter.org/wp-content/uploads/2025/05/Clinical-Care-Guide-First-Edition-2025-1.pdf or subscribe to receive notification of updates. https://batemanhornecenter.org/clinical_roadmap/ The guide describes the well-established clinical framework for ME/CFS, grounded in decades of research and patient care, for recognizing and addressing hallmark features such as post-exertional malaise (PEM), autonomic dysfunction, and multisystem impairment. By applying this blueprint and targeting the various components with structured, evidence-informed care, clinicians can deliver meaningful interventions to improve patient outcomes... This toolkit provides: ✦ A structured approach to assessment and management ✦ Guidance on key diagnostic tools and function-based assessments ✦ Condition-specific treatment strategies ✦ Disability and accommodation supports ✦ CME opportunities and additional educational resources Previous Next

Meal preparation can be a difficult task for people with ME/CFS. If possible, try to have some ready-made meals in the freezer or quick meal options for those days when you are very unwell or need to conserve energy for tomorrow's activities. We have curated a list of ready-made meals options below for pickup or delivery to your home. Easy Meals Meal preparation can be a difficult task for people with ME/CFS. If possible, try to have some ready-made meals in the freezer or quick meal options for those days when you are very unwell or need to conserve energy for tomorrow's activities. Consider cooking in bulk and freezing meal-sized portions. We have curated a list of ready-made meals options below for pickup or delivery to your home, or purchase at your supermarket. Not many would be affordable on a tight budget, but perhaps you can share with your whānau, in case they are in a position to purchase some meals for you from time to time. We hope to add supermarket bought easy-prep meal options as well soon. Please note that we made our best efforts to ensure the details were accurate when added, but we may have made some mistakes. Please double check details on the suppliers website before purchasing and do let us know if you discover an error or can suggest an additon. We are grateful to the following ready-made meal suppliers who have offered discounts for our ME/CFS community. See full details and conditions further below. Several suppliers also have discounts for first time purchases or offer specials regularly. Clean Meals - 10% discount EATL8R - 10% discount Kai 2 You - 10% discount Meal Prep - 10% discount My Kitchen Table - 15% discount Also worth highlighting in the list below: Nourish Oraka, a charity based in Shirley, Christchurch, offer meals for $7 each. Meals on Wheels may be an option for you. Ask your GP to refer you. Gluten free and dairy free options are available from Clean Meals, Fit Food, Health Kicks, My Kitchen Table, MYLK Food Store, Primal Kitchen, Richards Real Kitchen. Health Kicks offer low FODMAP options. DISCLAIMER: We have no formal relationship with the business activities listed on this website page. Links to these activities are included for convenience. ME/CFS Canterbury / West Coast is not responsible for the currency or accuracy of content on such websites and the inclusion of such links does not imply endorsement by MECFS Canterbury of the linked website or its provider, products and services offered. Readers are advised to take their own appropriate due diligence steps prior to engaging with the businesses and individuals listed. Meals on Wheels https://www.cab.org.nz/community-directory/KB00033364 Hot, nutritious meals for people who have difficulty preparing their own meals. Freshly made meals with a main and a dessert for 3, 4 or 5 days per week. Meals are subsidised in Canterbury and the West Coast by Health NZ and cost $8.70 each. Clients are invoiced at the end of each month and pay Health NZ Canterbury by monthly direct credit or by automatic payment each week/fortnight. Meals on Wheels (MOW) are available by referral from a General Practice team or other Health Professional for a person that meets the following criteria: unable to prepare a hot meal without assistance due to a medical condition or disability; have no family or whānau assistance readily available; need a delivered meal to maintain good nutrition and independence. Other restrictions may apply. For availability in other regions, visit https://info.health.nz/services-support/support-services/meals-on-wheels or search the CAB website. GLUTEN FREE, LACTOSE FREE, VEGETERIAN, DIABETIC, MINCE, PUREED AND SOFT OPTIONS ARE AVAILABLE. Delivery Details: Free delivery around noon each work day by volunteers, to Christchurch, Lincoln, Kaiapoi, Rangiora, Ashburton, Greymouth, Reefton, Hokitika, and some rural areas. Discount Offered - Nourish Oraka https://nourishoraka.com Affordable healthy meals made by a community group in Shirley, Christchurch. Fresh and frozen meals and soups. Limited range available. Meals from $7 (extra 50c if you don't intend to return the container provided), soup is free or $3. Some items are freshly cooked each Monday and Wednesday and refrigerated for pick up. Unused meals are then frozen and offered for later purchase. GLUTEN FREE, DAIRY FREE AND VEGETARIAN OPTIONS AVAILABLE. see https://nourishoraka.com/products/dietary-options. Delivery Details: Pickup available from in store, 27 Acheson Ave, Shirley at limited times on Monday and Wednesday, or pre-ordered frozen pick-ups are available anytime at Riverlution Pantry, 46A Vogel St, Richmond. They are trialling $5 delivery on Mondays to addresses within 5km. Contact ME Respite https://merespite.org.nz to organise delivery by volunteers within greater Christchurch. Discount Offered - BBQuick https://bbquick.co.nz Real food, made properly — no shortcuts. Freshly made frozen full-sized meals, soups and desserts. Pricing starts at $14.49 per meal. Ready-to-go packs or pick-n-mix to build your own pack. VEGAN AND VEGETARIAN OPTIONS AVAILABLE. Delivery Details: Shipped nationwide from Dunedin with same or next day dispatch. Example shipping fee for 8 meal pack is $14.50 for South Island and $19.50 for North Island delivery. Discount Offered SuperGold Card holders are eligible for $10 off every BBQuick order over $99. Balance by Sim https://balancebysimo.co.nz Ready made meals for a healthy lifestyle by award-winning chef. Freshly made main meals. Subscription or casual pricing starts from $52.00 for minimum of 3 meals per week. GLUTEN FREE, KETO, VEGETARIAN, LOW CARB AND DIABETIC OPTIONS AVAILABLE. Delivery Details: Delivered to your door in the Christchurch city area for $7 per delivery. Order by Sunday for Wednesday delivery. Discount Offered - Clean Meals https://cleanmeals.co.nz Eating clean doesn't need to be bland. Freshly made meals, breakfasts, and snacks. Meals are chilled not frozen. Prices start from $15.50 per meal. Subscriptions and one-off orders available. VEGETARIAN, VEGAN, GLUTEN FREE, DAIRY FREE, NUT FREE, SHELLFISH FREE, SOY FREE, SPICY AND BENSON DETOX OPTIONS ARE AVAILABLE. Delivery Details: Pickup available in Christchurch. Nationwide delivery to your doorstep on Tuesday afternoon. Rural delivery at own risk. The cut-off time to change your meal selections or place an order for the following week is the previous Thursday at 6pm. Discount Offered Use code MECFS25C for 10% off your order. Crisp and Vale https://crispandvale.co.nz Chef-made heat and eat ready meals. Made fresh and stored frozen. Freshly made frozen meals, sides, soup, and dessert. Main meals start from $20.00 serving 2 to 3 people. Casual orders. GLUTEN FREE AND VEGETARIAN OPTIONS AVAILABLE. Delivery Details: Pickup in Sydenham. Same day or next day delivery in Christchurch and surrounding suburbs for $12 within 15km radius, or $25 for up to 25 kms, with minimum spend of $60. Discount Offered - EATL8R https://www.eatl8r.co.nz Nutritious meals delivered to you. The Eatl8r menu changes weekly and with the seasons. Meals, soups, desserts with petite size meals starting at $13 and regular size at $15. Ingredient information provided. Delivery Details: Pickup in Waltham or delivered to Christchurch city suburbs for $6 or Canterbury for $11. Deliveries are made on Thursdays. Discount Offered Use code MECFS10 for 10% off your order. Eat https://www.eat.co.nz Home of fresh, ready to heat and eat meals delivered to your door. Freshly made meals, soups, desserts, and baking with regular sized meals (400g) starting from $13.50 and large (500g) from $15. Frozen potluck boxes and Tiddly meals are frozen. VEGETARIAN OPTIONS ARE AVAILABLE AND TEXTURE MODIFIDED PUREE MEALS ARE AVAILABLE that meet the International Dysphagia Diet Standardisation (IDDSI) Level 4 Puree for people who have difficulty swallowing or have digestive problems. Delivery Details: Delivered nationwide from Wellington with a $35 shipping fee to the South Island. Order by 11am for delivery next day. Discount Offered - Farro https://www.farro.co.nz Dinner made deliciously easy. Build your own meal bundle and care package. Family meals, frozen pizzas, sides, soups, sauces, and desserts. Heat and Eat meals start from $14.99, 2-3 serve meals start from $19.99. Also available to purchase are meal bundles and ready-to-cook options. VEGETARIAN OPTIONS AVAILABLE. Delivery Details: Delivered from Auckland to Christchurch and surrounding areas for $35. Order by Thursday 10am for delivery on Monday. Discount Offered - Fit Food https://www.fitfood.co.nz Healthier. Easier. Better. Fresh and frozen single serve meals, family meals, meal bases, sides, sauces, breakfast meals, and desserts. Fresh meals starting from $12.00. Frozen meals starting from $14.90. Family meals starting from $37.90. Subscription or casual orders. KETO, GLUTEN FREE, DAIRY FREE, VEGAN AND VEGETARIAN OPTIONS ARE AVAILABLE. Delivery Details: Pickup from Rangiora on Monday and Tuesday. Delivery fee within South Island is $12.50. Order by Thursday night for Tuesday delivery. Discount Offered - Freshchef.nz https://freshchef.nz Chef made. Hearty portions are sealed to lock in the freshness & flavour. Freshly made frozen meals and desserts. Meals start from $15.99 with most around $18.49. Order a subscription box or purchase one-off. GLUTEN FREE, VEGAN, VEGETARIAN AND KETO OPTIONS ARE AVAILABLE. Ingredient information provided. Delivery Details: Pickup in Rangiora or delivered nationwide the next day with shipping starting from $9.90. Free shipping on your first order. Discount Offered - Health Kicks https://healthkicks.nz When life happens. We have you covered. Fresh lunch and dinner meals changing each week. Plans start from $70.00 per week for 5 meals. Order meal packs by subscription or one-time purchase. MOST MEALS ARE GLUTEN AND DAIRY FREE. VEGETARIAN AND VEGAN OPTIONS ARE AVAILABLE. Delivery Details: Order by Monday evening for delivery in Christchurch, Timaru and Ashburton on the following Monday. Shipping within Christchurch around $7. Do not deliver to rural addresses. Discount Offered - Healthy Kiwi Dinners https://www.healthykiwidinners.co.nz/ Roast dinners and more that bring comfort, warmth and satisfaction. Frozen and fresh meals, salads, sandwiches, soup and desserts. Fresh meals from $14 and available in three different sizes. Frozen meals are $14 each. Bulk pricing specials. Order by phone. GLUTEN FREE AND VEGETARIAN OPTIONS AVAILABLE. Delivery Details: Pickup in Woolston or delivered to Christchurch area only for around $8 on minimum order of $30. Discount Offered - Just Good Food https://justgoodfood.co.nz Want natural, home-made meals without the fuss of making it? Frozen meals and desserts. Regular meals $12.00, large mains $14.00, Desserts are $10.00. Ingredient information provided. Delivery Details: Christchurch delivery only with $5 fee for minimum order of $40. Free delivery for orders over $100. Order by 2pm Tuesday for delivery Thursday. Discount Offered - Kai 2 You https://www.kai2you.co.nz Ready to heat and eat meals. Made with love. Fresh meals, frozen pies and sausage rolls, soups, scones and desserts. Regular meals from $15, petite meals $11, soup $5. No subscriptions. New menu every week. Gift vouchers are available. Ingredient information available. Delivery Details: Pickup in Papanui or delivered to greater Christchurch with $6-$8 per delivery, based on a minimum order value of $30. Discount Offered Use code MECF10 for 10% off. Supergold card holders get 14% off with code super14. MYLK Food Store https://mylkfoodstore.com From my little kitchen to yours. Handcrafted nutritious meals ready in minutes. Freshly made meals, soups, sides and desserts. Soups start from $9, main dishes from $9.90 (single 200g size). Menu changes each week. One-off orders. Gift vouchers available. GLUTEN FREE, DAIRY FREE AND VEGATERIAN OPTIONS AVAILABLE. Delivery Details: Delivered from Napier to the South Island for $25. Cannot deliver to rural addresses. Order before 4pm on Tuesday for delivery following Tuesday. Discount Offered - Meal Box https://www.mealbox.nz Chef crafted meals. Save time and energy. Freshly made main meals that are flash frozen, and breakfasts. Main Meals from $15.99 each. Breakfast add ons are $9.00. Purchase one-time or on subscription. KETO, LOW CALORIE AND PROTEIN+ OPTIONS AVAILABLE. Ingredients information provided. Delivery Details: South Island shipping cost is $29.99, and North Island is $14.99. Minimum of 5 meals need to be ordered. Next day delivery. Discount Offered - Meal Prep https://mealprep.nz High-protein meals—no prep, no stress. Just heat, eat, and enjoy! Freshly made breakfast meals, lunch and dinners. Lunch and dinner from $14.90. Care packages and gift vouchers available. DAIRY FREE, VEGAN, PLANT BASED AND VEGETARIAN OPTIONS AVAILABLE. Delivery Details: Delivered to the South Island within two days for $28. Discount Offered Use code MECFS10 for 10% off first order of 3 different meals above $50. Not available on subscriptions or meal plans. My Food Bag – Ready Made Meals https://www.myfoodbag.co.nz/ready-made-meals Award winning. Fresh, Ready-Made Meals. Freshly made meals, soups and dessert. 18 meals to choose from every week including homestyle favourites and healthy options. Order in bulk from 4, 6, 9 or 12 meals per week. Pricing starts from $72 for 4 meals ($18 per plate). Purchase on subscription or one-off order. Ingredient information provided. Delivery Details: New Zealand wide delivery $15. Delivered to your door on Saturday, Sunday or Monday depending on your area. Discount Offered - My Kitchen Table https://mykitchentable.nz Chef quality meals proudly made fresh and frozen in Nelson. Freshly made frozen meals, soups and meal boxes. Soups from $9.99 each, single mains from $12.99 and double from $19.99. Meal Boxes start from $89.00. Also available in selected Fresh Choice and New World supermarkets. GLUTEN FREE, DAIRY FREE, VEGAN AND VEGETARIAN OPTIONS AVAILABLE. Delivery Details: Delivered from Nelson to Canterbury and West Coast $14.90 per order. Orders made by noon are normally delivered the next day. Discount Offered Use code MECFS15 for 15% off. Not available on specials. Pasta Vera https://pasta.co.nz/product-category/retail-range/ready-meals/ Locally made lasagne, filled pasta, and ready meals. Lasagne, pasta and other meals. Meals from $9.49. VEGETARIAN, VEGAN, GLUTEN FREE AND DAIRY FREE OPTIONS AVAILABLE. Delivery Details: Available from selected supermarkets and the factory store in Wigram. Discount Offered - Primal Kitchen https://primalkitchen.co.nz All natural. Grain free. No refined sugar. Soy free. Freshly made meals, frozen meals, meal packs, subscriptions, family packs, snacks and treats. Frozen Meals start from $14.95, frozen subscriptions start from $69.95 per week, Random selection of frozen meals are $15.25. Gift Vouchers available. GLUTEN FREE, DAIRY FREE AND KETO OPTIONS ARE AVAILABLE. Delivery Details: Delivered from Porirua, Wellington, to South Island for $35. Order on Friday for delivery on following Tuesday or Thursday. Discount Offered - Richards Real Kitchen https://www.richardsrealkitchen.co.nz Delicious fresh and frozen heat and eat meals in single and family size. Fresh and frozen meals, soups and desserts. Meals from $14 each for a single serve (large by weight, volume and protein), family-sized from $39. One-off orders. Gift vouchers available. GLUTEN FREE, VEGAN, DAIRY FREE AND VEGETARIAN OPTIONS AVAILABLE. Fewer processed additives. Delivery Details: Pickup from Wigram or delivery fee from $5 for Christchurch and surrounding areas. Order by 11am for same day delivery. Leave a chilly bin on the doorstep for delivery. Discount Offered - Strength Meals https://strengthmealsco.co.nz/ High protein, macro balanced meals formulated by nutritionist Frozen meals and chilled or canned soups. Soups $5.50 and meals $13.50. VEGETARIAN, VEGAN, GLUTEN FREE, DAIRY FREE, LOW SUGAR OPTIONS ARE AVAILABLE. Delivery Details: Only available from Woolworths supermarkets. Discount Offered - Timata https://www.timata.nz Tīmata provides easy access to affordable, nutritious ready-made meals. Fresh meals and desserts purchased in bulk. Six meals for $79.98 ($13.33 each) or 8 Meals for $99.98 ($12.50 each). Subscription, with variable weekly options. Timata provides additional supports designed for the Enabled Good Lives disabled community including delivery of medications and groceries, and a platform to connect providers with members. Delivery Details: Free delivery nationwide from Invercargill, excluding rural delivery addresses. Delivered overnight or on the day selected. Discount Offered - Traiteur https://www.traiteur.co.nz/order/heat-eat Homemade happiness, delivered to you. Heat and eat meals, soups, salads, sweet treats, and butchery meat. Heat and eat meals start from $14.50, soups $10.50, salads from $7.50, weekly menu starts from $21.95. treats from $4.95. One-off orders. VEGETARIAN OPTIONS ARE AVAILABLE. Delivery Details: Pickup from Papanui or delivery in surrounding neighbourhood on Tuesday, Thursday, and Friday. Discount Offered -

Management approaches for ME/CFS include identifying the most problematic symptom first and exploring options for improvements, along with implementing pacing and activity management.​ We have collated some information for you. Managing Specific Symptoms We aim to collate information here to help you manage your ME/CFS and the specific symptoms that may be present, particularly as our team deliver presentations on these topics. DISCLAIMER: MECFS Canterbury does not provide recommendations for any treatments for your particular situation on this website. Any advice, either explicit or implied, is not intended to replace the qualified medical advice that is necessary for each individual. Please discuss any lifestyle and treatment changes with your doctor first. MECFS Canterbury does not accept any responsibility for any treatment undertaken by readers of any content or for any error or omission in connection with an article or content published on this website. Overview of ME/CFS and its Management We invite you to watch our presentation about Myalgic Encephalomyelitis / Chronic Fatigue Syndrome and its Management on our YouTube channel. This presentation covers: What we know about ME/CFS The diagnostic criteria for ME/CFS Impacts and severity spectrum Key management principles and approaches How to make a meaningful life Management approaches include identifying the most problematic symptom first and exploring options for improvements, along with implementing pacing and activity management. There is also a pdf of the slide deck available. Orthostatic Intolerance (OI) Orthostatic Inolerance (OI) is an umbrella term for several conditions in which symptoms are worsened by assuming and maintaining an upright posture. When someone with OI stands up or sits for too long, they may experience symptoms such as light-headedness, dizziness, spatial disorientation, feeling faint, sweating, headaches, nausea and palpitations. Many symptoms improve with lying down, although some take hours or days to resolve. People with ME/CFS may have low OI, or meet the criteria for the more severe Postural Orthostatic Tachycardia Syndrome (POTS) or Neurally Mediated Hypotension (NMH). Diagnosis involves ruling out other causes, a Tilt Table or NASA Lean test, and assessments such as Hours of Upright Activity (HUA). OI symptoms is one of the most treatable symptoms associated with ME/CFS and it is usually possible to increase functional capacity through the following management approaches: Increase blood volume by drinking water and consuming more sodium (if safe for you to do so). Provide mechanical support by using compression garments and postural counter manoeuvres (movement that moves the blood up the legs to the heart). Make lifestyle adjustments such as avoiding overheating, alcohol, large meals. Introduce movement or gentle exercise done in a lying down or recumbent position first. We invite you to watch our talk about Orthostatic Intolerance (OI) and its Management on our YouTube channel. A pdf of the slide deck is also available. Further Reading Clinical Care Guide from Bateman Horne Centre, USA, a 98 page document published 2025. This covers the basics and common co-morbidities. Clinical Primer from IACFSME (International [Clinician] Association for CFS/ME), 2014. Particularly Section 5 Management and Treatment. Advice from ME Association UK, who are strongly evidence-based. They provide general guidance and leaflets covering various supplements, therapies and medications https://meassociation.org.uk/free-literature-downloads/ Visit our Links page for more information.