Since some comments made the comparison to psychological factors, CFS is not an imbalance of neuro-transmitters in the brain, which it is the case for all psychological illnesses.

As for the latest research, it is a dysfunction of all mitochondria in the body. More specifically, when ATP is reduced to ADP to produce energy, N+ and O+ radicals are created. Usually, those are eaten up by killer cells. However, in CFS patients, this mechanism is damaged, so that way too much N+ and O+ are created or, they are not eaten up fast enough after only very little exertion. That is why, CFS patients are bedridden for weeks and months after only running for the bus for 2 mins, because their body becomes overloaded with free radicals.

Those damage your cell membranes and create all sorts of pain, fatigue, brain fog, and many more symptoms.

I've been suffering from CFS for almost 3 years now. I went from building my own startup and loving life to massive pain and other symptoms within 24h. Over the years, I managed to reduce the symptoms by staying in bed completely for 1 year and paying a lot of attention to not exert myself for the remainder. I can do small things now without having "crashes" and am taking a lot of anti-oxidants after having found a doctor (Prof. Huber) in Germany who has specialized in CFS and developed a therapy. He said there are only 10 more doctors in Germany who know about CFS.

Before him, I went to see 30
other doctors who didn't give a damn about finding out what's wrong with me. Doctors also will not do more than the usual testing, because they don't want to exceed their per patient budget. You need to find a private insurance doctor.

So for 2 years all doctors have told me it's all
psychological. I went to see psychiatrists who prescribed me heavy anti-depressant. They told me I have heavy depression. When I asked them why they would say that, because I don't fulfill the depression criteria they became angry.

In order to be diagnosed with depression, you need a minimum of symptoms including suicidal thoughts, sleep disturbances, change in appetite etc. I did not have any of those, I just had massive pins and needle pains all over body, blurred vision and muscle twitching.

I told that to the psychiatrists and became angry, because I questioned their authority. They are the expert and not me. Then they tried to gaslight me by saying that I feel depressed multiple times even though I told them that I don't. Then they told
me I am a narcissist, manic, anti-social etc. and that is why I have these symptoms.

After 2 years I finally found a doctor who was not like this and who did more tests. He found elevated S100B protein (the CRP of the nervous system), MDA-LDL (free radicals) and low killer cells.

So, this is what you can expect when having CFS, doctors become angry, they try to actually gaslight you. Doctors vigorously say that CFS doesn't exist even though it is described specifically in the ICD.

Apart from that, your parents will desperately try to convince you that you're mentally ill and that it's all in your head, because that's what the doctors say and become desperately angry to try to convince you and maybe also cut contact with you, because they can't see their child withering away in bed, while he/she refuses to "listen to the doctors".

There are examples of recovery, so it is possible. However, most patients do not recover ever, because they have kids or need to work a job. If someone with CFS has kids or a they need to work, it's almost a death sentence, because you cannot do anything for years if you want to recover and you should not have more than 5 or so crashes in total, because the recovery time increases by several months for every crash, at least at the current state of therapy.

So, it's hard, but I've now had a 2 out of 5 main symptoms disappear after 2 years of avoidance of exertion and hope the other ones clear in the next few months.