Bob
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My first post on here, so hello to all.
I have had a diagnosis of CFS/ME/FM since 1998 and consider myself to have been diagnosable since 1996. Variety of probs prior to that.
I would like to say that whereas it is very important for physicians to recognise and treat 2e depression in CFS/ME/FM, and for physicians to recognise that these conditions are not a form of primary depression, the depression of CFS/ME/FM is not necessarily always secondary and to be equated with that of "any other chronic disease". This is an oversimplification imo.
A variety of neuroimmune illnesses may present with depressive aspects as part of the organic complex, due e.g. to changes in tryptophan use in immune activated states.
It is not simply a matter of people being depressed because they have lost their health, jobs, friends, families etc.,Though I know from experience that this is a major factor, it is not good biology to ignore the impact of immune activation on mental health.
Given the variety of bizaare symptoms/reactions we suffer to a variety of stimuli whether external or in our own bio-terrain, is it not also possible that some depression may arise from our disordered neural networks as just one of many odd responses to inputs that would not be noxious to healthy networks?
I do feel that the "all the depression is 2e" argument is questionable.
Hi Richie, a very big welcome to the forum
Just to clarify, "2e" means "secondary". (But I've not seen the use of '2e' before now.)
I absolutely agree with much of your post, but I disagree with the bit about depression not being secondary.
In medical terms, a secondary condition is considered to be caused by the primary condition.
So, in the scenario, where depression is 'secondary' to the ME, it would be considered that if the ME was successfully treated, then depression would no longer be a problem.
That's not to say that the depression can't be debilitating for ME patients, or perhaps even sometimes a patient's biggest complaint.
In the case of ME, what it means is that if the ME is fixed, then the depression would resolve itself.
If depression is considered 'primary', then it's classed as an independent condition, and the main problem to be fixed, so that the main focus should be on resolving the depression. If ME was considered to be 'secondary' to the depression, then it would be considered that if the depression is treated successfully, then the ME would resolve itself. (Clearly the evidence does not support this.)
It's also possible to have co-morbid conditions, which both arise independently. So if a condition is considered to be 'co-morbid' to the ME, then it would be considered to be independent of the ME. (Depression would be demonstrated to be 'co-morbid' if it still existed if the ME was successfully treated/cured.)
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