Cognitive and behavioral coping in people with CFS: An exploratory study...

[Woolie]

http://www.enhertsccg.nhs.uk/sites/default/files/pathways/Hospital Anxiety and Depression Scale (HADS).docx

The items that relate to depression are:
[*]I still enjoy the things I used to enjoy
[*]I can laugh and see the funny side of things
[*]I feel cheerful
[*]I feel as if I am slowed down
[*]I have lost interest in my appearance
[*]I look forward with enjoyment to things
[*]I can enjoy a good book or radio or TV programme

Wow, @Dolphin, that's pretty messed up. And this scale is supposed to be designed for sick people? No wonder James Coyne is so scathing about it.

 

[alex3619]

I still refuse to interpret CFS as a life lesson, but I have to admit there are a few (modest) pluses to have come of it.

Bad things are not good because you gain a little wisdom. The wisdom is good but its something else as well.

While these might suit some people with depression and anxiety, they didn't seem to suit somebody with ME as well.

Actually I think they can be dangerous, and rather than treating depressive symptoms in some ME patients they might actually cause them. Depending on the individual case this might be a cookie cutter approach to treatment, or to put it another way its due to a miscategorization and using treatments designed for other circumstances, even if they are superficially similar.

I currently find little in this papers excerpts I would cheer about, but then I find little that is absurd or obviously objectionable. This might mean (though I have not read the whole paper) that its a better framing of the situation than the CBT/GET nonsense.

I am still wary of scales and questionnaires that use ME symptoms as evidence of, for example, depression. Its a bit like faulty bookkeeping.

 

[alex3619]

Wow, @Dolphin, that's pretty messed up. And this scale is supposed to be designed for sick people? No wonder James Coyne is so scathing about it.

I think I can be depressed (I do get brief but rare transitory depressive feeling on rare occasions) and still answer a big yes to every question, whether its geared in one direction or the other. We really need our own well validated scales for ME and CFS, and I do not mean anything like the one Chalder uses for fatigue.

I still think one of the best questions that separates depression and ME is to ask the patient what they would do if they were better tomorrow. I strongly suspect the doctor would call a halt to the session before most patients would stop their lists.

 

[Dolphin]

While these might suit some people with depression and anxiety, they didn't seem to suit somebody with ME as well.

Actually I think they can be dangerous, and rather than treating depressive symptoms in some ME patients they might actually cause them. Depending on the individual case this might be a cookie cutter approach to treatment, or to put it another way its due to a miscategorization and using treatments designed for other circumstances, even if they are superficially similar.

I doubt this person's experience waitressing was overall positive anyway. They struggled trying to keep the job. Being upright was a problem as was some cognitive task (remembering things?) as I recall.

Then failing at it/having to give it up I doubt did much positive to their mood. I can't remember the details: I got information from somebody else.

Also overdoing it can affect your mood negatively in ME/CFS.

 

[alex3619]

I doubt this person's experience waitressing was overall positive anyway. They struggled trying to keep the job. Being upright was a problem as was remembering things as I recall.

Untreated orthostatic tolerance is a big issue. Most patients probably have some form of it.The test for it is from 1940. There is really no excuse all these decades later.

 

[Sean]

Whether these strategies are related to depressive symptoms in people with CFS remains to be studied.

 

[Valentijn]

Wow, @Dolphin, that's pretty messed up. And this scale is supposed to be designed for sick people?

It's designed for people staying in a hospital. That means it's generally going to be for patients with acute and simple conditions, which have already been treated. People staying in a hospital are also being fed and generally getting the assistance they need.

It's blatantly perverse to use it on disabled patients who are being neglected instead of treated, and pretty inappropriate for chronically ill patients or those with multi-system diseases as well. But it's a wet dream come true for quacks who like to equate disability with depression.

 

[Skycloud]

I'm reminded of somebody who developed depression and anxiety alongside their ME. They tried to die by suicide a few times and eventually did take their own life.

I was unimpressed with the approach I heard the mental health professionals were taking in her case. They were encouraging her to do normal activities such as taking a part-time job, going back to full-time education and other behavioural suggestions. While these might suit some people with depression and anxiety, they didn't seem to suit somebody with ME as well.

Rubbing salt in the wound.

 

[Mithriel]

Alex said " think I can be depressed (I do get brief but rare transitory depressive feeling on rare occasions) and still answer a big yes to every question, whether its geared in one direction or the other."

One of my symptoms is a transient deep depression which comes on when I am tired and can go away with a short nap. I don't get that desperate exhaustion now I don't have small children but there is still a pattern when I have overdone things; sore throat and pain, aches dizziness then depression which my husband notices as a pattern while I am thinking what I am feeling is the proper response to how bad I feel. If I ignore it and rest it goes away.

In fact calling it depression, while it feel bad at the time, is like all those people who say they are fatigued like us when it just lasts a short while. It must be dreadful to feel so hopeless all the time.

Mithriel