Are endogenous depression and cfs close relatives?

[Undisclosed]

From Eleanor Stein -- Differences between ME/CFS (left column) and Depression (right column) (http://www.mecfs.org.au/media/resources/Article-ESteinPsychiatricCFSGuideline05.pdf) makes it fairly clear the two are distinct conditions i.e. 'not close relatives'.

 

[Snow Leopard]

I have had major depressive disorder for most of my life, long pre-dating my CFS diagnosis. I was extremely depressed at the time I got the diagnosis, in fact. I've taken psychotropic drugs from A to Z and none of them helped until I got Cymbalta (duloxetine) during my third hospitalization.

Given that different drugs work for different people, doesn't this suggest that depression isn't a homogenous group (biologically) and that there are different underlying factors at play?

 

[stridor]

I skipped through this thread and I just want to air a bit of laundry, I hope returning to an earlier point doesn't derail anything.
I want to talk about the pharmaceutical companies. Back in the 70's the American Psychiatric Association decided to share their bed with the drug companies. At first, it was to sponsor conferences and the like but it was only a short period of time before they were influencing what was taught and thought in the industry.

The DSM doubled in size and then doubled again as attempts were made to pathologize more and more human behaviour. And thereby legitimize treatment.

When the labs were unable to create more patent-able analogs of earlier meds, the pharmaceutical companies got new patents by showing that the old meds were useful for other ailments. At the same time they extended markets and now our kids are targeted.
Know what? I am just going to stop now. This is one topic capable of changing my mood for the day. I get pretty worked up. People get cancer but societies can get it too.

Change topic:
I met the criteria for Bipolar Disorder for much of my life. I could not get my Dr to see anything but psych-symptoms in my presentation. Our disagreements around this have soured our relationship. Especially when I informed him that I was moving against mercury and adopting Freddd's Protocol and had the audacity to improve.

Try not to let words like Bipolar, depression, Generalized Anxiety Disorder and the like, get under your skin. Still. fight to have PEM, brain-fog and OI etc recognized as having the greatest impact on your day-to-day functioning if that is where you are with your illness.

Like every other symptom spoken of here, there will be a continuum. If we polled how depression manifests itself in this population it would extend from a bad case of the blues all the way to a vegetative state. But no matter how severe, "depression" is still just a word. A communication device to help people categorize clusters of symptoms. It is not a "thing". Depression is just one of the ways that the brain uses to say, "ouch".

I have had this as part of Bipolar cycling and as a stand alone symptom. Some of us would be dead at our own hands if we did not "own" this, put a name to it, and treat it. There have been times in our lives when depression has been our worst symptom.

PEM is not stigmatizing; OI is not stigmatizing (at least not in this community) and there are no impassioned entries or arguments about them on this site - only the symptom cluster called "depression" seems capable of bringing this out.

I feel that there are people who, if they were honest about it, find this idea or diagnosis to be objectionable at some level. For some funny reason this makes me feel as if I am being somehow judged and I'll bet that I am not the only one.

 

[Valentijn]

PEM is not stigmatizing; OI is not stigmatizing (at least not in this community) and there are no impassioned entries or arguments about them on this site - only the symptom cluster called "depression" seems capable of bringing this out.

I feel that there are people who, if they were honest about it, find this idea or diagnosis to be objectionable at some level. For some funny reason this makes me feel as if I am being somehow judged and I'll bet that I am not the only one.

No one is judging or stigmatizing. I don't feel stigmatized when someone proclaims that all ME/SEID patients must be depressed. I feel annoyed because it's inaccurate: depression has a certain set of symptoms which I don't have, and which is completely different from the symptoms of ME/SEID unless you were diagnosed with Oxford CF.

If you had major depression, would you be unbothered by being labeled as having borderline personality disorder instead? If you had MS, would you be unbothered by being labeled as having cancer instead? We don't have to feel that a label is stigmatizing in order to reject it for being inaccurate and therefore inappropriate. We have different symptoms, and we require different treatments. Different labels simply reflect that.

And every time someone starts the "stigma" discussion, I feel like the entire ME/SEID community is being labeled as ignorant and intolerant. It's completely unwarranted and it's offensive.

 

[Snow Leopard]

Like every other symptom spoken of here, there will be a continuum.

There is certainly a spectrum of (depression associated) symptoms.

The key point is that this is a separate spectrum to ME/SEID.

I've known quite a few people who have had severe depression and a couple of people whom had bipolar disorder. Their experiences of life are quite different. Depression feels very different.

Why are we so sensitive about this issue? Because so many people, including doctors, journalists etc. keep repeating the myth that ME is 'like' or somehow associated with depression, stress, childhood abuse etc, the myth that most or all patients have depression and so forth. We have to fight so hard to end these myths that we are very sensitive about it.

 

[stridor]

I am more than happy for the people here who have not had to contend with depression, nor have had an existing psychiatric diagnosis interfere when trying to find help. And I mean that.
I would be willing to separate the ME symptoms from the depressive symptoms if I thought for a second that it was true. There are too many of us for this not to be one of the possible expressions of this illness.

My depression, I am happy to say cleared within 3 days of starting mB12. B12 deficiency certainly can cause depression, not just any depression, but severe depression with psychosis in extreme examples.

So, if a disturbance in methylation can contribute to the development of ME symptoms and and concurrently cause depression, how is it that I am supposed to separate the two?

Some of you who are adamant that you do not have this, I challenge you to ask a few of your close friends and family to rate your mood over the past 12 months from -10 to +10 with zero being neutral. You're not going to like the answer.

Those who are upset by all of this are likely to continue to be so. Unfortunately there are enough of us presenting with ME as well as depression that this "myth" isn't going anywhere.

 

[Snow Leopard]

Some of you who are adamant that you do not have this, I challenge you to ask a few of your close friends and family to rate your mood over the past 12 months from -10 to +10 with zero being neutral. You're not going to like the answer..

I have recently had a massive shift in my mood, motivation and so forth, towards depression after many years of not being depressed. That is why I'm saying that it feels very different.

 

[IreneF]

Given that different drugs work for different people, doesn't this suggest that depression isn't a homogenous group (biologically) and that there are different underlying factors at play?

There's definitely a difference between people who have a long personal history of depression and a familial history of mental illness, and those who become depressed later on in life and don't have any relatives or ancestors with psych symptoms. The former are likely to be the people who are helped by meds, the latter maybe not. I thinks it confounds studies on the effectiveness of antidepressants. They actually work for the right group of patients.

Even if meds help you, finding the right one can take an agonizingly long time. Years, decades even. I have no idea why. Some of them seem to have pretty much the same pharmacology, but one will work and the rest won't.

 

[Valentijn]

So, if a disturbance in methylation can contribute to the development of ME symptoms and and concurrently cause depression, how is it that I am supposed to separate the two?

Your underlying assumption has no basis. There is no real evidence that methylation problems in any manner contribute to developing either ME or depression. And your personal experience regarding your depression reacting favorably to B12 is not sufficient to extend a conclusion to all depression or all ME patients.

 

[heapsreal]

Once upon a time one had to feel sad , a deep sadness to be considered depressed, a rather simple explanation. Now the psych industry have made it so complex that one can be diagnosed without feeling sad.

I came across a good example of this today speaking to a young woman who said her mum got diagnosed with depression. Her mum went to her dr with symptoms of fatigue, sleeping all the time etc. I think she was in her 50s. She was given antidepressants and sent on her way. She went and saw another dr after a few weeks of not getting any better. This dr actually did some blood work and found abnormalities and sent for further blood work. She was told she had cancer of the bowel, lung and liver.

the criteria for depression is so wide and includes so many symptoms that if a dr doesnt do proper blood work and other testing, many people could easily get misdiagnosed. Its very scary when a dr cant distinguish depression from some other symptom/illness. You could probably rule out alot of these issues just by asking someone if they feel sad all the time. One would feel very sad after a cancer diagnosis but treating this sadness/depression isnt going to fix cancer although might make one feel better about feeling like shit.

 

[stridor]

@Valentjn
If we give a diabetic insulin and the blood sugar lowers, we might be drawn to conclude that a lack of insulin will cause the blood sugar to rise again. If bolstering the methylation system helps with some people's ME symptoms then it is not a huge leap of logic to assume an improperly operating methylation system will make their symptoms worse.

And I did not say that a problem with methylation contributes to the development of ME, I said the it contributes to the development of ME symptoms. There is a difference.
If there is a redox-activity component to ME, and this in any way contributes to symptoms..... and problems in the methylation pathway can lead to dysregulation of this redox-activity.... then this would contribute to symptom development.

Depression walks hand-in-hand with other disease processes that affect the brain. Is it such a huge leap to believe that an illness that is messing with cognition, concentration and memory might also produce a change in mood in some of us? Are we able to freely discuss our ME experience on this site without upsetting people? Or is it preferred that we compartmentalize one or more of our symptoms that others do not share?

Finally, like I said, I don't have to prove or disprove anything. There are enough people presenting with both ME symptoms and depression that this idea will self-perpetuate.

 

[heapsreal]

@stridor I think many like to seperate depression and cfs/me because most dr's believe cfs/me is depression and treat it the same way. I think its hard for people to freely discuss this because for many of us it was rammed down our throats that all we had was depression and treating the depression will fix the cfs/me, many have been severely burnt by this from many dr's unfortunately.

Also this site is looked at by alot of people, patients, dr's, non sufferers etc and i guess worried that mentioning depression in cfs/me could be taken in isolation and reguarded as the same. I dont think cfsers have a stigma for depression as such as there is alot more stigma to saying you have cfs/me than if one said they had depression.

I think many cfsers are willing to say they have varying degrees of depression as secondary effect of having cfs/me, just like any other chronic illness. The other thing is that we need to be very careful of how depression is treated in cfs/me as we respond very differently to antidepressants than do say non cfs/me with depression.

One other thing i would like to say about depression and this is in general not cfs/me, but many people hear of someone suffering depression and think someone is crazy or psychotic. Many dont understand that being depressed is very different to being psychotic, but i think thats the general stigma depression has been fighting for decades. So with that there is a lot of people see cfs/me as depression which equals psychotic, 3 different illnesses that a laymen thinks are the same.

I guess its a touchy subject???

 

[gregh286]

I don't have any depressive tendencies but moderate cfs.
Never did have any mental issues pre cfs.
Can low neurotransmitter cause biological symptoms? Pem......cold feet.....thirst and so on?

 

[Mij]

I am more than happy for the people here who have not had to contend with depression, nor have had an existing psychiatric diagnosis interfere when trying to find help. And I mean that.
I would be willing to separate the ME symptoms from the depressive symptoms if I thought for a second that it was true. There are too many of us for this not to be one of the possible expressions of this illness.

My depression, I am happy to say cleared within 3 days of starting mB12. B12 deficiency certainly can cause depression, not just any depression, but severe depression with psychosis in extreme examples.

So, if a disturbance in methylation can contribute to the development of ME symptoms and and concurrently cause depression, how is it that I am supposed to separate the two?

Some of you who are adamant that you do not have this, I challenge you to ask a few of your close friends and family to rate your mood over the past 12 months from -10 to +10 with zero being neutral. You're not going to like the answer.

Those who are upset by all of this are likely to continue to be so. Unfortunately there are enough of us presenting with ME as well as depression that this "myth" isn't going anywhere.

Why can't you just accept the fact that many of us don't have depression? Why don't you (and I'm referring to everyone who insist that we are all in some sort of depressive state) respect that?

 

[stridor]

@Mij
I absolutely do accept that many with this do not have depression, but I also accept that some do. I never once said that everyone had this symptom to my knowledge. If I did, I am sorry -that was not my intention.
I do suspect that more people would meet the criteria than are willing to acknowledge. But I totally understand that there is a need to keep the practitioners focused on the underlying problem and not just one symptom of it. I did the same thing.
@heapsreal just posted and it captures some of my ideas on this.
It was my intention when I "liked" the post before yours to let this drop. I am sorry that you felt that I wasn't being respectful. My only intention was to shed light on my experience. When people "spit" every time "depression" is mentioned on this site it is felt by some of us who have had to deal the this sometime symptom of the illness. We are an equal part of this community.

That is all I have to say on this topic.

 

[Valentijn]

When people "spit" every time "depression" is mentioned on this site it is felt by some of us who have had to deal the this sometime symptom of the illness.

Who is "spitting" and when? Someone disagreeing that they have depression, or that all ME/SEID patients have depression, or that depression in an integral ME/SEID symptom, or that depression and ME/SEID are closely related is not "spitting".

Some people just disagree with your opinion on the matter.

 

[gregh286]

Well the real crux of it is.....can you be depressed in such a way that you have total fatigue without feeling blue or down. Being pissed off with having this crap is not considered down or blue....it's just frustration.
Maybe there is a certain mix of ballsed up neurotransmitters that can produce such a set of conditions.
I would love to hear from doctors who battle cfs..surely there is a few thousand of them considering the number that suffer globally.

 

[Valentijn]

Well the real crux of it is.....can you be depressed in such a way that you have total fatigue without feeling blue or down.

I don't have fatigue. I have ME: PEM, various sorts of pain, orthostatic intolerance, ataxia, some vertigo, swollen lymph nodes, sore throat, low body temperature, muscle twitches/spasms/cramps triggered by minor muscle use, etc, etc.

How does anyone ever conflate that with depression? I guess it's just one of the great mysteries of the universe

 

[gregh286]

Totally Valentijn.
I have heavy fatigue,puffy eyes, bad pem, thirst, twitches, freezing feet, sore elbows.
My so called GP friend says it's depression and the physical symptoms are a manifestation of out of whack neuro Chemistry.
This is my point maybe it is possible that haywire neurotransmitters can cause huge physical symptoms.
Hard to believe but I could believe anything at this stage.

 

[Valentijn]

My so called GP friend says it's depression and the physical symptoms are a manifestation of out of whack neuro Chemistry.
This is my point maybe it is possible that haywire neurotransmitters can cause huge physical symptoms.

I'd love to hear how neurotransmitters could cause swollen lymph nodes. You should ask your doctor friend about that and record the answer - it should be pretty hilarious