@
Bob
Alongside my ME/CFS, I used to regularly go through bouts of depression that would last for around a week, and so I am in the position of being able to easily compare my depressed periods with my non-depressed periods. It seemed to me that in my case, the depression was caused by biological not psychological factors, though now I have found some good antidepressant medications that work quite well for me, so I no longer have depression.
Regarding the question: "
I did not feel like eating; my appetite was poor."
Certainly when I had anhedonia (a sub-symtom of depression), my appetite was so poor that I almost had to force myself to eat, and even when I did eat, I had no good feeling from eating, nor any of the normal satisfaction you get from filling your stomach. But once my anhedonia improved, I started getting my appetite back and began enjoying food again, even though my ME/CFS was still present.
Obviously that is just my own personal experience of depression and ME/CFS, though in general, loss of appetite is commonly found with depression, but not as far as I am aware commonly found in ME/CFS.
Regarding the question: "
My sleep was restless."
Certainly ME/CFS involves plenty of sleep issues, such as unrefreshing sleep, circadian rhythm disruptions (eg: sleeping during the day and wide awake during the night), and being too "wired" to get to sleep. However, whether these ME/CFS sleep issues could be described as "restless sleep", I am not so sure. Very occasionally I get restless sleep if I have taken some sleep-perturbing drug or supplement just before going to bed; but other than that I rarely have what you could describe as restless sleep. Since both ME/CFS and depression can involve sleep problems, it may be hard to identify the exact type of sleep problem when answering a questionnaire. But personally I would not say I have
restless sleep as a results of my ME/CFS.
Regarding the question: "
I felt lonely."
I had some periods of depression where I had this intense emotional feeling of loneliness, but this would occur even when I was with people. It was a loneliness so severe, than even socializing with people could not cure it! So this makes me think that the feeling of loneliness in depression may not directly relate to how much human company you have or don't have, but rather is just biochemically generated by some biochemical pathology of the brain. Of course, in ME/CFS you may feel genuinely lonely if your disability prevents you from going out and meeting people.
Regarding the question: "
I could not get going."
I may be wrong, but I interpreted this question as referring to how readily and easily you engage in tasks or activities. I had some periods where I had major motivational problems (a symptom often found in depression). This very low motivation — the inability of my brain to engage in tasks — did not seem to relate to my energy levels, but seemed to me to be an obvious malfunction in the motivational circuitry of the brain. Even for very simple tasks, like answering an email, my brain would not "take the bait" and engage in the task at hand. This became quite a serious problem for me, as nothing got done. And as I say, this was not due to lack of energy; it was because my brain lost the ability to instigate itself into tasks and purposeful activities. If you have never experienced this strange mental state of motivational deficiency, it can be hard to imagine. Eventually I found that low doses of the drug pramipexole greatly improved my motivational response, and I started doing things again, which was a greatly relief. You can start to view yourself as very lazy when you have this low motivation state; but in fact, as soon as you fix it with the right drugs, you get straight back to doing things again. Anyway, low motivation is common in depression, but is not uncommon in ME/CFS, so in this case, this question may not be that great at disentangling depression from ME/CFS.
Although in one thread I started
here about low motivation in ME/CFS, everyone denied that there was any low motivation in ME/CFS, so if they are right, then this question would be entirely appropriate.
My above experiences with depression are of course just anecdotal, but I do think that you have to look quite closely at these questions before you can say they are either appropriate or inappropriate for estimating depression levels in ME/CFS patients.