Depression/Anxiety Differential Diagnosis.

[bananabas]

I have recently posted my extensive symptom list and medical history.
I have heard more than one licensed psychiatrist state that this whole list can be explained purely on the basis of depression/anxiety.

Is there some unrefutable evidence to the contrary? By evidence here I mean published research or at least convincing arguments.

 

[Snookum96]

I have a lot of doctors tell me that's what it is and I do have depression.

Typically, people with depression have no motivation to do anything. a major part of depression is a loss of interest in activities previously enjoyed.

CFS on the contrary is the opposite. We want to do all kinds of things but we physically can't. I would give up near anything to go for a run. If I were depressed right now I wouldn't want to.

I'm not aware of any studies but the Canadian Consensus Criteria has a small section that states the above. It may be useful as it's written by a committee of experts so people may take it more seriously.

 

[halcyon]

EEG spectral coherence data distinguish chronic fatigue syndrome patients from healthy controls and depressed patients-A case control study
"Conclusion: EEG-derived spectral coherence factors accurately classify unmedicated subjects with rigorously-defined CFS, and reliably distinguish them from matched healthy control subjects, while at the same time not falsely classifying depressed patients as having CFS. This finding is in accord with other objective evidence that CFS is associated with organic, brain-based pathophysiology"

Health status in patients with chronic fatigue syndrome and in general population and disease comparison groups.
"Conclusion: Patients with CFS had marked impairment, in comparison with the general population and disease comparison groups. Moreover, the degree and pattern of impairment was different from that seen in patients with depression."

National Institute of Health Pathways to Prevention Workshop:Advancing the Research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
"Although psychological repercussions (e.g., depression) often follow ME/CFS, this is not a psychological disease in etiology. A multitude of symptoms are associated with ME/CFS, with substantial overlap with other pathologic diseases (e.g., fibromyalgia, major depressive disorder, and a variety of chronic pain or inflammatory conditions)."

Neuropsychological function in patients with chronic fatigue syndrome, multiple sclerosis, and depression.
"The findings support the view that the cognitive deficits found in CFS cannot be attributed solely to the presence of depressive symptomatology in the patients."

 

[wastwater]

I think the main differences are Depression isn't usually acute viral onset.
And the depression in ME/cfs doesn't come in episodes like regular depression of between 6 month to 2 years with medication removed after episode.
Exercise is very good for depression but doesn't work for ME/cfs
Its comparing unknowns with unknowns,as both conditions are poorly understood.
I think there is a form of depression connected to ME/cfs but a very biological depression via a different route,maybe like depression in cancer or MS

 

[Snookum96]

I think the main differences are Depression isn't usually acute viral onset.
And the depression in ME/cfs doesn't come in episodes like regular depression of between 6 month to 2 years with medication removed after episode.
Exercise is very good for depression but doesn't work for ME/cfs
Its comparing unknowns with unknowns,as both conditions are poorly understood.
I think there is a form of depression connected to ME/cfs but a very biological depression via a different route,maybe like depression in cancer or MS

Regular depression doesn't always have medication removed after each episode. For some maybe, but that's not a hallmark. I've been on meds for almost 20 years, they just change when I have an episode.

 

[A.B.]

I have recently posted my extensive symptom list and medical history.
I have heard more than one licensed psychiatrist state that this whole list can be explained purely on the basis of depression/anxiety.

Some psychiatrists are not right in the head.

On a more serious note, there is no biomarker for depression, anxiety, ME or CFS. It is therefore impossible to disprove the claim that someone is suffering from depression. A more pragmatic approach is to decide what makes more sense to you. Does viewing the problem as depression and anxiety and treating it accordingly with lifestyle changes, medication and psychotherapy lead to improvement in symptoms? Speak with other people with similar symptoms and try to find out whether they had success treating it as depression and anxiety. Exercise is said to be good for relieving depression, so I'm guessing this isn't your main problem.

 

[bananabas]

Yes, aerobic exercise is recommended for both anxiety and depression I think. I used to regularly go swimming, thinking it would help, ignoring the fact that it left me unable to move for the rest of the day and pretty much unable to do even simple mental tasks the next day, as everyone was telling me I was probably "out of shape". I did this for about 3 months and seing that there was no change to the better (quite the contrary) I concluded there is no way for me to "get in shape".

 

[Kyla]

http://link.springer.com/article/10.1207/s15327558ijbm1303_8

Abstract
The goal of this study was to identify variables that successfully differentiated patients with chronic fatigue syndrome, major depressive disorder, and controls. Fifteen participants were recruited for each of these three groups, and discriminant function analyses were conducted. Using symptom occurrence and severity data from the Fukuda et al. (1994) definitional criteria, the best predictors were postexertional malaise, unrefreshing sleep, and impaired memory-concentration. Symptom occurrence variables only correctly classified 84.4% of cases, whereas 91.1% were correctly classified when using symptom severity ratings. Finally, when using percentage of time fatigue reported, postexertional malaise severity, unrefreshing sleep severity, confusion-disorientation severity, shortness of breath severity, and self-reproach to predict group membership, 100% were classified correctly.

 

[bananabas]

My swimming story is in fact very similar to the one in Mark VanNess's video, that I just discovered! It is precisely what I was trying to describe. Despite best efforts and neglecting everything else, I was unable to get in shape and never understood why!

 

[JayBO]

There's no reason why someone can not have CFS and depression/anxiety at the same time. In fact, it's completely natural to get depressed when one is coping with a chronic debilitating illness (in which case the depression would be secondary to the fatigue). Though some of the symptoms overlap, any stress or physical illness will exacerbate the depression and anxiety. If you do have anxiety or depression along with CFS, antidepressant medication may be helpful, but it will not help your fatigue symptoms (and if it does than you will have more information about what is going on).

I have rarely if ever mentioned my fatigue symptoms to my psychiatrist, perhaps only casually mentioning that I have had difficulty exercising since having mono in college. He has never inquired more about it and I don't really want to discuss it with him. Like many others, I've found it's not even worth mentioning CFS symptoms to doctors who are not experienced in treating it because there is still widespread misunderstanding even among doctors. Good luck!