What i dont like about psychiatry is that there is now actual diagnotic test for certain conditions only symptom based and behavioural based diagnoses. If they could prove that certain neurotransmitters were low, a commercial test gp's could use etc then i think it may have merit in being more scientific and then classified as neurology.
Also i think they could have a special neurology type docs who deal with ME/CFS where they treat these neurological symptoms like pots but diagnose patients better with proper tilt table testing etc.
Depression is a common secondary effect of any chronic illness, it would be nice to be able to test a patients serotonin, noradrenaline and dopamine levels and treat appropriately, not just guess which antidepressants are going to help, which would reduce alot of the trial and error guess work of using antidepressants, plus also use the past experience of me/cfs patient that shows we can only tolerate low doses, much lower then commonly used by general public and the tricyclics seem to be the better tolerated then the newer ssri's.
I think many of us can end up in a hole feeling depressed and hopeless, but medication isnt going to cure us but they should realise it can help us feel abit better about feeling like crap, no different to having a broken leg and being given pain killers, they dont address the problem directly but help us cope until we start to recover or stabilise.
Another thing i think docs really need to be up to speed with that can help neurological problems as well as things like depression is balancing hormones etc. I think if studies were done on depressed population they would find many abnormalities in these people and addressing these issues is alot closer to the cause sometimes then just uses/handing out antidepressant and should be looked into first before blindingly handing out antidepressants.
Lastly i really think neurology of cfs/me really needs to get up to speed on sleep, lack of sleep can effect everyones emotional state, treating sleep effectively can also help correct many hormonal issues as well as depressed feeling etc i think medicine is too far behind in treating chronic sleep disorders like insomnia found in cfs/me and is just shrugged off as anxiety related which i dont think is the case in many cfs/me people.
We need proper specialists in cfs/me neurologists and then immunologists, thats my opinion on the matter for what its worth.
cheers!!!