Why chronic fatigue is mistaken for depression

[southwestforests]

Saw this via a post on Tumblr by an ME/CFS activist in Ireland,
https://rollingout.com/2025/04/20/why-chronic-fatigue-mistaken-depression/

Why chronic fatigue is mistaken for depression
The consequences of misdiagnosis for an invisible illness

By Kendrick Ibasco
Apr 20, 2025
8:00 am

Patient experiences reveal patterns

Common narratives emerge among those misdiagnosed with depression instead of chronic fatigue:

A previously active professional becomes bedridden following a severe viral illness. Despite wanting to return to normal activities, overwhelming fatigue prevents basic functioning. Multiple providers suggest depression, prescribing medications that fail to address the core energy depletion.

Only after seeing specialists—often years into their illness—do these patients receive proper diagnosis and appropriate management strategies.

These experiences reflect a systemic pattern rather than isolated incidents, with patients reporting similar journeys across different healthcare systems and geographic regions.

Moving toward better understanding

Bridging the diagnostic gap requires changes from multiple stakeholders:

Medical professionals: Taking time for comprehensive assessment, listening to patient experiences and remaining open to physical explanations for fatigue.

Patients: Documenting detailed symptom patterns, seeking knowledgeable providers and connecting with support communities.

Healthcare systems: Allowing adequate time for complex case evaluation and updating diagnostic frameworks to better capture ME/CFS patterns.

Until these changes occur broadly, the critical distinction between chronic fatigue and depression will continue to be missed, leaving many patients without appropriate care for a condition that significantly impacts their daily lives.

The Tumblr post,

https://myalgicencephalomyelitiscfstom.tumblr.com%2Fpost%2F787130014213750784

 

[Rufous McKinney]

Great post.

I'm not buying the notion that there are similarities with depression. Only for the ignorant and blind.

"Reduced interest in previously enjoyed activities": nope, still keenly interested, but body can't pull it off.

I do not see that. You, @southwestforests for example. You have plans and creative projects you dip into all the time. And also cancel. And feel disappointed, about canceling.

Agree: lack of diagnosis is a huge problem particularly in certain geographies.

However, I have a diagnosis. And that didn't result in any meaningful treatment. ONE PILL got added that I can tolerate- LDN.

And insurer wont pay for the LDN, so much for diagnostics.

I never FOUGHT with the insurer, I just threw in the towel. Oh, that sounds like what a depressed person would do.

 

[southwestforests]

"Reduced interest in previously enjoyed activities": nope, still keenly interested, but body can't pull it off.

I do not see that. You, @southwestforests for example. You have plans and creative projects you dip into all the time. And also cancel. And feel disappointed, about canceling.

I feel seen, to use a phrase I've seen used by the younger crowd.

And for some strange reason, with my brain being my brain and doing what it does,
talking about feeling depressed,
connects with when Marcus did not feel repressed any more on the Babylon5 sci-fi television show.

 

[Rufous McKinney]

I feel seen, to use a phrase I've seen used by the younger crowd.

 

[Rufous McKinney]

on the Babylon5 sci-fi television show.

I had to look up that show. From the 1990's. I was busy, nor did I have the station described as carrying this show from 1993-1997.

 

[southwestforests]

nor did I have the station described as carrying this show from 1993-1997.

I went and got a TV just to watch it and Star Trek for a few years.
Also had board games and miniatures games for the two shows.
Were/are role playing games for the 2 shows, didn't get in to those but did get a couple of the source books for each. Wanted them as references or inspiration for costume and spacecraft designs.
Sold the games when health crashed, still have the books, and just 2 or 3 miniatures.

Okay, off now to see if this body lets me make 4 more parts to my sci-fi rocket model - that is a goal for today.

 

[ilivewithcfs]

The doctors keep misdiagnosing me with depresion for 9 years. It's beyond upsetting. The illness itself is hell, and being misunderstood makes it so much worse. I'm convinced, that in my case, it's because they don't know what CFS is. They don't study it in medschools, which is a shame. They can't comprehend the concept of PEM. And there's nothing I can do or say to change their minds. I'm devastated.

 

[southwestforests]

They don't study it in medschools,

As evidenced by the fresh new doctor which replaced the one who retired last year, as has been said on here, when I asked Dr. Sutton about ME/CFS his response was that he'd not heard of it.

 

[Rufous McKinney]

And there's nothing I can do or say to change their minds. I'm devastated.

The "depression diagnosis" was laid on me, Im at the doctor because of acute inflammatory reactions I was having, and all they do is try to shove antidepressants down our throats.

 

[ruben]

I desperately wish my problem was depression. If that was the case, one there'd probably be a medication which would help. And 2, I'd take up jogging.

 

[Viala]

I am sure anyone who had both ME/CFS and depression could easily tell the difference. The problem is doctors do not want to listen to us and fixate too much on depression. It's not depression if we want to do things, but physically can't. The concept of ME/CFS is not that difficult to understand, there's just no will to do it.

 

[Mary]

I saw an endocrinologist several years ago, I forget why or what I hoped to get from him. He was nice, treated me with respect, but when I told him I couldn't exercise due to PEM and tried to explain what PEM was (plus I'd brought some literature with me which he actually took but who knows if he read it), he gently suggested why didn't I just "try" to exercise a little . . . argghhh!!!

But - what stuck with me was that he explicitly stated in his notes that I was not depressed! I guess I must have seemed chipper at that appointment while I was trying to explain how my life had been destroyed by this illness . . . of course he didn't see me the next day when I was bedridden from the drive and the appointment --

 

[southwestforests]

But - what stuck with me was that he explicitly stated in his notes that I was not depressed!

Even though your event was a little different in nature from what my Dad went through in 1982 to 1985 as military doctors in Virginia were trying to figure out what was happening to him before in 1985 he became USN's 1st medical retirement with CFS and fibromyalgia, it brings to mind how way back then he asked psychiatrist outright whether this thing was a psychological thing, was of psychological cause, and the answer was no, is documentably physical.

And they saw Dad at both okay and at very much not okay, as somewhere along the path he was a psychiatric inpatient for several weeks, maybe a couple months, because the sudden total collapse of his health without any clear explanation seriously damaged the psyche of a still very much physically fit and active guy who was a military officer, had been a college athlete, a high school athlete, a midwestern farm boy.

My attitude is that some medical providers here 40 years later still thinking ME/CFS is psychological tells the world far more about their pathetic inadequacies as human beings generally than it tells about the disease.

 

[Viala]

The system is set for them to not to know, which is all the more suspicious. Military knows it's physical, but doctors and specialists all over the world still haven't heard about it 40 years later. And then there's the long covid sequel. Should I say more? It can't be a simple omission.

 

[Rufous McKinney]

The concept of ME/CFS is not that difficult to understand, there's just no will to do it.

Kaching

 

[Rufous McKinney]

And then there's the long covid sequel. Should I say more? It can't be a simple omission.

Who produces the text books?

Who decides course curriculum in medical schools?

This is part of a clear conspiracy fostered in the US by the private insurers, and Big Pharma.

"never heard of it- BS"

 

[Rufous McKinney]

Asking AI these questions, since our disease is underfunded and all the etceteras, it won't be showing up in medical texts which are produced by a biased system.

I was also told this by Google AI

4. "Hidden Curriculum":

• There's a "hidden curriculum" in medical education, where students learn values, attitudes, and behaviors through observation and experience, not just formal teaching.
  
  
• This hidden curriculum can inadvertently perpetuate biases and neglect certain aspects of patient care.
  
  
• For example, negative attitudes toward disability can negatively impact workforce diversity and patient care.

 

[Mary]

Who produces the text books?

Who decides course curriculum in medical schools?

Rockefeller Medicine Men: Medicine and Capitalism in America - I first read about how Rockefeller coopted our medical schools in the book World Without Cancer by G. Edward Griffin. This all started in the early 1900's. It's a fascinating story. I haven't read Rockefeller Medicine Men, but I believe it tells the same story only in greater depth. ​

I'm sure this doesn't answer your question though as to who has decided not to include ME/CFS in medical school course curriculum. I have blamed Simon Wesseley et al. for a long time for the staggering ignorance of doctors but it hit me the other day that the real question is, why was an unproven theory that 17 - 24 million persons worldwide are delusional as to what they are experiencing, accepted as valid? Was this just to save money for disability insurance companies?

I think the odds are staggering that 20 million people (rounding off for convenience) would all be afflicted by the exact same delusion and would all rather stop their lives than do a few simple things, such as GET and CBT. How do 20 million people all develop the same delusion (that exercise hurts them)? I've heard it's because we read about it on the internet, we are all so gullible and looking for anything to explain things. They really have a very dim view of humanity. If it's so simple, we should all just change our reading and get well then, right? If reading about PEM can cause it, then the solution should be to read about how well we really are, which I think we have all done.

And this doesn't explain how all the people (including me) who got ill before there was any real information about ME/CFS on-line, still managed to come up with the exact same delusion even without reinforcement from others - it's astounding!

I don't think I'm explaining myself very well here but I hope I get the gist across.

It reminds a bit of the early days of AIDS where at least one shrink posited the theory that AIDS was a result of mass hysteria or somehow psychological in origin - it was all in their heads. until people started dying.

 

[Rufous McKinney]

I have blamed Simon Wesseley et al.

This is the story of the United Kingdom but not the United States. It's a huge story, but I dont see Wessley playing any role here.

GET and CBT aren't considered treatments in the US. Maybe at a certain Kaiser Permanente.

 

[Rufous McKinney]

I'd like names. For who exactly in the United States reviews Medical Text Books and fails to include a paragraph on the existence of these diseases.

What exactly are doctors taught to do when a patient shows up with these symptoms? Nothing? It's just a nothing?

Are they directed to refer the patient to psychiatry? No, not even that.

That does not happen either.