Posted by bleauberry on September 26, 2010, at 9:11:33
In reply to Re: depression? Fatigue? what's the difference? » floatingbridge, posted by SLS on September 26, 2010, at 6:35:05
I have a different take on this topic. Chronic fatigue has a cause. The top contenders are within the arenas of thyroid, adrenal, and chronic infections. Tests for these things are notoriously flawed and misleading....as just one example, someone with apparently normal thyroid numbers can have all the symptoms of hypothyroid and respond well to T3....they were clearly hypothyroid despite the lab's interpretation of the numbers. Bottom line, symptoms and suspicion should guide the treatment. Response to various treatment attempts further narrow the suspicions in the right direction.
In the absence of depressed mood, I personally seriously doubt it should be diagnosed or treated as depression. Indeed, the entire spectrum of depression symptoms have the above issues at the heart of them. Chronic fatigue sufferers find more relief and remission from things such as LDN, antibiotics, and antifungals, than they do with any psychiatric medications.
That said, Ritalin is often very helpful to treat the symptoms and get the patient feeling better while they undergo other treatments directed at exposing the real problem. Psychiatric meds are not likely to improve CFS symptoms and in many cases can make them worse. In addition, they do nothing to stop the progression of the disease as it slowly gets worse over time.
It is a common fad these days for doctors to question patients about depression symptoms, as docs have taken some criticism in the last few years for not asking enough questions and not identifying depression sitting right in front of them. The pendulum maybe swings a bit too far in the opposite direction sometimes?
Can depression present itself as just fatigue? Some would say yes. I say no. For example, on a depression scoring questionnaire, if you score the worst possible number for the fatigue category, but you score average or normal for the other things such as sleep, appetite, interest, anxiety, etc...well, your total points came nowhere near meeting the threshold of depression.
poster:bleauberry
thread:963802
URL: http://www.dr-bob.org/babble/20100926/msgs/963824.html