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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by floatingbridge on September 26, 2010, at 1:11:08
Haven't you read about someone who goes to the doctor for something like high cholesterol and says oh yea, I feel tired. No psychological complaints. The doctor suspects depression. So depression can be *just* physical and not psychological? (Yes, beneath the surface of every normal individual is a psychological drama of some sort. That's a given.)
Then a *depressed person* experiences chronic fatigue. Well, you know... say the doctors, that's depression.
What's depression?
I still spend too much time lying down, even when there are things I want to do. Yes. I have interests now. I thought that was a positive sign. And true, I'm not in bed crying or thinking painful thoughts.
Does anyone have any ideas about physical manifestations of depression?
I am confused :(
Posted by SLS on September 26, 2010, at 6:35:05
In reply to depression? Fatigue? what's the difference?, posted by floatingbridge on September 26, 2010, at 1:11:08
> Haven't you read about someone who goes to the doctor for something like high cholesterol and says oh yea, I feel tired. No psychological complaints. The doctor suspects depression. So depression can be *just* physical and not psychological?
Yes. Although depression can be initially induced by psychosocial stress, once it evolves, depression can present with primarily vegetative (somatic) symptoms. Somatatization is an extreme example of how one can experience physical symptoms as the expression of depression. Through the CNS and neuroendocrine systems, the brain directs the activities of almost every organ of the body. It is my belief that the consequences of having a biological brain disorder like MDD and BD, where the dysregulation of interacting systems is evident, is a syndrome of physical symptoms.
What happens when someone with an affective disorder goes through years of productive psychotherapy despite the persistence of MDD or BD depressions? You may end up with a very psychologically healthy depressive. Perhaps you are psychologically healthy and still suffer the persistence of a physiological depressive disorder.
- Scott
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.
Posted by Phillipa on September 26, 2010, at 11:12:46
In reply to Re: depression? Fatigue? what's the difference?, posted by bleauberry on September 26, 2010, at 9:11:33
FB it's really a great question as so tired a lot myself. I'm sure you've had your thyroid tested lately? Glad your thoughts are not depressive. Phillipa
Posted by floatingbridge on September 26, 2010, at 13:13:23
In reply to Re: depression? Fatigue? what's the difference? » floatingbridge, posted by SLS on September 26, 2010, at 6:35:05
Thanks you three for weighing in.
So physiological depression.... I'm wondering if rTMS will help.
I do have hashimoto's. Next week I meet with a new gp and intend to ask for a compounded t4 t3 slow release. I guess t3 is the best medicine can do for hashi's.
I've been and am being tested for all sorts of stuff. Doctors seem to think negative tests results are a happy thing. There is enough literature out there from the patient's pov describing the frustration over finding lack of cause.
Alright. Good luck to us.
Posted by Phillipa on September 26, 2010, at 20:53:24
In reply to Re: depression? Fatigue? what's the difference?, posted by floatingbridge on September 26, 2010, at 13:13:23
FB what is this compounded slow release combo T4 & T3 called? Thanks Phillipa
Posted by floatingbridge on September 26, 2010, at 22:31:18
In reply to Re: depression? Fatigue? what's the difference? » floatingbridge, posted by Phillipa on September 26, 2010, at 20:53:24
Phillipa, I don't know. When I find out, I'll let you know.
Posted by Phillipa on September 27, 2010, at 19:45:55
In reply to Re: depression? Fatigue? what's the difference? » Phillipa, posted by floatingbridge on September 26, 2010, at 22:31:18
FB thanks I know you will:) Phillipa
Posted by floatingbridge on September 27, 2010, at 20:06:08
In reply to Re: depression? Fatigue? what's the difference? » floatingbridge, posted by Phillipa on September 27, 2010, at 19:45:55
I do believe it is something a doctor prescribes that is prepared at a compounding pharmacy. My pdoc has an interesting comment about hashi's and armour: how can one tell if a hashi patient is developing antibodies to the pig gland? Well, I had no answer there. So will try and get a synthetic compound and see if here's any improvement.
Posted by floatingbridge on September 27, 2010, at 20:11:15
In reply to depression? Fatigue? what's the difference?, posted by floatingbridge on September 26, 2010, at 1:11:08
After reading a bit on physiological depression, well, the thread title says it all. Yeah, I have ailments, autoimmune stuff, but....
I am considering rTMS. If insurance will cover some or all. Supposedly can help some people with some physical symptoms, as Twinleaf noted in another thread.
Fighting the good fight...
Posted by Phillipa on September 27, 2010, at 21:32:46
In reply to guess I am depressed after all..., posted by floatingbridge on September 27, 2010, at 20:11:15
And as my infection control doc said after the infection think of it like a gun shot and the damage it did and then fix that. Kind of the same thing. Found out never any taste and smell today. So deal with it. But how? Phillipa
Posted by twinleaf on September 27, 2010, at 21:50:18
In reply to guess I am depressed after all..., posted by floatingbridge on September 27, 2010, at 20:11:15
I'm glad you are considering TMS. I don't know for sure, of course, but I think the combination of TMS and therapy may have finally gotten me into remission after ten years of medication failures. I know of one person whose insurance paid partially for TMS, but most plans do not. I hope that changes in the future. If you do decide on it, do let us know what your experience of it is like.As I've mentioned before, you don't have to worry about physical emotional or cognitive side effects, but you unfortunately do have to worry about the costs! That only becomes a major problem if the
TMS is successful and you need a lot of maintenance treatments.
Posted by Phillipa on September 27, 2010, at 22:03:02
In reply to Re: guess I am depressed after all... » floatingbridge, posted by twinleaf on September 27, 2010, at 21:50:18
No clinical studies left or help for payment? What if you donate you brain to science seriously? Phillipa
Posted by floatingbridge on September 27, 2010, at 22:07:28
In reply to Re: guess I am depressed after all... » twinleaf, posted by Phillipa on September 27, 2010, at 22:03:02
Phillipa, that is terrible, disappointing news. I'm really sorry.
(((big hugs)))
Posted by floatingbridge on September 27, 2010, at 22:13:15
In reply to Re: guess I am depressed after all... » floatingbridge, posted by twinleaf on September 27, 2010, at 21:50:18
Thanks twinleaf, for the encouragement. I'll definitely post about my process (and hopefully progress).
Posted by Phillipa on September 28, 2010, at 0:04:14
In reply to the news » Phillipa, posted by floatingbridge on September 27, 2010, at 22:07:28
I know but a facebook friend also had lymes and is fine and a musician he gave me name of a book and said there is still hope. Love Phillipa
Posted by Maxime on October 6, 2010, at 21:39:45
In reply to guess I am depressed after all..., posted by floatingbridge on September 27, 2010, at 20:11:15
Keep fighting the good fight! You can do it!
Posted by floatingbridge on October 6, 2010, at 23:46:59
In reply to Re: guess I am depressed after all... » floatingbridge, posted by Maxime on October 6, 2010, at 21:39:45
Posted by creepy on October 8, 2010, at 14:57:04
In reply to depression? Fatigue? what's the difference?, posted by floatingbridge on September 26, 2010, at 1:11:08
Ive been in a state of chronic fatigue for 3 months now. Have a lot of aches and pains too. It just started abruptly and hasnt let up since.
I had a bunch of tests done by an endocrinologist and all of my readings were normal. My sleep is probably normal too.
Ive been thinking its the depression coming back. And I have been on lower doses of my ADs even before the fatigue came on.
the real clincher was last night I met with my therapist and let loose a whole bunch of pain Ive been carrying around for awhile. An hour later I felt a LOT better. Still feeling a bit improved.
So I think I also agree with previous posters that depression CAN manifest in physical issues like fatigue and pain, sometimes just out of nowhere.
Posted by Phillipa on October 8, 2010, at 19:55:46
In reply to Re: depression? Fatigue? what's the difference?, posted by creepy on October 8, 2010, at 14:57:04
I feel you are right as when the pdoc I had used a massage therapist for an hour before each visit always felt much better. Phillipa
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