Differences Between Depression And Chronic Fatigue Syndrome
Although depression and chronic fatigue syndrome are often mistaken for each other, there are distinct differences that set each one apart. Symptoms of depression include experiencing continuous feelings of sadness, anxiety, or emptiness, feeling hopeless, helpless, or worthless, losing interest in once loved hobbies, eating too much or too little, having difficulty concentrating or making decisions, having headaches, cramps, stomach pains, and other types of pain.
Symptoms of CFS include headaches, joint pain, tender lymph nodes, muscle pain, and sore throat.
Depression and CFS can affect patients differently, depending on their daily activities. Depressed patients will feel tired and indifferent to activates. CFS patients want to engage in activities, but are too tired to carry them through.
In order to properly diagnose CFS, its important that your doctor rules out other conditions that have similar symptoms.
Signs And Symptoms Of Fibromyalgia
Body wide tenderness and widespread chronic pain are the notable features of fibromyalgia. This pain affects several areas of the body, significantly affecting the tendons, joints, and muscles.
Stiffness is common in the joint, as well. Although the pain generally affects the areas below and above the waist, localized regions such as the neck, lower back, or shoulders may be affected. People with fibromyalgia often feel flu-like symptoms, as though they hurt all over.
It is common for some sufferers to experience flare-ups situations where the chronic pain and other symptoms last for prolonged periods of time.
Another symptom of fibromyalgia is fatigue. It especially manifests upon waking up in the morning, but it may also be noticeable mid-afternoon. It is common for people to be awakened with a light feeling, even after sleeping all night. This feeling may be combined with multiple disturbances during the night, with difficulty getting back to sleep.
Although body wide pain, sleeping difficulty, and fatigue are hallmarks of fibromyalgia, the illness is also associated with other symptoms such as disordered thinking. Patients have reported cognitive disturbances, brain fog and difficulty with enough focus to complete set tasks.
Other symptoms may include headaches, abdominal pain, pelvic pain, heart palpitations, diarrhea, dry eyes and mouth, tingling and numbness in extremities, nausea, and weight gain.
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Demographic Intrapsychic Interpersonal And Health
Our nationally representative study supports the majority of findings of the previous research on depression and CFS from regional community samples and from clinical samples. In accordance with the previous literature on demographic characteristics associated with depression among those with CFS and among those with other chronic illnesses,, we found that being younger and/or female was associated with depression. Both socio-economic status, in generaland food insecurity, a measure of extreme poverty, was associated with an increased risk of depression. Marital status was associated with depression in the bivariate but not the logistic regression analyses. Unlike previous research on depression among individuals with inflammatory bowel disease, education level and immigrant status were not significantly related to depression. Although the association between immigrant status and CFS was not significant in this analysis, it would be helpful if other studies would investigate this under-researched topic with larger sample sizes.
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Fatigue: Don’t Assume It’s Depression
Fatigue is a part of a wide spectrum of diagnoses ranging from being a symptom in depression, anxiety, seasonal affective disorder,53 and multiple other diagnoses to being a full syndromal disorder in CFS, yet CFS goes undiagnosed in 80% of cases and is often misdiagnosed as depression. The Diagnostic and Statistical Manual of Mental Disorders doesn’t list CFS as a diagnosis although the International Classification of Diseases, 10th Revision, does.12 In clinical practice, CFS presentations range from complicated cases associated with a psychotic state resulting in multiple murders in one case report54 to noncomplicated presentations with multiple psychiatric disorders, primarily depression.55 It is very important to understand the distinctive features between chronic fatigue and depressive disorder when evaluating a patient with a main complaint of fatigue. A full detailed history accompanied by questionnaire forms can be very helpful to differentiate CFS from major depressive disorder. There is still no specific test that can confidently differentiate between them. Multiple studies have tried to find distinctive factors and they are listed in Table 2.
What Are The Aims Of The Service
The service is based on NICE and EULAR guidelines for these conditions.
- Help you understand your condition
- Enable you to develop helpful coping strategies to manage symptoms
- Reduce distress and disability
- Improve your quality of life
We use a holistic approach, meaning that we look at the physical and the psychological aspects of the illness.
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The Role Of Depression In Cognitive Impairment In Patients With Chronic Fatigue Syndrome
Abstract:
BACKGROUND AND OBJECTIVE: To analyze the role of depression in cognitive deficits of patients with chronic fatigue syndrome .
PATIENTS AND METHODS: 57 women with CFS were assessed by neuropsychological tests that included measures of attention: CalCap, Mental control of the WMS-III, PASAT, forward and backward digits , symbol digit modalities test executive functions: Stroop Test, Trail Making Test , FAS, Tower of London memory: Auditory-Verbal Learning Test , Rey Complex Figure , and psychomotor skills: Grooved Pegboard. The raw scores on the tests were adjusted according to normative data and transformed to T scores. The sample was divided into two groups based on the presence or absence of depression, assessed by clinical interview and administration of the Hospital Anxiety and Depression Scale . This study compared neuropsychological test scores between the two groups.
RESULTS: CFS patients showed cognitive deficit in attention and executive functions, regardless of the presence of depression. There were no significant differences between the two CFS groups.
: The cognitive impairments in patients with CFS are not secondary to the presence of depression. These results should be taken into account in the implementation of therapeutic programs in these patients.
Diagnosing Depression And Fatigue
To make a depression diagnosis, your doctor will ask you about your medical history and give you a questionnaire that assesses depression. They may use other methods, such as blood tests or X-rays, to make sure another disorder isnt causing your symptoms.
Before diagnosing you with chronic fatigue syndrome, your doctor will run several tests to rule out other conditions that can cause similar symptoms. These may include restless leg syndrome, diabetes, or depression.
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How Is Chronic Fatigue Diagnosed
There is no definite test or result that can prove or disprove a diagnosis of CFS. Instead, a diagnosis is made after other causes of fatigue have been ruled out and symptoms have been present for six months or longer.
The National Institute for Health and Care Excellence lists the following symptoms:
- muscle pain
Forms Of Oi In Me/cfs
Orthostatic Hypotension
Orthostatic hypotension is defined by a sustained BP reduction of at least 20 mm Hg systolic or 10 mm Hg diastolic during the first 3 min after assuming an upright posture . This problem is rarely seen in children except at times of febrile illness, acute dehydration, hemorrhage, adrenal insufficiency, excessive histamine release, or as a response to certain medications.
A more common pediatric variant, termed initial orthostatic hypotension , is characterized by a transient drop in BP immediately after standing, but resolving within 60 s. Its recognition requires a continuous beat-to-beat BP measurement device. The diagnosis is missed by standard, automated sphygmomanometer measurements . Although this is not usually a condition that requires clinical treatment, chronic orthostatic symptoms in those with IOH have been reported , suggesting that they can develop other orthostatic abnormalities on more prolonged monitoring.
Postural Tachycardia Syndrome
Postural tachycardia syndrome is increasingly being recognized as the most common form of OI in pediatric ME/CFS. As is the case for pediatric ME/CFS, postural tachycardia syndrome is more common in females than males, is more common after the onset of puberty, and often follows an apparent infectious illness .
Neurally Mediated Hypotension
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Psychosomatic And Hypnotic Paralysis
Paralysis can be induced in susceptible people using hypnosis, andbrain-imaging research has shown that there is a specific brain signatureassociated with hypnotic paralysis which is different from feigningparalysis. The findings suggest that hypnotic paralysis works bycontrolling movement through increasing self-imagery and reducing couplingbetween the areas of the brain which plan movement and the areas whichexecute it.
Brain studies of patients suffering from functional/psychosomatic paralysisshow a similar pattern of brain activation to the hypnotized subjects,suggesting that the same mechanism is involved in both.
Pain can also be suppressed through hypnosis, and hypnosis has been shownto be effective in reducing fibromyalgia pain.
A Psychologist Differentiates Depression And Chronic Fatigue Syndrome
Dr. Kristina Downing-Orr, a clinical and research psychologist who developed chronic fatigue syndrome is well acquainted with both conditions. She reports that
- The exhaustion in ME/CFS is more constant, disabling and global than in depression and is exacerbated by exertion
- Apathy is common in depression but not in ME/CFS. Instead, the limitations imposed by ME/CFS leave most patients feeling frustrated, upset and impatient to get better.
- Depressed people dont want to get out of bed. People with ME/CFS want to get out of bed but often cant.
- When people with ME/CFS push themselves too much they feel worse and can experience a lengthy setback . When people with depression push themselves they usually feel better.
- Mental exertion can lead to a worsening of physical symptoms in ME/CFS but has no detrimental effects in depression
- Self esteem is not affected in ME/CFS but is in depression
- Suicidal thoughts, when present in depression tend to be pervasive. If suicidal thoughts occur in ME/CFS they tend to be temporary
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Fibromyalgia And Related Conditions: Electromyogram Profile During Isometric Muscle Contraction
Abstract:
OBJECTIVES: To evaluate electromyogram profiles in patients with three related conditions: fibromyalgia, chronic fatigue syndrome, and depression.
METHODS: We studied 44 healthy volunteers, 22 patients with fibromyalgia, 11 patients with chronic fatigue syndrome, and 10 patients admitted for depression. The trapezius electromyogram was recorded during maximally sustained, bilateral, 90 degrees abduction of the shoulders. EMG signal frequency and amplitude were measured throughout the test.
RESULTS: In the fibromyalgia group, isometric contraction duration was significantly shorter than in the other two patient groups and the EMG frequency and amplitude pattern indicated premature discontinuation of the muscle contraction. Findings in the chronic fatigue patients were similar to those in the healthy controls. The patients with depression had a distinctive EMG profile characterized by excessive initial motor-unit recruitment with a shift in the frequency spectrum.
: Fibromyalgia was associated with a specific EMG pattern indicating premature discontinuation of the muscle contraction. Therefore, maximal voluntary muscle contraction tests may be of limited value for assessing function in fibromyalgia patients. Chronic fatigue syndrome patients had similar EMG findings to those in the healthy controls. The EMG alterations in the patients with depression were consistent with manifestations of psychomotor retardation.
Other Tips On Management Of Fibromyalgia
- Timed Exercises: Consistent exercises can improve your nighttime sleep, but avoid exercises 3 hours before bedtime, to ensure you do not experience any sleep breaks and interruptions at night due to overstimulation.
- Avoid mid-day naps: Sleeping at mid-day could affect your nighttime sleep. If you must sleep, set your alarm for a limited period say 1 hour only.
- Night time is sleep time: Engaging in activities such as working with your laptop, seeing the late night news, or reading a novel can keep you awake long into the night.
- Epsom salts baths: A warm bath before bed with a couple of handfuls of Epsom salts dissolved in the water can help ease sore muscles and ensure a restful sleep.
- Other therapies: include massage, acupressure, acupuncture, myofascial release therapy, and light aerobic activities.
- Pacing:Learning to pace activitiescan be helpful in managing the symptoms of fibromyalgia and in reducing flares.
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What Are Chronic Fatigue Syndrome And Fibromyalgia
They are chronic conditions which affect daily functioning and involve chronic fatigue not much relieved by rest and made worse by exertion, chronic widespread muscle pain , sleep disturbance , concentration difficulties, and sometimes mood disturbance, headaches, intestinal, urinary and a range of other possible symptoms.
Relationship Between The School The Student The Family And The Treating Physician
During regular appointments with the young patient, the physician should ask how school is going. The clinician needs to be sensitive to the relationship between the young person, her/his parents, and the school. Many families have followed a long and circuitous route to a diagnosis and the young patient can be months or years behind in school by the time a diagnosis is reached. The young patient and parents often perceive dealing with the school to be very stressful, especially so when they face disbelief about their invisible illness from teachers, other parents, and the young patients classmates . Compounding these stresses, parents see that their childs academic performance has deteriorated and they might fear that she/he will not receive an education that eventually allows for employment and independent living. Many parents need to place their own lives and/or careers on hold in order to stay at home and take care of the young person. If both parents need to work, that can be problematic for the young patient at home alone.
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Health Issues Connected To Hypersomnia
Another motivation to seek diagnosis, and possible treatment, for hypersomnia are the health ramifications that come with it.
Hypersomnia, again, tends to be a signal of a larger health problem that has gone untreated. As mentioned earlier, sleep apnea is often connected to hypersomnia. Left untreated, sleep apnea has been shown to increase your risk of heart failure by 140%.
Diabetes, depression, hypertension also known as high blood pressure and erectile dysfunction are also common health problems encountered by those suffering from sleep apnea. These are serious medical conditions that can shave years off a persons life and make their day-to-day lives more challenging.
Thats why its critical to look at hypersomnia as a check engine light that should be inspected by a medical professional immediately. It can help you determine whether you have primary or secondary hypersomnia.
If you have secondary hypersomnia, you can treat the underlying health issue, and reduce your odds of suffering a medical emergency. If you have primary hypersomnia, a diagnosis can greatly improve your everyday life, and allow you to get the help you need.
Create A Relaxing Bedtime Routine
Fibro fatigue isnt necessarily something that can be fixed with a good nights sleep, but quality sleep can help over time.
A relaxing bedtime routine is an important first step toward getting a good nights rest.
Here are a few tips for a healthy sleep routine:
- go to bed and get up at the same time every day
- avoid alcohol, nicotine, and caffeine
- invest in a good quality mattress
- keep your bedroom cool and dark
- turn off screens at least an hour before bedtime
- keep electronics out of the bedroom
- avoid having a large meal before bedtime
- take a warm bath before bed
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Fibromyalgia Is Believed To Be Caused By An Abnormal Sensory Processing In The Central Nervous System Which Intensifies Pain Experienced By Fibromyalgia Patients Physiologic Abnormalities Have Also Been Seen Such As Decreased Blood Flow To The Thalamus Decreased Levels Of Serotonin And Tryptophan Increased Levels Of Substance P In The Spinal Cord And Abnormalities In The Function Of Cytokine Genetics And Trauma Are Also Linked To The Occurrence Of Fibromyalgia
The exact cause of chronic fatigue syndrome is not known. However, its development is associated with viruses, a weak immune system, low blood pressure and hormonal imbalance. Another speculation for CFS is that some people have a genetic predisposition on developing the condition. Epstein-Barr virus, rubella, human herpes virus 6, mycoplasma, Ross River virus, and Coxiella bumetti are studied to be possible causes of chronic fatigue syndrome.
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Chronic Pain Vs Chronic Fatigue Vs Depression
While it is true that chronic fatigue syndrome is not the same as depression,there are certainly many overlaps between chronic pain, chronic fatigueand depression, with many patients experiencing all three.
Pain, fatigue and depression can be thought of as protection mechanismsagainst injury , excess energy expenditure , and excess emotional or mental energy expenditure . While pain and fatigue can be the result ofactual physical tissue damage or actual energy expenditure, in manycases there are no physical anomolies causing the pain, and pain is more of aprotective mechanism rather than a measure of tissue damage. Similarly, fatigue is not always a measure of actual energy expenditure, and psychological factors have a large influence on fatigue.
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Identification Of Twins And Data Collection
Twins were recruited through a variety of sources, including advertisements in patient support group newsletters through clinicians and researchers familiar with chronic fatigue syndrome solicitations placed on CFS electronic bulletin boards twin researchers or organisations friends or relatives and through various other means . All recruitment efforts emphasised that fatigued twins were desired regardless of either the health of the co-twin or a definitive diagnosis of CFS. Written, informed consent was obtained from each participant in accordance with the regulations of our institutional Human Subjects Office.
Depression And Chronic Fatigue Syndrome: How Are They Linked
Depression and chronic fatigue syndrome, although different, may actually be linked. In both conditions, the patient will feel extremely fatigued, regardless of the sleep quality the night before. It is possible that a patient may have depression and chronic fatigue syndrome simultaneously, or mistake one condition for the other. Its important to recognize the key difference between depression and CFS in order to receive a proper diagnosis.
Depression is the feelings of sadness, anxiety, or hopelessness experienced for extended periods of time. Depressed individuals often have difficulty sleeping or may not sleep at all.
In CFS, the patient feels extremely fatigued even when well rested, and there is no explainable cause of this fatigue. CFS is often misdiagnosed and taken for depression, according to research findings.
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