Chronic Fatigue Syndrome vs. Depression: One Doctor's View

Lack of Energy or Lack of Desire?

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For decades,  people with chronic fatigue syndrome (ME/CFS) have battled the misconception that they were "just depressed." Many doctors and a large chunk of the general public believe that myth - in spite of a wealth of research showing numerous physiological abnormalities across multiple systems.

In a recent comment here, a doctor (obviously one of the good ones!) left a comment that really rung true with me and I think is the best description I've ever seen of the difference in mentality between depression and ME/CFS:

"In my years of practice I have seen hundreds of pain sufferers with depressed mood, but only a couple of patients with true clinical depression. One of the features of true depression is energy or the lack of desire to do anything (it is very difficult to put this in words). Another feature of clinical depression is "social apathy" or having no desire to participate in social activities. These features are exceedingly rare in people suffering from all types of chronic pain and/or ME. Indeed, ME sufferers uniformly have an unabashed yearning to be able to DO things, to participate in life!" - Doc ForthePeople

I really think the doctor summed it up perfectly. In the 4 years I've been hearing personal stories about ME/CFS, I've come across a lot of people who say they miss the things they used to do, that it hurts them to stay home when everyone else is off having fun, or perhaps that they've given up trying to participate because they pay so dearly afterward.

However, I just don't hear people say that they don't want to do things anymore.

Certainly, some people with ME/CFS become depressed. That's true of every single chronic, debilitating illness out there. When illness hits you out of the blue, derails your life, takes away myriad things that you love and that provide you with a sense of worth, and leaves you miserable and disabled ...

um, yeah. It's depressing! Depression is a major issue in cancer and no one blames the tumors on depression. Likewise, it's being falsely implicated in ME/CFS. The same logic applies to fibromyalgia.

I've seen the difference first hand. I have fibromyalgia and a close family member has severe depression. Early in my illness, I spent a large portion of my flagging energy researching my illness, trying different treatments and working to figure out what I needed to do to get better. That was in spite of searing pain, intense fatigue and thick brain fog.

My relative, by contrast, laid in bed. She wouldn't read the information other people sought out for her, she wouldn't keep her counseling appointments, and she wouldn't take her prescription meds. She frequently made statements such as, "Nothing's going to work. I just have to accept that I'm going to be this way forever." And that was before she'd given anything a chance to work.

From the outside, she and I look fairly similar. We were both mothers and successful professionals who quit our jobs and withdrew from nearly everything we used to do. We both had pain, fatigue and cognitive dysfunction. But on the inside, we're different because our illnesses are different.

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