Depression

Depression as a symptom of ME/CFS

Presentation
Depression as expressed in patients with ME/CFS is generally considered as secondary depression or reactive depression due to the debilitating effects of ME/CFS. LaFerney, a psychiatric clinical nurse specialist, outlined several ways in which depression in major depressive disorder and ME/CFS differ:

1) Individuals with major depressive disorder often cannot provide a reason or identify a loss to explain their depressed mood. ME/CFS patients are more likely to report feeling discouraged and depressed because of the inability to perform tasks, be employed, or engage in social functions due to ME/CFS symptoms.

2) Depressed patients typically report a lack of interest in activities they previously found pleasurable. ME/CFS patients say they would engage in favorite activities more if their illness would allow it.

One question that can differentiate the two groups is to ask the patient, "If you were cured tomorrow, what would you do?" Depressed patients typically can not answer the question without forethought. ME/CFS patients typically can list an abundance of activities without prompt. The Forgotten Plague Facebook page had a "If I was cured tomorrow..." campaign encouraging ME/CFS patients to upload their dreams.

3) Although both patients report fatigue, only ME/CFS report post-exertional malaise typically worsening 12 to 48 hours after an activity and lasting for days to weeks.

4) In depressed patients, the diminished ability to think or concentrate should improve with antidepressant therapy. In patients with ME/CFS, antidepressants often do not improve concentration or memory.

Prevalence

 * Katrina Berne reports a prevalence of 65-90% for depression.

Symptom recognition

 * In the Holmes criteria, depression is an optional criteria for diagnosis, under the section Minor Symptom Criteria - Neuropsychologic Complaints.

Learn more

 * Depression or chronic fatigue syndrome?