Depression and Chronic Fatigue Syndrome: Which Came First?

There has been a lot of controversy over the years over whether Chronic Fatigue Syndrome is a result of depression or if the depression comes once the illness has started. It is kind of like the chicken or the egg - which came first?

Skeptics and the medical professionals who do not believe in Chronic Fatigue Syndrome believe that the illness is psychological in nature and may be a result of depression. For those of us living with the illness, we know from our own medical history and life that depression was not an issue for many of us before becoming ill. If depression was an issue, it wasn't extreme enough to warrant symptoms like those of Chronic Fatigue Syndrome.

With depression, the person will lose interest and not want to participate in any activities, hobbies or anything that they previously were involved in. As I have explained over the years to doctors and other medical professionals, it is not like that with CFS. Those of us with CFS want to do all of the things we once could but physically we are unable. The desire and mental drive is still there to do these things, the physical capability is just not. The frustration of not being able to live life as we previously did is what often leads to depression in CFS patients. Depression is often a symptom of this chronic disease, not the cause.

Something else that stands out as different between Chronic Fatigue Syndrome and depression is that with CFS, most patients will try to continue on with their lives, will try to continue work and keeping up with extra activities. In depression, the desire to even try is gone.

According to the National Institute of Mental Health, the main symptoms of depression include:

- Feelings of hopelessness or pessimism

- Irritability and/or restlessness

- Persistent, sad, anxious or empty feelings

- Feelings of guilt, worthlessness or helplessness

- Loss of interest in activities previously enjoyed - this includes sex

- Fatigue and decreased energy

- Concentration problems, decision making problems, memory issues

- Insomnia or excessive sleeping

- Overeating or appetite loss

- Thoughts of suicide or suicide attempts

- Persistent aches or pains that are not relieved with treatment

According to the CFIDS Association, the main symptoms of Chronic Fatigue Syndrome include:

- Incapacitating fatigue that is experienced as profound fatigue and extremely poor stamina.

- Cognitive difficulties. For example, someone with CFS might get lost driving in an area where they have lived their entire lives.

- Flu-like symptoms that include pain in the muscles and joints that penetrates deep to the bone, tender lymph nodes, unrefreshing sleep, sore throat and headache of a new or different pattern.

- Post-exertional malaise - worsening of symptoms following physical or mental exertion occurring within 12-48 hours of the exertion and requiring an extended recovery period.

- Visual disturbances

- Shortness of breath

- Chills and night sweats

- Gynecological problems that include PMS and endometriosis

- Multiple chemical sensitivities

- Weight changes without changes in diet

- Irritable bowel syndrome

As you can see, there are some similarities between the symptoms of depression and Chronic Fatigue Syndrome, but the symptoms of Chronic Fatigue Syndrome are that much more devastating than those of depression. I'm not making light of depression and I do believe it is a serious illness as well.