Differentiating Between CFIDS and Primary Depression
Attribution missing, 1995
Frequently, people with CFIDS are misdiagnosed as having clinical depression as their primary disorder. In fact, most current research indicates that, while depression is often present in CFIDS (accompanied by numerous other physical symptoms), it is a secondary, not a causative, condition. And while psychiatric consultation may be an appropriate recommendation for people with CFIDS, it should not be the primary or the only medical response. It seems to be overlooked by too many health professionals--and family members--that depression is a not-unexpected ailment associated with chronic illnesses.
What are the factors that contribute to the physician's difficulty in differentiating CFIDS from a primary depressive disorder?
Some of the symptoms of CFIDS also occur in depression:
There are similarities between depression and CFIDS in presentation and diagnosis:
Many patients with CFIDS do suffer from depression, making the diagnosis an easy first call.
The way CFIDS has emerged on the medical scene and the way primary medicine works have added to the confusion:
The confusion surrounding
CFIDS and depression is a frustrating one for physicians and patients.
The treatment for depression related to chronic diseases like CFIDS is often different from that for primary depressive disorder, because in CFIDS the immune and nervous systems are involved. For example, people with CFIDS who take anti-depressant medications for a variety of reasons (pain, immune modulation, and depression) often must take considerably lower doses of anti-depressants than those with primary depressive disorder. The following information should be helpful in this discussion.
Both CFIDS and primary depression have the following symptoms in common:
Symptoms of clinical depression:
Symptoms of anxiety:
CFIDS has the following symptoms NOT common to depression:
The following are significant differences between primary depression and CFIDS:
Note: individuals meeting the diagnostic criteria for fibromyalgia only do benefit from some exercise, while those individual meeting the diagnostic criteria for both CFS and FM experience severe exacerbation of symptoms after even mild exertion.
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