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What kinds of fatigue are normal with depressive mental illnesses?


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But I'm not talking medication-related fatigue here. Sorry about that.

 

So... fatigue is said to affect a significant portion of clinically depressed people. But what is it like? How is it different from normal exertion-related fatigue, or, say, the fatigue caused by flu? I'd very much appreciate any first-hand account of that.

 

Is there anybody here for whom the fatigue (apart from sleepiness) is accompanied by somewhat flu-like physical sensations? Dull full-body muscle aches? Mild headaches? Generally, anyone who has a prominent physical component to their fatigue (unrelated to medication)? Or do all these things sound just too weird?

 

Also, does depression-related fatigue translate to exercise intolerance for you? Does exercise tend to aggravate your tiredness, or is it the contrary?

 

Regardless of all of the above, also, how disabling is it comparing to the other aspects of your illness? How does it respond to treatment?

 

I'm asking all of this because it all holds for me, and it has always seemed very weird. Abrupt onset, muscle aches, headaches, burning eyes (the hell, really?), exercise intolerance, worsening condition due to exercise... It was the first symptom to appear, and probably still the most disabling one.

 

Doctors (including psychiatrists, of course) always tell me that it's part of the depression, if they choose to diagnose me with it at all. The latest fringe theory to personally reach me was that it's schizophrenia all the way down (lack of actual psychosis notwithstanding) and that "the fatigue is a negative symptom".

 

But the unmistakable lack of first-hand accounts of anything similar makes me suspicious. Also, the fact that I've gone for long periods of normal mood still accompanied by strong fatigue of the aforementioned kind... But, again, according to this, that's normal.

 

I've obviously considered chronic fatigue syndrome, but I lack what has recently been outlined as the main symptom of it, that is, the "crashes" – the so-called "post-exertional neuroimmune exhaustion".

 

And... okay, I'll stop here. I've already digressed too much.

Edited by Epicaricacy
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But I'm not talking medication-related fatigue here. Sorry about that.

 

So... fatigue is said to affect a significant portion of clinically depressed people. But what is it like? How is it different from normal exertion-related fatigue, or, say, the fatigue caused by flu? I'd very much appreciate any first-hand account of that.

 

Is there anybody here for whom the fatigue (apart from sleepiness) is accompanied by somewhat flu-like physical sensations? Dull full-body muscle aches? Mild headaches? Generally, anyone who has a prominent physical component to their fatigue (unrelated to medication)? Or do all these things sound just too weird?

 

Also, does depression-related fatigue translate to exercise intolerance for you? Does exercise tend to aggravate your tiredness, or is it the contrary?

 

 

All of the above sounds like atypical depression. Atypical depression actually is the most common type of depression despite its name. Anyways, google "atypical depression." You'll find a lot to support what you are describing here.

 

These symptoms respond to treatment like the rest of depression symptoms - sometimes altogether, sometimes certain aspects respond more quickly or completely. Depends on you.

 

Personally, I'd want a second opinion on a sz diagnosis. What you describe sounds to me, a total non-professional, more like MDD that isn't completely resolving.

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yes to most of epicaricacy's questions,

but with a caveat...

in addition to my mental illness,

i also have a sleep disorder in which i get little,

if any,

restorative non-rem sleep.

the working theory is one feeds the other,

but which starts the cycle is an unknown.

as a result of one or the other,

i wake up mentally and physically exhausted.

and it's always been that way,

regardless of what treatment or which med.

and for me,

it's more flu-like...

a constant fatigue.

i did have a sleep study done,

and the treatment prescribed would have been amphetamines during the day,

with sedatives at night to compensate.

i said no thanks...

the cure sounded worse than the disease.

that being said,

how did you sleep last night?

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I also suffered from fatigue which my doctor dismissed as part of depression. After going to my GP and getting blood tests done it turns out I had signs of epstein barr virus and chronic fatigue syndrome. Look dor another opinion

Edited by CookieN
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 Abrupt onset, muscle aches, headaches, burning eyes (the hell, really?), exercise intolerance, worsening condition due to exercise... It was the first symptom to appear, and probably still the most disabling one.

 

 

I am so sorry for your condition. My depression definitely includes SOME of the above but my first gut feeling was autoimmune something or another, chronic fatigue, Lymes, mono, IDK.  It just sounds like something MORE than depression, if that is even possible. heh.

 

Are you able to exercise when not depressed?  Did the fatigue start recently?

 

I have a friend who after 10 years of illness w/unsuccessful treatment finally found out he had babesios, tick bourne illness i.e. autoimmune disease.  And now there are still no answers.

 

 I just read this article - What's Wrong With Me? -  in the New Yorker  written by Meghan O'Rourke about her endless struggle to become 'healthy'.  The end of her treatment search becomes the beginning of her new normal.  She is determined NOT to be defined by the word illness.  It is just as it is even though her best may not be the same as before.  

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Uh, I have this too. So if anyone figures it out I would love to know if I can do anything about it.

 

As far as I can tell it's depression related because it seems to come on at the same time. Then again, the depression is almost always triggered by something very stressful or other physical health stuff and those would tire anyone out. The physical symptoms of fatigue (I always feel like I'm getting over the flu) muscle and head aches and general brain fuzziness are definitely more debilitating than any other depression symptoms, at least now. I can't really function at all on less than 10 hours sleep a night. I can exercise - but it makes me more tired, rather than less and the muscle aches are much worse afterwards.

 

I have been tested for things like anaemia, epstein barr virus and hypothyroidism and nope, all the bloodwork is fine. The thing is, there's no cure for chronic fatigue syndrome or myofascial pain syndrome, just a few treatments and lifestyle things to manage it. 

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I have fatigue that usually requires more sleep than usual. Also for some reason I can not build up the motivation or drive to continue a exercise program to become healthier physically and mentally. For example when I am just sitting around the house/apt what have you I will choose taking a nap over lets say doing some kind of activity. I know that because of past drug use the doctors will not prescribe me a stimulant, but I am not looking for a high. I am looking for something that is going to help in these sleep patterns and no motivation which is coming from a lack of energy. I have even thought about taking Hydroxycut for energy since I am overweight, but I decided against it because it would interact badly with my medications.

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Note: a diagnosis of MDD is much easier to make, rather than a diagnosis of pain & fatigue.

 

It's sad, but it happens so often it's a common mistake professionals make. It does not help that the lines of diseases like CFS, Fibromyalgia, and even many Autoimmune Diseases have a comorbidity of depression. As well, most of the disorders I mentioned are hard to diagnose because the symptoms vary. Also and it takes a lot of time & effort for a physician to sift through those various symptoms.

 

The link you used, OP talks a lot about the physical exhaustion & lethargy of depression, rather than the aches & other symptoms you describe. The best part of that article that you should take, is this:

 

Dr. Fava: First, I want to confirm that the patient actually has a diagnosis of MDD. There may be some patients who complain of many symptoms of fatigue but do not have MDD, or there may be some patients with comorbid illnesses that include some depressive symptoms and fatigue, but are not truly MDD. Second, it is really important to differentiate between symptoms of fatigue that have been caused by the drugs we are using to treat the MDD in contrast to symptoms that are present as residual symptoms of MDD.

 

My advice? Seek a different opinion.

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Thanks to all for the input – and for the support, of course – but I'm afraid my illness continues to make no sense.

 

And what's even worse, is that the whole story of it is probably even too hard for me to retell by now. The fatigue, the lack of motivation, the word finding difficulties, the memory deficits (both long-term and working memory, it seems) and that whole strange "autoimmunity to my own serious thoughts" thing, which remains a major mystery on its own right... (It could be anything, probably even an attention deficit in disguise, but I can't have ADHD if I didn't have it as a child, can I?) It seems as if all of those things conspire against me (just figuratively, of course) so that I couldn't properly inform anyone about my illness. Ha. What a bummer. How the hell am I going to get help now?

 

So I do have quite obvious psychiatric symptoms too, huh. It's just that they don't seem to point to any common diagnostic entity, at least for now. Most of them followed the onset of the fatigue by a month or two. So, yeah, the fatigue was the first thing to happen to me. And it "happened" essentially overnight. I usually say that I lost more than 90% of my energy in just a few days. It has essentially stayed this way ever since, with just minute improvements.

 

As for mood... no, the fatigue doesn't seem to respond to mood changes at all. The first year of my illness consisted mainly of normal, "flat" and slightly elevated moods – not depressed ones – and all the other symptoms including fatigue were still present and at their full potential. None of the antidepressant medications tried up to this point, including Anafranil (a TCA), have been of any help to reduce the fatigue either.

 

Then, of course, there's sleep – but it's of no help too. Neither long nor short sleeps are refreshing for me. It's also quite messed up. I can spend obscenely long time lingering somewhere between wakefulness and sleep, for example. Not properly asleep, but all of my thoughts still following some delusional dream logic. This, of course, always resolves after getting out of bed.

 

I've thought of having a sleep study done, but I highly doubt that a sleep disorder could coincide with a mental disorder so close in time. Perhaps I'm wrong?

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And it "happened" essentially overnight. I usually say that I lost more than 90% of my energy in just a few days. It has essentially stayed this way ever since, with just minute improvements.

 

 

This definitely sounds very similar to my friend with babesiosis. He was a very active man with a full life and then, bam!  everything changed.  Most people think he is just depressed but after years watching my girlfriend with a husband who can barely walk the kids to school, I realized this is much more complicated than a mental diagnosis.  THis is physiological.  Both mental and physical, and most probably he was bit by a tick and the disease went into his brain stem which then creates an unholy mess.

 

I don't know if you read the article I linked but this woman managed to get back into shape slowly but surely with diet, exercise, mental health, etc.  She is still not where she was 'before' but is clearly much much better off.

 

My husband has a sleep disorder and it did not happen overnight.  NOt at all.

 

I don't know where you live, but I can refer you to the doctor my friends have found tremendously helpful.  PM me if you like.

 

I would definitely start a blog here on CB.  Just writing all this down can help.  It is so complicated and so unnerving, dumping out the thoughts and actions might assist you in at least getting them out of your head and onto a page.

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I can't speak for anyone else but I am certainly like that when depressed. The fatigue is very much physical. I ache all over, I'm physically weak, constant headache, I can only move slowly etc. It does feel flu-like, yes. I think your doctor is right, this is depression.

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I can't speak for anyone else but I am certainly like that when depressed. The fatigue is very much physical. I ache all over, I'm physically weak, constant headache, I can only move slowly etc. It does feel flu-like, yes.

 

This is true for me as well. I also had leaden paralysis, where you can't get out of bed, you feel like your limbs have tons of weight on them. I don't remember everything you said, but a *lot* of symptoms you list can be of depression. I'm not saying MDD is your dx, I just think you are underestimating how severely ill someone with MDD can be. I would be so tired, I was scared to drive, because I would doze off, for instance.

 

I can't say whether you have MDD or not, but nothing you listed rules it out.

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I've not had fatigue like you describe, Epicaricacy, but the tiredness, low energy, struggling to get out of bed - all the physical manifestations of depression - were helped with Wellbutrin 300mg. It didn't lift my mood,  but it did get me going.

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Thanks again to all of you. I guess I should feel reassured, then. Reassured that it can be purely depression-related. It's just all this stupid hope that I build up by questioning my diagnosis. As in "maybe it's something treatable", because given that it's really depression, then it has already turned out to be completely treatment-resistant. And that, in turn, makes me question the diagnosis even more.

 

As for Lyme, yes, I've tested negative. Just like for many other things. Two brain MRIs, everything thyroid, ANAs, CRP, ESR, multiple full blood counts and much more.

 

Now regarding babesiosis, it seems that none of the clinics in my country have any tests for it at all. But that's not surprising; I'm from Eastern Europe, after all. Obviously, psychiatry is in an absolutely horrendous state here as well, but I digress.

 

So I guess I'd like to ask @water if this friend of yours had all the usual physical testing (full blood count, CRP etc.) done before the "discovery". I suppose he had... Did it all turn out normal? Guess so too... I just don't know, really. And the internet seems to be of no help; there's just basically nothing about any "chronic babesiosis" out there, and regular babesiosis seems to be always described as resolving spontaneously in several months.

 

On the other hand, I fell ill in winter. I guess that renders tick-borne infections very unlikely, although apparently the incubation period for babesiosis can be as long as 8 weeks.

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Epicaricacy, I can relate to everything you've posted; what you suffer from. Exact same here. I've been tested as well for auto-immune diseases and my thyroid checked out. Aside from depression, they could find nothing leading to my constant fatigue and tiredness regardless of the amount of sleep I get, and it also has nothing to do with my moods. My muscles ache continuously, as well. I push and exert myself beyond what I feel capable of many times because my anxiety drives me, and won't let me sleep well at night. But if I sit or even stand too still for too long, I start to feel dizzy and lightheaded and like I'm going to pass out in certain instances.

 

I found out I'm anemic and my hemoglobin is quite lower than normal, and that iron deficiency can cause several of the symptoms I experience. I also learned it can worsen with time, starting out mildly when you're younger and becoming more and more debilitating. I take iron supplements which are horrible on my bowels. It almost makes the situation worse. But anyway, have you looked into the possibility of being anemic? Also, how is your blood pressure? Mine is super low and can also cause the constant fatigue.

Edited by NeonGhost
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So I guess I'd like to ask @water if this friend of yours had all the usual physical testing (full blood count, CRP etc.) done before the "discovery". I suppose he had... Did it all turn out normal? Guess so too... 

 

Yes and yes.  It did turn out normal, and he did test negative for Lymes.  My friend told me exactly which diagnosticians you should see, not knowing that you are on CB. I just told her that it was someone I knew.  But she also said this:

 

I recommend she get her blood tested for two different kinds of bebesiosis, Duncani and Microti.

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So I guess I'd like to ask @water if this friend of yours had all the usual physical testing (full blood count, CRP etc.) done before the "discovery". I suppose he had... Did it all turn out normal? Guess so too... 

 

Yes and yes.  It did turn out normal, and he did test negative for Lymes.  My friend told me exactly which diagnosticians you should see, not knowing that you are on CB. I just told her that it was someone I knew.  But she also said this:

 

I recommend she get her blood tested for two different kinds of bebesiosis, Duncani and Microti.

 

 

Aw, I'm sorry. That's so amazingly caring of you, yet all I can respond with is that... You've probably assumed that I'm from the US, and I'm not. I'm on the other side of the Atlantic. I don't know, this still felt rude to say. Again, sorry, I probably should've made it clearer in the first place :/

 

P.S. As for the note, got it. But that's only if I ever get the opportunity to get tested at all, since, as I've mentioned, they don't seem to test humans for this illness where I live whatsoever.

Edited by Epicaricacy
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