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difference b/n depression and fatigue?


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on the one hand my docs say they've never seen fatigue like mine accompany depression.  i'm unable to recover from even moderate exercise.  they claim most depressed people, though tired, still feel better after exercise.  but then they'll turn around and say they've seen depressed people who can't even get out of bed and need to be fed with a tube.  i don't get the discrepancy?

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Well, if you are having problems discriminating the two, depression has a well defined set of criteria and any competent Pdoc should be able to diagnose and treat.

After treating the depression and getting it in remission, you can then address fatigue issues.

a.m.

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on the one hand my docs say they've never seen fatigue like mine accompany depression.  i'm unable to recover from even moderate exercise.  they claim most depressed people, though tired, still feel better after exercise.  but then they'll turn around and say they've seen depressed people who can't even get out of bed and need to be fed with a tube.  i don't get the discrepancy?

<{POST_SNAPBACK}>

If you're female and of breeding age you could easily be anemic. I have MDD exacerbated to the MAX to be 70's cliche, because I bleed out once a month, thank you uterus, and my anemia is chronic. It can kick your ass. And a lot of women have no clue, and their stupid doctors don't even think to ask or test.

A quick check you can do yourself, by no means diagnostic, but a check point...

Go look in the mirror closely at your eye (either one), pull down on your bottom lid, as if you were inserting contacts or medication and check out the color of the INSIDE of your eye lid. If you have good iron rich blood, it should be nice and pinkish red. The paler the color, for example, mine is vaguely tinged with a pinkish color, but they mostly look white, the higher the indication that you might be anemic.

FWIW. My Uncle Mike taught me this trick, he was a medic in Vietnam. I am also pasty white and goth doesn't look cool at 45 years old!

S9

Edited to add: And any doctor that says they've never seen extreme fatigue and depression go together like yours? You gotta be f'ing kidding me? They go together like peanut butter and jelly!

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on the one hand my docs say they've never seen fatigue like mine accompany depression.  i'm unable to recover from even moderate exercise.  they claim most depressed people, though tired, still feel better after exercise.  but then they'll turn around and say they've seen depressed people who can't even get out of bed and need to be fed with a tube.  i don't get the discrepancy?

what do you mean by being unable to recover from moderate exercise?  how long are you fatigued by it?  hours, days, a week?

how long have you been depressed, and how long have you had this kind of fatigue?  are you on meds for your depression?  keep in mind that some meds can cause fatigue.

all this said, i have MDD (in remission) and chronic fatigue syndrome.  my cfs is slowly getting better.  (here is a link to the diagnostic criteria for cfs, if you're interested.  it's more than just fatigue, and it must persist for 6 months for the dx to fit.)

so, for me, the remedy for treating my fatigue required treating my depression (wellbutrin) and my chronic fatigue.  treatment for cfs is complicated, and there are still some doctors (that i'd like to bonk in the head) that think that it is a Somatization disorder.  for me, it was easy to distinguish between depression fatigue and cfs because i've had MDD since i was quite young and it felt different.  that and i haven't been depressed for the majority of the time i've been sick. 

If you're interested in reading about CFS, i highly reccomend reading From Fatigued to Fantastic!: A Proven Program to Regain Vibrant Health, Based on a New Scientific Study Showing Effective Treatment for Chronic Fatigue and Fibromyalgia by Dr. Jacob Teitelbaum.  (ignore the cheesy title.)  my doctor uses many of his techniques, and he gets into how cfs is usually caused by a combination of many factors.  (for me hypothroidism, adrenal hormone issues and low b12...) 

i hope i didn't overwhelm you with detail there.

it isn't an easy question to answer because depression really does impact the body in a physical manner.  but it also is possible that you have other things going on.  and, a lot of people with cfs do see improvement with anti depressants (which still does not mean it's all in your head.) 

good luck.  feel free to ask me about any of this if you want.  it took me close to a year to get on a good cfs treatment protocol so i'm here to bitch at if you need to vent, because it can be frustrating. 

one last thing... even if it is just the depression that is causing the fatigue, you should probably get a full blood work-up done including a thyroid panel, a test of your levels of folic acid and B12, anemia, and a girly hormone panel.  if you have a vitamin deficiency or a hormone inbalance, fixing it will aid in treating your depression.

good luck

penny

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Heya sunburnt22,

What other symptoms do you have?

B/c "leaden fatigue," feeling like your limbs are made of lead, is part of so-called "atypical" depression, which is BP until proven otherwise, and which your doc should pick up on.

Generally goes along with:  sleeping too much; eating too much; interpersonal rejection sensitivity; reactive mood (able to brighten up if something good happens).

Or, maybe not.  But for *damn sure* worth looking into as it affects what treatments you're offered.

--ncc--

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I've been depressed enough that exercise didn't feel good or help my mood much. But it didn't really wear me out very much at any time. Usually, the exercise helps a lot. I know at least one person who seems to have a much closer connection between fatigue and depression than I do, although maybe it goes the other way. She enjoys things like hiking, but claims that the exercise alone doesn't change her mood. Hmmm... I've gone on lots of vigorous outdoor activity while depressed, and got maybe a little bit of enjoyment out of it.  Winter backpacking with 50 lb pack in a group, thinking about how alone I was. A couple of years ago, chasing a group of cyclists I was late for, for 30 miles, tho I'll admit I started to enjoy some of that.

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all this said, i have MDD (in remission) and chronic fatigue syndrome.  my cfs is slowly getting better.  (here is a link to the diagnostic criteria for cfs, if you're interested.  it's more than just fatigue, and it must persist for 6 months for the dx to fit.)
Penny,

I was recently dx'ed with fibromyalgia...just fyi...I didn't think to mention that when I was talking about anemia. I am still in the "rejecting" stage of the fibro dx. This is my MO. It took me 20 years to accept MDD, 2 years to swallow ADD, it's like that.

I have other connective tissue disorders, RA, etc., but good call on mentioning the CFS. I don't even bother to consider ;) fibro could be a component of my bone crushing fatigue. I've been anemic for so long, and depressed since the womb. <shrug>

Good Info.

S9

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Assuming that this goes beyond your depression let me make some suggestions on some less dire stuff it could be:

Hypothyroidism: many folks with depression and other MIs turn out to have thyroid disfunction.  Any doctor can check your thyroid levels.  If yours are even slightly low (or TSH a little high) I'd suggest a trial of thyroid supplementation to your doc.  Many pdocs will check thyroid as a matter of course because thyroid affects energy and mood so much.

Cortisol: I've had a lot of physical and mental fatigue most of my life, even after taking psychiatric medications.  My pdoc recently had me do saliva tests (four times a day for a day, process through a lab) and found that my cortisol levels were extremely low.  He put me on supplemental cortisone and my energy levels are much more even and I deal with stressful situations better and recover faster.

Other hormones: basically any hormone imbalance can cause depression and/or fatigue.  High insulin, low estrogen, pretty much anything. 

Anyhow, maybe it would be worth a blood workup including thyroid and hormone levels. It could be easily treatable with a little bit of supplementation (and all of these are cheap meds to get).  If that doesn't work you should definitely be checked for the more serious syndromes and illnesses that have been mentioned.  But simple is best.

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  • 3 weeks later...

Depression includes feeling worthless, sometimes guilty, like you are a waste, and losing interest in things you used to like. Also, sometimes people stop eating enough or start eating too much. It can come and go in cycles. People often feel tired too.

As others have pointed out, it could be another disorder. Talk about it with your GP and either rule in or rule out depression, then you'll have a better idea of where to go..

loon

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Sunburnt, I take cortisol, not cortisone.  Cortisol is a hormone one's body makes to deal with stress.  Too much is unhealthy, but so is too little.  Too much and I think your body never winds down, and too little impairs the immune system and has other effects.  I've heard some holistic types say that chronic stress can cause "adrenal fatigue" which cuts down on cortisol production. 

My pdoc had me do a saliva test for it (spit into vials four times a day and send it off to a lab for analysis) and my cortisol levels were extremely low throughout the day.  7.5 mg/day orally seems to help a lot.  My pdoc confesses he doesn't completely understand the mechanism, but I've noticed I deal with stress better, don't freak out under pressure anymore, and get over stressful situations faster.  I don't get the brain freeze I used to get when speaking to groups.  I used to use propranolol PRN for performance anxiety, but I haven't needed it since starting the cortisol.

According to the test instructions, my saliva test could have been thrown off if I were using a lot of topical cortisone, so the two are related somehow (I'm sure one of our smarter buddies here could elucidate).  I've heard bad things on the boards about BP reactions to cortisone, though, so they must work differently.

[edited because I can't write so good]

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