to be exhausted with my friend's Chronic Fatigue Syndrome?

[LemonDifficult]

My friend has been diagnosed with CFS. Over the past 6 months or so she's been struggling with tiredness. She's had blood tests which found nothing, she's looked into herbal medicine and so on. A couple of weeks ago the GP said it's CFS.

During the past few months she has become more and more self absorbed. She is single, she wants to meet someone and have a family and is feeling the pressure as she's in her late 30s. Along with this taking up much of our conversations, she talks constantly about her tiredness, or just other aspects of her life. Almost nothing about me, except on a couple of occasions some bitter digs about how parents are so rude/thoughtless/whatever. I'm sympathetic but beginning to get sick of it. I'm also sad about it because we have been great mates. I try, I really do, but my frustration with her is getting the better of me.

If she was to ask me I'd say I think it's depression or stress by another name with sleepy side-effects, but if I so much as hint at that I get the brush off. In my view, she needs a serious amount of counselling to deal with the trauma of losing both her parents when she was young and various other issues that have come up along the way. She has barely had a proper relationship - the last one was 12 years ago. That the CFS might be in anyway be a MH issue is a non-starter with her.

So AIBU? Is this CFS absolutely out of my friend's hands? And at what point am I allowed to say, 'I've done my duty as a mate and listened to how hard it is not being able to get up until noon. Now I'm fed up with your jellyfish comments about the evils of 'screaming babies' or whatever'?

YABU. How would you feel if the tables were turned and you had CFS? I'm assuming you would want friends you felt you could talk to as much as you needed to?

Well, yes, I agree but probably with the caveat... 'provided you didn't see this a carte blanch to be snide'. I also like to imagine that I would have the self awareness to pretend to be interested in other people's lives even if I wasn't.

Some people assume you'll take your turn talking about yourself when you like, instead of inviting you to do so - I've had friends who seem to see things that way. She might genuinely not realise that she's not asking you about your life - maybe the only way is to mention it to her.

I think you're confusing two issues.
I really don't think your friend's CFS and the way she is treating you unpleasantly are linked to be honest.

I'm newly diagnosed with Fibromyalgia, and I get chronic fatigue and severe pain throughout my body. I've had it many years but only just found out what it is that has made me feel so terrible that climbing a flight of stairs wipes me out. So I'm coming to terms with it, the fact there's no real cure, and yes I'm talking about it a fair bit to get my head around it.

I've had someone turn around and tell me it's all in my head, but as my gp said to me "medical science may not have all the answers but it doesn't mean your condition is any the less real". Have you any idea what that person did to my mental state saying that to me?

Thing is if you can't support your friend emotionally in this then the best thing to do is back off. She can do without the negativity. And as much as I talk about my recent diagnosis I would fully expect friends to pull me up if I did behave as unacceptably as your friend. (I mean in the unkind remarks about you, not talking about her condition)

Also going to add that I agree with Kitty that she probably knows she's being unpleasant and I can imagine that would make her feel worse. "not only is she unwell, and single, and doing badly at work, but she's acting like a bitch to her friend" - if she's thinking about herself in that way, I can imagine that would act as a vicious circle.

I think you do need to call her on her bad behaviour. That's entirely reasonable.

Just talked it all over with DH again and discussed all that's come up in this thread so far. DH says that the correlation with my friend's mental health (stress) over the last 18 months and her CFS is so direct that it's hard to believe they are unrelated. I said about the 'Shit Life Syndrome' a poster mentioned early on in the thread and he said 'exactly'.

So if CFS isn't a psychological illness, is it possible that in fact my friend HAS got a MH issue but with the same symptoms as CFS and therefore received the same dx? Perhaps an illness that she could influence?

I'm not going to diagnose her, btw, I'm wondering hypothetically.

The GP will be well aware of mental health issues and will certainly have considered this as a possible cause of fatigue. I'm sure having CFS, like any long-term illness, would be enough to make many people miserable.

Why are you so determined to put your own label on your friends illness? It is no wonder your friend goes on if she is constantly having to justify herself to you while you, for some reason, question what is/isn't wrong with her.
Depression often goes hand in hand with a lot of chronic illnesses and life changing events in general. She quite possibly has depression on top the cfs.

LemonDifficult Tue 04-Oct-11 23:39:30
"cory - I can imagine that someone with CFS could fear that there was something else going on."

I didn't just mean this. My experience has been that many people with CFS are afraid that doctors will decide CFS is a purely MH condition and that this will affect their treatment. E.g. they will be made to push against the fatigue or treated with CBT rather than helped to pace themselves, because pacing makes more sense if one is assuming an underlying physical problem.

It's like when dd was given counselling for her connective tissue disorder; it meant that there was noone to explain to the school that actually she shouldn't be made to walk if she was in pain or forced to do contact sports. It wasn't about any harm done by the counselling, but about the good that was not being done iyswim.

My condition is co morbid with depression in some cases, similar to CFS.
I'm not depressed though. I'm so utterly not. I've had two depressive episodes in my adult life and I recognise them.

Have you not stopped to think her depression may be caused by the CFS? Having your capabilities reduced is enough to depress anyone, surely?

It's entirely possible your friend has a MH illness, whether or not CFS is psychological.

Here's the thing tho. You're desperate for her to fix herself.

Your first thought after "Is it a mental illness" is "can she influence the illness?"

She has a doctor to discuss diagnosis and treatment with. You're not that doctor. It's not up to you to decide you or she can cure her by taking her out, or not taking her out. By calling her or not calling her. By telling her it ain't cancer and she should DO something.

It's wonderful if you support her, and of course you'll have to decide where to draw the line regarding what you'll put up with.

But please stop trying to fix her, telling her she can fix herself, or projecting your own beliefs onto her. You are doing the equivalent of bombarding someone with macrobiotic kumquats and healing crystals when they're diagnosed with cancer.

It must be horrendously frustrating, and you want to help. But IT'S NOT ABOUT YOU.

Sorry. It sounds like you mean well...

Her depression (severe stress would be a better description) started about 18 months ago. The exhaustion has been the last six months, maybe a bit longer. The depression isn't a result of the stress as it came first.

Well for the gp to suspect cfs he must be satisfied that she has symptoms beyond the depression she was already diagnosed with. Without being a qualified doctor or having access to her medical notes I really don't know how you can speculate or what speculating achieves other than likely seeming to belittle your friends suffering in her eyes.

Clinical depression is a specific illness. It's not to be confused with stress and exhaustion.

As she was already diagnosed with depression it surely would have been the easy option for her gp to stick to that dianosis. He obviously has reason to suspect cfs even if you don't.
I can only imagine how frustrating I would find it if a friend was constantly implying I wasn't suffering from something that both I and my doctor believed I was suffering from.

I really don't know how you can speculate or what speculating achieves other than likely seeming to belittle your friends suffering in her eyes.

I do not, not, not, think having a mental illness is belittling. I'm speculating because if there's a chance that her CFS isn't CFS but something else that would be worth knowing.

OP, if you want to maintain a relationship with your friend, may I suggest you read "Feeling Good" by David Burns.

It is the bible of CBT. I am not suggesting your friend has depression or any form of MH problem because I can't judge. BUT this book has an EXCELLENT chapter on how to deal with difficult/negative people. Which, rightly or wrongly, she is.

One concept behind it is that a lot of moaning/sniping is motivated by a desire for validation NOT for solving the problem. And that you can move into a more productive conversation/relationship by acknowledging and then putting the onus onto the individual as to what they can do - even if it isn't very much it is still something.

EG if she is moaning (or to you it comes across as moaning) about the children next door and their noise, rather than "mmm mmm" or "well children make noise you know" validate then bring back to her. EG "Yes, it can be very tiresome when young children make a lot of noise. God knows, I know! What can we do to make it more manageable?"

Crucial to this is that you are respecting her feeling (she is entitled to feel however she wants about kids' noise for example) without feeding it. You do have to keep at it, like a broken record, but certainly IME it does work. She might not be able to resolve her problems, but she may be able to mitigate some of their effects. And that is better than nothing. In any case, skim the book if you can get a copy on Amazon or in the library and see what you think...worst you can lose is the time you spend doing that.

I'm really not sure why you are so tied up in questioning her diagnosis. It does seem a bit odd.

In most cases you have to have had symptons for at least 6 months, and have had blood tests to rule out anemia and other things (usually you "hope" for it to be something else as that can be "fixed" more easily, ie by taking iron). In our area you then have to be referred to a cfs/ME clinic where a consultant who specialises in ME/cfs will take a full history and further diagnose - for all forms my diagnosis date is from when I went to that clinic. Clinics are often able to help assist in recovering/coping with cfs/ME so hopefully there is a clinic in your area. There aren't in all areas sadly.

Treatment for depression and ME/cfs are usually quite different, at least initially. With depression there certainly is encouragement to "do more" at least in small stages, to slowly increase exercise or activity. With ME/cfs by the time it is diagnosed people have usually been trying desperately to do all they can to "do more" or to "get over it" with activity. I certainly had - I was a high flyer career wise and life wise and initially thought I would take it in my stride and keep "battling" at it. Most of my clinic group were similar. Initial advice for those with ME/cfs often is to STOP and to rest and recover.

When I started at the clinic the aim initially was to discover a "baseline" of activity that could be carried out reliably every day without symptons. This meant pretty much stopping all activity. For most people when diagnosed they are on a "Boom and bust" cycle which means they try to do something (anything from going to the shops, going for a walk, working, social event) but that it tires them unbelievably and then they can crash the next day and not have any energy at all. Initial treatment involves breaking that cycle and severely restricting activity. As an active person by nature (met my husband through a walking group, often was the person organising activities etc) I found that very hard - however after 6 months with the clinic I was managing my symptoms a lot better. It is a complete lifestyle change though to adapt to a disabling condition.

Not sure at all what you should do about your friend but it does seem like you have a problem with her diagnosis as much as anything else. She certainly will need people around her to support her rather than question her.

I don't think it makes a difference to you, really, whether she has CFS/depression or a combination of the two. Her symptoms are what they are, her negativity is what it is, and you are not treating her youself so it doesn't matter. The fundamentals of listening and validating (as IHeart says) are really there. Your role isn't to diagnose or fix her, but to just carry on being a support through this life stress.

I too, like Pseudonym, and finding it very hard to stomach your obession with disputing her diagnosis.
Maybe Dr Lemon, you'd like to come and have a word with my Consultant. And advise her too. she is the UK Diabetic Specialist and she is flumoxed by my poor Diabetic Control, and my Chronic Fatigue.
But, I bet you have all the answers.
You seem to think you do, re your friend.

I have had depression (ante-natal) since I have had CFS, my treatment for AND was ADs and CBT. It didn't make one bit of difference to my fatigue levels or how CFS affects me, they sorted out the depression no problem though.

So do I think CFS is linked with depression? No, I think suffering from it can lead to depression for some but I don't believe it can be caused by depression. Personally.

Oblomov, I'm sorry I've touched such a nerve with you. I do think, however, that if I'm doing my research here, I may as well discuss the other factors which may affect things for her, and probably are affecting my relationship with her.

There's no need for sarkiness, and I'm not disputing your CFS or it's causes. When I said in my earlier post:

I'm not going to diagnose her, btw, I'm wondering hypothetically.

What I meant was: I'm not going to diagnose her.

I am interested that any link with depression is getting such a strong response from you and others. If there's no mental health connection I realise it must be as frustrating as me saying 'I've got a cold', and everyone else saying 'Yeah, looks like sunburn to me'.

Someone in RL I know did the Lightening Process with great results apparently, and I've heard that the whole theory behind LP is dealing with the adrenaline sent out by the brain when stressed which can cause sleepy side effects. DH says he can't see how, in the case of my friend, the CFS and MH can't be interconnected as the stress levels - he thinks - were so high that it seemed inevitable that they could have a physical effect.

My query is that if KittyFane believed her symptoms were caused by depression, is it not possible that my friends could be the same as Kitty's? And before you all rant at me - 'well what does it matter' - I ask because I'm interested.

You have said you're not going to diagnose her yet you have been speculating about her diagnosis for most of the thread. To think that you know better about what is wrong with your friend than her and her gp is arrogant in the extreme. And if a friend of mine told me they didn't think I had something when I knew I did I'd tell them to fuck off tbh.

Still waiting for you to tell us all what medical qualifications/expertise you have which makes you so sure you know better than your friends gp what her condition is.

There is a link with depression in some sufferers btw. A lot of cfs sufferers also have depression. IBS, migraine and other condition are also often co-morbid with cfs. I think what people are taking such offence at is your insinuation that her symptoms are a result of depression and nothing else. You don't know this yet you seem somewhat obsessed with diagnosing your friend despite the fact you say you don't want to diagnose her and you have no authority to diagnose her.

I have no medical qualifications. I do know this friend very well and know that she has been under mounting stress/distress for 18months or so. The kind of stress that my DH says he thinks has a physical impact, the kind that might qualify for KittyFane's experience, and would definitely qualify for the previous poster's description of 'Shit Life Syndrome'.

As an aside, the GP's diagnosis of CFS was very much a 'don't know what else to say' (I'm sure lots of posters can relate to that). I understand CFS is an odd one to diagnose, therefore it does seem relevant to discuss the diagnosis - not arrogant - and I have no intention of telling her she has or hasn't got any disease or illness.