Exhaustion - how do you know if it is depression or CFS?

[RomiiRoo]

I am actually really struggling, and have been for a good while, with fatigue. I feel like my energy is getting less and less to do every day things. I have been having regular migraines and just generally feel drained. It is not like I don't want to do things, but any ideas which I have in my head, the reality is just too much. This is not how I used to be.

I have had a very stressful few years, and right now, things are at the phase where they should be settling down, and be easier, but it feels like that I have actually just stopped working physically and mentally. I am on anti-depressants and am seeing a psychotherapist, but it is like someone just sapped all the energy out of me slowly and I don't know how to get it back. I feel like there is nothing much left of me.

I am obviously still looking after my children (I am signed off work), and make sure and go for a walk every day to get out the house, beyond that it is a fraction of what I used to do. I did take the children to the library after school yesterday and I am going to take them swimming at the weekend, but then that is taking all my energy and I can't keep up with the housework. I have no idea how I am going to do my job (guessing that is why I am signed off)

The fatigue has been an increasingly worse symptom, over a year, I would say, and I am wondering if it is CFS and the depression is a result of that, or the other way around. And i just wanted to write it down somewhere.

Have you had your iron, thyroid, b12 and vitamin d checked?
I had severely low ferritin (stored iron) and I felt like you describe

Thanks, Equiem, yes, Dr has done thyroid and iron, both normal, that was about six months ago, but diet etc has not changed. I take vitamin D3 and an energy multi vitamin, but not had these checked. I probably need to raise it with my doctor again.

My diet was pretty good, took a multi vit with iron, didn't have heavy periods but my levels were so low.
Ask for the levels then have a look online, unfortunately the 'normal' levels recommend by NHS are far off what is optimal. For example for ferritin it should be about 70 NHS say you're fine if it's in high teens

My dh is bedbound. He couldn't go for a walk or swimming if he wanted to. He doesn't leave the house for days. Sometimes he can barely stand.
He has CFS.

You sound tired and stressed. It's not CFS. Being a bit tired isn't CFS. That's one of the reason's people judge CFS sufferers because people are quick to claim they have it.

Bendy I was referred to an ME/CFS consultant even though my doctor had my blood test results.
Not everyone with CFS is bed bound. No need to be so rude!

Actually before Christmas I couldn't leave the house, and going for a walk or doing something with the kids leaves me exhausted. But it's not a competition, I am sorry your DH is so unwell bendy. I was just asking for advice, not claiming anything. If you wanted to make me feel worse, you have succeeded and I can't see how that helps anyone.

Slugseatlettuce, thank you, I am on 60mg of Prozac. I need to go back and speak to my doctor. That is probably the best thing to do.

X-post, Eqiem, thanks. I'll see what happens.

Not much advice but from a long term sufferer of depression. I can certainly empathise with wanting to do stuff but feeling the reality is too much and also the debilitating lethargy. Good advice from pp to see your GP about meds and bloods.

I was diagnosed with CFS when I was at school after contracting glandular fever. They both sort of merged into each other so I'm not entirely sure when one ended and the other began.

I was housebound for months at a time. Ended up with a home tutor after missing so much school. I can remember my mother having to wash my hair for me, me crawling up the stairs on my hands and knees, lots of nose bleeds, dizzy spells.

The more you try and do, the worse you feel.

Eventually it turned into depression. It felt like a black wave rolling over me. I would start crying for no reason. Several times a day. I'd actually forgotten how bad it was.

I was prescribed anti depressants then after seeing a specialist and gradually got better.

Sorry you're going through this. It's horrible to not feel well for such a long time.

How do you feel 24 hours after exertion (or maybe 48 hours)?

One of the characteristics of M.E./CFS seems to be delayed post-exertional malaise.

Yes, pausingflatly! That's exactly what I had. If I overdid it at all, it would come back to bite me the next day.

Mine's a 48 hour delay and took me years to spot. Because I'd heard of the day after thing but used to think, "But I wasn't doing much yesterday". Or I'd exert myself and think the next day "Got away with that - I'm not really ill."

Sorry you have this pausingflatly.

It's a very long time ago for me but I definitely remember the delayed response.

I think I had some kind of viral problem building up slowly for months before the full blown glandular fever hit.

I used to go to swimming lessons once a week and remember literally dragging myself out of the pool after each lesson. My body felt like a lead weight and I'd be so exhausted afterward that I couldn't hold a conversation. We used to have lunch at the pool after and I used to just sit there silently with exhaustion.

thank you ; that is all helpful. I need to reflect and pay attention a bit more. Right now, I have been up for just over three hours, got the children out the door, and just want to go back to bed.

From what you are saying, it seems most likely that the fatigue could be part of the depression and/or a side effect of the medication; and I really appreciate you taking the time to reply. I certainly feel tired after both physical and mental exertion, and was already planning my work diary around how tired I felt I would be the day after meetings etc/when I could work at home; but I think that was worse after the medication was increased. That said, the reason that got me thinking about this was because I remember two periods in my life where I had this level of exhaustion before; but it was just me, and I could organise myself around it. Whereas now I have two children and I am the sole resident parent, so the thought of not being able to go back to work is rather terrifying; and probably one of the reasons I put off admitting I was ill for so long.

The dose I am on is the maximum dose, and rather than change meds, it was stepped up twice (from 20 to 40mg by one doctor, and then to 60mig by another, over a period of 18 months) whereas I think it sounds like it should have been changed at one of those points. To be fair, this is what my doctor initially suggested most recently, but then suggested maybe we should wait and see how the time off helped.

Thank you all for sharing your experiences; to those of you still unwell, I am sorry and hope that things get better/easier. And Lucy, I am sorry if my post brought difficult times back to mind.

No need to apologise Romii. If it's at all helpful, the anti depressant I was put on was called Prothiaden. This was about 25 years ago now though so I imagine things have moved on since then.

Hope you are feeling better soon.

Leonard Jason says about CFS "Fatigue is too general, but post-exertional malaise is the key piece. Some do not experience fatigue anymore because they try to avoid doing too much. It is a lack of endurance, stamina, or energy that can be sustained that is the key issue."