Cortisol levels in Chronic Fatigue Syndrome and atypical depression measured using hair and saliva specimens, 2020, Cleare/Chalder/others

I think lots of things might mask the onset of ME. My own clinical picture was confused by hypothyroidism and borderline a anaemia. My hypothyroidism wasn't well managed as the GP at the time felt TSH and T4 levels in "normal" range should relieve all symptoms.

Then we have the effect where early signs of other conditions are misdiagnosed as ME. I've met a couple of MS patients who lived with an ME diagnosis for years when they had MS.
 
I was curious about what is atypical depression and it's frankly a mishmash of non-specific things that likely include quite many mild CFS patients but also a very random assortment of unrelated things:
Symptoms of atypical depression can vary from person to person. Key signs and symptoms may include:
  • Depression that temporarily lifts in response to good news or positive events
  • Increased appetite or weight gain
  • Sleeping too much but still feeling sleepy in the daytime
  • Heavy, leaden feeling in your arms or legs that lasts an hour or more in a day
  • Sensitivity to rejection or criticism, which affects your relationships, social life or job
Click to expand...
Honestly really looks like about 90% of mental health research is a bunch of pseudo-random guesses and attempts to fit various things in boxes for the purpose of having boxes filled with stuff. No one understands anything about this stuff, the field is about at the stage cosmology was in the middle ages, mostly guesses, mostly wrong and not useful for much but damn are those celestial sphere pretty and awe-inspiring.
 
rvallee said:
I was curious about what is atypical depression and it's frankly a mishmash of non-specific things that likely include quite many mild CFS patients but also a very random assortment of unrelated things:
Symptoms of atypical depression can vary from person to person. Key signs and symptoms may include:
  • Depression that temporarily lifts in response to good news or positive events
  • Increased appetite or weight gain
  • Sleeping too much but still feeling sleepy in the daytime
  • Heavy, leaden feeling in your arms or legs that lasts an hour or more in a day
  • Sensitivity to rejection or criticism, which affects your relationships, social life or job
Click to expand...
Honestly really looks like about 90% of mental health research is a bunch of pseudo-random guesses and attempts to fit various things in boxes for the purpose of having boxes filled with stuff. No one understands anything about this stuff, the field is about at the stage cosmology was in the middle ages, mostly guesses, mostly wrong and not useful for much but damn are those celestial sphere pretty and awe-inspiring.
Click to expand...
A bit like astrology really - make enough sufficiently vague statements applicable to much of the population, and people end up thinking it's science!
 
The paper writes:
CFS is not included within the most recent edition of the Diagnostic and Statistical Manual (DSM-5; 2013), although might fit within the new category of Somatic Symptoms Disorder (SSD), which explicitly includes patients with “medically unexplained symptoms” (Dimsdale & Creed 2010)
Click to expand...
Weird how they got this all wrong. The whole point of the SSD construct was to stop the association between somatisation and medically unexplained symptoms. So SSD can be diagnosed as a comorbidity in patients with cancer, heart disease or CFS - it doesn't matter if symptoms are explained or not. Dimsdale et al. who presented the new SSD construct wrote that "It deemphasizes the centrality of medically unexplained symptoms and defines the disorder on the basis of persistent somatic symptoms associated with disproportionate thoughts, feelings, and behaviors related to these symptoms."

The authors of this seemed to have really misinterpreted SSD, unless they actually wanted to make the suggestion that CFS is a psychiatric disorder characterized not by symptoms but by disproportionate thoughts, feelings, and behaviors.
 
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strategist said:
People here seem to be worried about depression being misdiagnosed as ME/CFS when I think the other way around might be much more likely (maybe not with these authors but in general). Depression seems to be even more heterogeneous and less well defined than ME/CFS. It's not reliable point of reference to use.

For all we know a lot of these depressed patients could have CFS or that's being particularly badly managed which causes distress. An easy way to mismanage CFS would be to tell a a patient they have depression and must make an effort to do more, exercise and not give up so easily. The outcome of that is likely to be a lot of repeated relapses and despair.
Click to expand...
Yes
 
rvallee said:
I was curious about what is atypical depression and it's frankly a mishmash of non-specific things that likely include quite many mild CFS patients but also a very random assortment of unrelated things:

Honestly really looks like about 90% of mental health research is a bunch of pseudo-random guesses and attempts to fit various things in boxes for the purpose of having boxes filled with stuff. No one understands anything about this stuff, the field is about at the stage cosmology was in the middle ages, mostly guesses, mostly wrong and not useful for much but damn are those celestial sphere pretty and awe-inspiring.
Click to expand...

I was looking for the definition of a-typical depression, but there it is. So, it’s pretty much nothing specific? Random symptoms?
 
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