Help! Fatigue due to physical illness or depression?

Hey all,

Sorry for posting in this section (just joined and am not sure where the right area is), I'm just desperate and I'm worried if I might have chronic fatigue syndrome or another physical ailment. Basically my question is, how do you tell whether chronic fatigue is due to depression or another physical ailment?

In addition to bad fatigue these past few months, I've also had a lot of weakness in my legs (sometimes they feel shaky going up and down the stairs), frequent headaches, some slightly painful palpitations (but it's usually only like one/two skipped beat/s at a time) and more recently, frequent dizziness/nausea/bad balance. Routine blood work came back normal and I've been told not to worry, and that perhaps these symptoms are due to depression. However, while I have felt down sometimes this past year, I have started seeing a therapist (who did not diagnose me with depression), and my mood has been getting better while my physical symptoms have gotten worse. Could this possibly still be due to depression? I'm worried that it could be due to something else, but because it's assumed to be due to depression it won't actually be alleviated/will get worse.

Have any of you guys experienced this? How did you guys discover that you had chronic fatigue syndrome, or depression, or etc?

I'm frustrated because I can't get referred to have more specialized tests to rule other things out, since I've been told twice that I'm probably having all of these physical symptoms due to depression (Also worried that this is a gender stereotype?)

Thank you for your time.

Depression fatigue and CFS or fibromyalgia fatigue are not the same. I suffered for years with depression and its fatigue before I found a medication that worked. Since then I've been diagnosed first with CFS by my primary doctor and then with fibromyalgia by my rheumatologist. Of course this came after a battery of tests which came back normal.

Depression fatigue comes from a deep psychological pain that does not happen to me now that I'm on antidepressants even when I'm severely exhausted from fibro. I got the diagnosis finally after seeing my rheumatologist. He touched some pressure points on my back, arms and legs and I was surprized to find this painful. I have also been having body aches and headaches and wobbly legs so you may want to make an appointment with a rheumatologist to get evaluated. This is the speciality that usually treats this disorder. I hope you feel better.

Kyyndred

It's unlikely, based on your symptoms, to be "just depression." Some medical doctors are, in my opinion, overly quick to suggest this because they don't know what exactly to diagnose you with and they (probably mistakenly) believe they can solve depression with medications. They prefer simple diagnoses, and things that can be demonstrated on blood tests. I went to at least three MDs who suggested my issues were "caused" by depression or anxiety before I found one who was awesome, actually listened when I described my many "small" symptoms, and was aware of recent research on the legitimacy of CFS/Fibro/this sort of thing (even though its still not easy to diagnose). (Depression and anxiety do, for some obvious reasons and maybe also unknown ones, frequently co-occur with conditions like Chronic Fatigue. That doesn't mean they cause them.)

Depression absolutely does cause fatigue, and can be very severe, of course. But on its own, it doesn't cause irregular heartbeats. Or dizziness or headaches, unless perhaps severe depression has lead to such limited physical activity that there's been severe deconditioning... beside the point.

My best suggestion is to keep visiting different doctors (as long as your insurance is able to cover this) until you find someone who you trust to listen to you. Your therapist may also be helpful in talking through the emotions and frustrations inevitable in that search. (E.g., I totally agree with you that gender dynamics can cause some patients to be "written off" too quickly, especially with behavioral diagnoses. There's a good body of research to show that this kind of bias frequently impedes women from accessing care, though I'm sure people of all genders suffer for it.)

I notice you posted this quite a while ago, so I hope you've had better luck since in seeking a diagnosis. CFS, along with many other things, may not be necessarily a "helpful" diagnosis in that there aren't cures or even clear treatments, but being able to validate your sense that these symptoms aren't just "all in your head" is a worthwhile pursuit. (Not at all to downplay the potential severity+realness of depression, which is itself more than "in one's head," but to suggest that you follow your intuition about what's really causing any issues you may be having.)

Note: I also saw an ND and other alternative practitioners that weren't necessarily helpful to me. My current excellent doctor is an MD. But some people do report better luck addressing these kinds of "diffuse" symptoms with doctors that have different training or more specialized training than your average Internal Medicine MD.