Yes, it is hard to know...since pain and fatigue can contribute to anxiety and/or depression, or the other way around.
My doctor has told me more than once that yes, I probably do have a touch of depression (gee, can't imagine why - maybe because I can't do 80% of what I used to, and want to) but he believes it's situational, not clinical. So, the small dose of Nortriptyline (an anti-depressant that I take at night for sleep) most likely helps boost my mood, but that's not why I'm taking it.
I get so upset when people in my life who should know better attribute my pain to worrying - "just don't think about
it so much!"
I want to yell, "Uh - excuse YOU, I'm not thinking about
it, I'm experiencing it - here and now! And it sucks!"
It's so easy for others to judge. I'd love to trade bodies with them for a few weeks and see if they could "just not think about
it" when they're living with what I do...I sincerely doubt it.
I also feel that if it's significantly impacting your life, pain needs to be treated, whatever its cause. If it does originate with anxiety, hopefully once that's under control, the pain will stop and that will be that.
I wish you luck figuring it all out and hope you can start feeling better soon!
Debbie