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Julie  Stachowiak, Ph.D.

Fatigue or Depression?

By September 2, 2008

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Some experts say that doctors can throw out all of the questionnaires and complicated diagnostic criteria that they use to determine if someone is depressed and just ask one or two questions: "Have you lost interest in things that you used to be interested in?" and "Have you felt depressed or sad much of the time?"

Apparently, a "yes" answer to one or both of these is a pretty good indicator of depression. However, what about the person suffering from fatigue related to multiple sclerosis (MS)? I can tell you that when I am fatigued (around 11:00 am on muggy July mornings, for instance), I sure as heck have no interest in anything except feeling better - and, damn straight, I am sad about it. Sometimes this feeling lasts for days on end. Last summer it was months in a row without relief.

Is this depression? Is this fatigue? Is it a combination? I guess what is hard here is not just seeking a diagnosis, but determining how to treat the problem - I think depression should be treated by psychiatrists, plain and simple. However, how many of them specialize in MS and would have a general understanding of what the physiological effects of MS-related fatigue are? If you are unfamiliar with the fatigue induced by MS, it sounds rather unbelievable (and, frankly, falls right along the lines of many of the depression symptoms).

Anyway, the point of all of this is that while there are treatments for both fatigue and depression, treating either or both of these in the patient with MS takes some skill and patience to get right. Hang in there and don't give up. Remember, this is not your fault.

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Comments
March 9, 2011 at 1:14 pm
(1) doris dugan says:

I have just read your article, as i was looking for something under the head line ms fatigue and depression.I have been trying to find the right words to tell dr and friends how I am feeling.I just can’t get it into words,is it Just the horrible fatigue, is it worsening sensory (which I find terrible), is is mentally fed up is it dementia. I know I feel horrible and I am really fed up, but I think it is Fatigue which just makes me feel terribk le both mentally and physically. How can we ever describe it to Drs, or anyone else. Even other Ms people don’t seem to get the seriousness of what I am trying to describe.Your article helped me. I think you might understand.

September 2, 2012 at 11:43 am
(2) Connie Prins says:

Dear Doris, I’m not a doctor, but a fellow ms sufferer with similar frustrations. I don’t have a solution, but thought you’d like to know that you are not alone in trying to figure out what’s depression, what’s fatigue, what’s diminishing sensory ability– which is very depressing!– and how much of the depression may be caused by the lifestyle changes we end up making, and the occasional isolation we feel when we can no longer do some things with friends and family.
I find that I have to ‘keep trying things’– I overcame a recent major depression by finding a psychopharmacologist who found by trial and error a different anti-depressant that worked for me. Then when I felt better, I was able to make changes that brought back old friendships– etc., etc. It’ll help for a while– and then I’m sure some new ms related issue will pop up!

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January 2, 2013 at 11:44 pm
(6) Debra Crawford says:

Since 1999 had been suffering with fatigue. I tried to fix the fatigue by pushing myself to exercise daily, eat right and drink plenty of water. I would push myself to the point of extreme exhaustion, where I was bedridden for a day of recovery or so. In 2003 I was diagnosised with MS. In 2004 my PCP wanted to treat me for depression. I said that I would give it a try, even though I didn’t think I was depressed. I thought it was all due to the fatigue, I didn’t feel sad, eventhough I had the clinical diagnosis. Anyway, medication was the key, in a few weeks I had enough energy to do everyday chores. I had the energy to enjoy life as I had once known it. I am thankful.

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