Imagine that you have the following complaints:
- You are tired all the time
- You have no motivation for things you once enjoyed
- You are eating more (or you have lost your appetite)
- You are lacking energy
- You are sleeping a lot (or you have trouble sleeping)
- You are depressed and/or anxious
- Your doctor might diagnose depression - and he or she may be right.
While these symptoms are often caused by depression, thyroid problems and chronic fatigue syndrome can also result in these symptoms. It's even possible (although probably less likely) that you have fibromyalgia, sleep apnea, or an autoimmune disorder such as rheumatoid arthritis or lupus. I will give you some very sketchy information on these diagnoses. About.com has complete sites covering these disorders. Please visit the above links for more comprehensive information and for complete communities of persons who have these disorders or are interested in them.
Thyroid Problems can result in either weight loss and feelings of anxiety or weight gain and feelings of depression. They can can also result in a complex mix of symptoms that don't seem to make sense. Mary Shomon, About.com's Thyroid Guide, can help you sort out these symptoms. The traditional model of thyroid function suggests that hypothyroid - low thyroid - results in depression and weight gain; while hyperthyroid - high thyroid - results in anxiety and weight loss. The traditional treatment involves medications which bring your body chemistry under control. Mary's site does an excellent job of explaining the exceptions to this model and helping you understand your thyroid.
Chronic Fatigue Syndrome remains a controversial diagnosis in some quarters. The NIH is funding research on this syndrome, and other research is going on worldwide. The National Institute of Allergy and Infectious Diseases defines Chronic Fatigue Syndrome as:
a pronounced fatigue that comes on suddenly and is relentless or relapsing, causing debilitating tiredness or easy exhaustion in someone who has no apparent reason for feeling this way. (Chronic Fatigue Fact Sheet 10/99)
They write the following about the cause:
Several different routes to chronic fatigue syndrome may exist. In some people, a persistent viral infection may provoke CFS symptoms, and virologists continue to explore this possibility. Vulnerability to CFS may be associated with a subtle immune system defect. It also appears likely, however, that CFS involves interactions between the immune and central nervous systems, interactions about which relatively little is now known. Scientists' concerted efforts to penetrate the complex neuroimmunologic events in CFS have created a challenging new concept of the pathology of this and other illnesses. (Chronic Fatigue Fact Sheet 10/99)
Fibromyalgia seems to overlap with chronic fatigue, but persons with this disorder also have sleep disturbance and chronic pain. The disorder is usually diagnosed by tender points in certain muscles which respond with pain when touched a certain way. Sleep disturbance is common in chronic fatigue and in fibromyalgia. Some research suggests that we need deep (stage 4) sleep in order to repair our bodies on a regular basis. A disruption in this stage of sleep may contribute these conditions. Carol Eustice, the Arthritis Guide has more information on this disorder.
Autoimmune Disorders involve the immune system attacking the body rather than attacking germs and other invaders from the outside. Rheumatoid Arthritis and Systemic Lupus Erythematosis (Lupus or SLE) are examples of autoimmune disorders. Autoimmune processes have also been implicated in diabetes and multiple sclerosis (MS). These disorders almost always involve a complex symptom picture which can include depression. They aren't nearly as common as depression, but they can cause similar symptoms.
Sleep Disorders such as obstructive sleep apnea can also many of these symptoms. If you snore, or if you are aware that your sleep is disturbed you should look into these disorders.
Depression remains a more common cause of most of these symptoms. People are complex. It is important to remember that people can have more than one diagnosis at a time. There are certainly people who have both clinical depression and low thyroid, for example. Some symptoms are more common in one disorder than the other, and this can help you begin to explore what diagnosis might fit you best. People with hypothyroidism, for example, frequently gain weight. This can happen in depression, of course, but it is even more common with low thyroid. People with chronic fatigue can be depressed, but it is also common for them simply to be very tired (and not the least bit sad).
Your best bet is to work with your health care provider in exploring your symptom picture. Lab tests can help make a definitive diagnosis in some cases. Knowledge really is power, though, and using reputable sites on the Web can also help you sort out these issues.
