Pulse: Long Covid training course - Dr Shah

[Hoopoe]

I do know a few people with ME with clinical depression and anxiety disorders who found an understanding of their cognition and taught ways to manage some of the determinants for fluctuating ME symptoms, really helpful in conceptualising their ME as a biomedical illness and how it differs from depression, anxiety and other mental health problems.

How do they describe it as different?

I was playing with the idea of reading patient descriptions of their illnesses to see if any clear differences to ME/CFS could be found. I started with depression and then sort of lost interest but the initial impression was that the fatigue was more or less the same but pattern of depressive episodes was completely different (depression slowly building over months, instead of day to day fluctuation in symptoms, with exacerbation related to exertion). Also people with depression seemed to retain more ability to function, but maybe that's the subset of patients who would publish articles on the internet. Pain and orthostatic intolerance were not mentioned either.

 

[Trish]

Thanks @hibiscuswahine, that makes sense.

 

[hibiscuswahine]

How do they describe it as different?

For some examples:

That might be in relationship to their level of

a) depressive disorder- eg. a term known as psychomotor retardation, when both physical and mental function is slowed. This is a sign of moderate to severe clinical depression. It is a very obvious clinical symptom but the subtleties come up when we do a cognitive exam and the processing speed is obviously impaired, some can not even participate in cognitive testing and is measured by observation and communication ability. In mild clinical depression, there are subtle changes but not enough to affect ability to function in most environments.

b) anxiety disorders and other related disorders - people with excessive anxiety, once they have lowered their anxiety (by whatever means) can easily process information and have no changes to their cognition, but in high states of anxiety have problems processing information quickly and drawing on learnt skills.

c) psychosis is very different, cognition is often very disturbed, but with treatment usually return to their previous cognitive status.

Edit: sorry I didn’t answer your question, they describe it much as pwME describe their cognitive problems but a psychiatrist/psychologist should be able to tease out the difference between ME and mental health disorders (yes, some can’t, need more training….)