This year I want to talk about two very different illnesses, both of which I’ve had experience with at different times in my life: Myalgic Encephalomyelitis, and depression*.
The whole M.E. vs depression thing is a controversial topic- amongst people who are unfamiliar with both diseases at least. And that’s understandable in a way. From the outside, mild-moderate M.E. (or Fibromyalgia, or Lyme Disease) can look very similar to mild-moderate depression: lack of participation, lack of energy, increased need for rest, even things like physical pain. Even more confusing, you can have depression and then completely separate to that develop M.E. (for example from a viral infection, as I did), or- like with all chronic illnesses- living with M.E. can sometimes cause a reactive depression.
However, they are very different diseases, with very different, almost opposing treatments. That’s why its so important to raise understanding of what those differences are and how to treat each disease. So here are a few basic differentiations for you:
1. With M.E., you have a strong desire to carry out activities, but are physically restricted from doing so.
With depression, you have no physical inability or backlash from activity, but have a reduced desire to carry activities out.
It’s especially important to note that people who have learned to manage their M.E. might appear to not have the desire to do things due to their superior desire to actually recover – sorting the motivation is key.
2. With depression, carrying out vigorous activity (especially exercise) generally results in short-term improvement of the condition.
With M.E., carrying out vigorous activity (especially exercise) generally results in short-term worsening of the condition – with effects often delayed by a day or so.
3. With M.E., regular physical exercise which pushes the person’s current activity ability results in long-term worsening of the condition.
With depression, regular physical exercise which pushes the person’s current activity ability generally results in long-term improvement of the condition.
4. With depression, pushing a person to do activities such as socialising which they feel incapable of, leads them to realise they are capable and can help them improve.
With M.E., pushing a person to do activities such as socialising which they feel incapable of leads them to have severe backlash and can worsen their illness.
5. M.E. is managed with lots of rest, careful pacing of activities, and sometimes the help of physical disability aids and painkillers. This can sometimes lead to recovery.
Depression is managed with psychological treatments/methods such as CBT and intentional carrying out of activities which are fulfilling and/or enjoyable. This can sometimes lead to recovery.
6. Depression is often successfully managed with anti-depressant medication, believed to correct chemical imbalances in the brain. This can sometimes lead to recovery, although often a patient may have to stay on these long-term.
M.E. is never successfully managed with anti-depressant medication. Painkillers** are helpful in managing the disease, but don’t lead to recovery. There are however promising drug trials with things such as chemotherapy treatments, which show long-term improvement whilst remaining on the drug.
7. The exact mechanism of M.E. is unknown, but is often triggered by viral infection or environmental toxins. The central nervous system, endocrine system, digestive system, circulatory system and more can all be adversely affected by the disease.
Depression is caused by a complicated mix of environmental and physical factors, often (but not always) triggered by adverse life events such as abuse, personal tragedy or long-term stress. Depression can cause changes in the body too, effecting the thoughts and emotions of the sufferer.
8. Depression is extremely emotionally painful, although activity can provide some respite and improvement for this. The exact mechanism is unknown, but as the brain struggles to deal with the levels of emotional torment it can cause physical pain too, such as a sore back or stomach.
M.E. is extremely physically painful – muscle pain is the most cited and often most severe symptom of sufferers. This constant physical pain, made worse by activity, can cause emotional pain to the sufferer as they struggle to deal with the intensity and unrelenting nature of it.
As you can see, treating one disease mistakenly as the other can have terrible consequences for the sufferer. That’s why it’s so important to spread understanding of the differences. There are however also important similarities between the two illnesses, which are equally vital to understand. For example:
1. Both depression and M.E. are long-term serious life-altering illnesses.
2. Both people with M.E. and people with depression are often socially isolated, due to the illness making it difficult for them to carry out social activities. Different reasons, same result.
3. Both depression and M.E. are often misunderstood illnesses. People assume you can think your way positively out of them, or just “pull your socks up” and get better- but in actual fact, they both require careful management and hard life changes to see any improvement.
4. Both M.E. and depression can be fatal.
5. Both depression and M.E. often require increased medical and social support for the sufferer.
6. Both M.E. and depression can cause changes in the physical structure of the brain. Different changes, to be sure, but changes none the less.
7. A healthy balanced diet can be beneficial to sufferers of both depression and M.E. in managing their illnesses.
8. Both M.E. and depression can occur at different severities and fluctuate over the course of the disease – and the experiences of each, like with all illnesses, are unique to the person suffering them.
If you’re suffering from either disease – or both – life is hard. It’s my hope this ME awareness day to clear up some of the common misunderstandings between the two, which often lead to more suffering by those already dealing with a hard illness. It’s also my hope to encourage people to love those around them struggling with these diseases, to reach out to them, and not to leave them alone in a very dark place.
* Obviously both diseases are far more complicated than this simplistic overview of some of the major differences between them, and if you want to find out more then I’d recommend researching them thoroughly. Perhaps start with the charities ‘Invest in ME’ and ‘Mind’.
** It’s worth noting for the astute that while some neuropathic painkillers are used as anti-depressants at a higher dosage, but when prescribed for neurological pain (such as found in M.E.) the dosage used is too low to use as an anti-depressant.