The Differences Between Depression and M.E

I have experience of both severe depression, and severe M.E. For a period of time, my depression and the beginning of my M.E overlapped, so it was hard to tell them apart until the depression lifted. There are a lot of similarities between the two conditions, but there are also differences. These are purely the ones I’ve experienced- other people are different, have different symptoms and experiences. Both conditions are serious and require help. (For those who are interested, I’d pick severe M.E over severe depression if I have to have either. My quality of life is much better, even though I can do less. Other people may think differently, and some people have both conditions at the same time.)

When I had severe depression, I was tired all the time. Getting out of bed was difficult. Walking to the shop seemed impossible. Getting washed and dressed frequently didn’t happen. Eating only happened if someone else reminded me. I ached all over. I didn’t want to do things. I had thoughts (and voices) telling me what an evil, despicable less-than-human being I was and that I should just kill myself as the world would be better off without me. Sometimes I acted on those thoughts. I frequently spent days in bed, not doing anything. I couldn’t care about anything, especially not myself. The things I used to enjoy (even penguins) didn’t make me happy any more.

It took a long time for me to get the correct treatment for my depression. I was depressed from age 12 to nearly 24, so almost 12 years (at the time, half my life). I had multiple stays in the local psychiatric unit, most of which were helpful. I tried lots of different medications, and discovered that not only was I very sensitive to them but most of them didn’t work the way they were meant to. I had psychiatrists that tried to fit me into boxes that weren’t right, and then would try and squish my experiences into that box. Luckily, I got diagnosed with autism (which explained most of my difficulties from childhood) and then got a psychiatrist who listened to me properly, and we worked together to work out the right medication for me, which ended up being 50mg trazadone and 50mg quetiapine. Both of those are low doses (see oversensitivity) but it worked both against the depression, and to me more importantly, against the voices I was hearing that were making my life a misery. I did have a couple of bad episodes even on that medication, but with help from my psychiatrist, Johan, my friends and my own discovering of who I was and how I could help myself, we got through it.

At the end of my last episode of depression, it cleared up completely. I started feeling properly happy again. I started caring about things. I wanted to live (previously, during the better stages that I thought at the time were not depression, I was ambivalent about death. I now know I was still depressed, just less so). The future started looking a lot brighter. But my ability to do things was decreasing. My legs were giving up on me when walking or attempting stairs. I was sleeping lots. If I went out, I’d feel horrendous for several days afterwards, and would have to stay in bed. I was having really bad pains in my arms and legs, that were nothing like the aches and pains I’d previously had, so I went to see the doctor, and eventually (after a diversion caused by a low thyroid test that on repeat came back normal) I was diagnosed with M.E. By that point I was needing a wheelchair for all but the shortest distances, and by January I could no longer walk at all.

Looking back, I could see when it started. I got swine flu in August 2009, and after that struggled physically more than I had before. When I attempted college in September, I was having to sit down when I got to the top of the stairs. I was really struggling to wake up in time to get there in the mornings. The exhaustion wasn’t being improved by activity. The pains in my arms and legs started. I had originally put all this down to depression, which is why I didn’t see a doctor until it had lifted.

So what are the differences? These are the main ones I’ve noticed.

• In depression, I feel exhausted all the time, but going out and doing things will make me feel better (or at least not any worse). I wouldn’t be any worse a couple of days later. With M.E, doing stuff will make me worse, but it sometimes takes a couple of days to feel the full effect.
• In depression, I had aches and pains constantly, but they were bearable (they just didn’t help with my mood at all). Exercise would make it feel a bit better. With M.E, the pain I get in my arms and legs especially (but also the rest of my body) is excruciating at times, and exercise makes it worse.
• In depression, even though getting out of bed and doing things was an enormous challenge, when I did it my body would work, though very slowly. With M.E, my body just completely gives up if I try to do more than I’m capable of, and I get a lot of extra symptoms (some of which are scary, like my heart racing, chest pain and fainting).
• Depression, by definition, comes with a low mood over an extended period of time. In M.E, I get all sorts of (normal) moods, and generally I’m quite happy these days (though I have down days, it’s nowhere near what I was like with depression.)
• With depression, I was suicidal most of the time. The best I ever got was not caring if I died or not. With M.E, I’m never suicidal unless the pain is unbearable, and then once the pain is treated I no longer want to die (the suicidal feelings are purely about stopping the pain).
• With depression, I heard voices telling me how evil I was and that I had to kill myself. With M.E, I’ve only hallucinated when I’ve been in extreme amounts of pain or had morphine (and the morphine ones are quite pleasant 🙂 )

The emotional pain that comes with depression is worse than pretty much anything I’ve experienced. There’s no quick treatment, and my quality of life was exceptionally poor. Though I was sometimes able to give an outward impression of being okay, inside I was suffering greatly. My M.E has been a lot less invisible, probably because I was getting worse so quickly and needed mobility aids (first crutches, then a wheelchair) and because I often look ill. In both cases, you wouldn’t see me at my worst because I’d be in bed, but the reasons are different.

I still have anxiety and panic attacks, though less panic attacks since I’m unable to get into as many situations that trigger them (travelling on the bus by myself was the worst- now I rarely go on a bus and when I do Johan goes with me as he’s pushing my wheelchair). It’s not fun, and I’m still looking for ways to deal with it, though some of it is related to being autistic (especially my extreme dislike of change). With depression I had a lot of paranoia and things that made it worse.

Both illnesses are serious. Both have a stigma against them. My belief that M.E isn’t psychological (though it definitely has psychological components, like most chronic illnesses) isn’t due to not wanting the stigma of mental illness, because I’ve had one. Between the two, for me the depression is worse. Although my quality of life is severely affected by having M.E, I have the will to do things (even if not the ability) and I’m able to be happy. With depression I didn’t have that. I’m more scared of getting depressed again than of my M.E getting worse (and  I’m not saying that lightly, having experienced very severe M.E).

M.E can cause depression, as it restricts life a lot, even at the milder end (those with mild M.E often have to give up hobbies or a social life to manage work or education). I’m lucky that I don’t have depression now, and I think a lot of that is due to my support network of Johan and friends (most of whom I’ve only ever spoken to online). I’m pretty sure if I didn’t have the internet then things would be different. I have heard some people say that if someone with severe M.E doesn’t have depression there must be something wrong with their head, but I don’t believe that as some people with severe M.E (including myself) are able to avoid it. Those with depression certainly aren’t failures, and it’s not their fault, it’s probably just a difference in circumstances.

I hope that more effective treatments for both conditions will be developed so that eventually no-one has to experience either. I have friends with depression (and other mental illnesses), with M.E, with both and some with other conditions (and even some with none at all!) and I love them all. You can’t pull yourself out of either, just like you can’t walk a broken leg better. Hopefully they’ll be taken seriously soon.

All of this has been my own views and experiences. I might have made mistakes or omissions due to brain fog or lack of knowledge. If I’m wrong or you think differently, feel free to correct me 🙂

(By the way, autism isn’t an illness. It’s a neurological difference and disability, but it doesn’t make the autistic person ill. Hearing it described as one annoys me.)