Chronic Fatigue Syndrome vs. Depression: Myths vs. Facts

Chronic Fatigue Syndrome vs. Depression: Myths vs. Facts

Fatigue is one of the most common symptoms that patients with most mental illnesses present with. The fatigue they experience cannot be compared to ordinary “tiredness,” as it is far more debilitating and does not seem to go away by taking adequate rest. Upon looking their symptoms up on the internet, patients often come across a medical entity called chronic fatigue syndrome (CFS). Many a time, I have seen patients who have diagnosed themselves with CFS, and have wanted a psychiatrist to verify and confirm it. Most of these patients had an underlying depressive, anxiety, or psychosomatic disorder. So, what makes this diagnosis so confusing?

Since symptoms of major depressive disorder are commonly mistaken for CFS, let us take a closer look at the differences between the two:

Differences between CFS and depression:

  • CFS is primarily a neuroimmune condition, while depression is primarily a psychiatric condition. However, it can occur concurrently with CFS.
  • In CFS Fatigue increases post-exercise or exertion and is not relieved on adequate rest. While in Depression, in mild to moderate cases, the feelings of fatigue and lethargy may improve on movement/exercise
  • In CFS,  additional symptoms such as sore throat, enlarged and tender lymph nodes, muscle pain, unexplained headaches, frequent colds, instabilities in blood pressure, and gastrointestinal symptoms must be present. In Depression, these symptoms are typically absent.
  • Anti-depressants do not significantly improve symptoms of CFS, While in  Depression, anti-depressants can improve the symptoms up to 90-100%
  • In CFS Other symptoms of depression such as feelings of guilt, shame, hopelessness, disinterest, and suicidal ideation are usually absent. On the other hand, a patient with depression experiences these symptoms over and above fatigue.

Sleep disturbances, problems with memory, attention, concentration and sensitivity to light and noise are common to both CFS and depression


To conclude, CFS is an extremely rare disorder with a prevalence that ranges from as low as 0.07% in adult population. If you are experiencing long term and unexplained fatigue, it could be a sign of an underlying psychiatric disorder. Please do not self-diagnose, as it always does more harm than good. A psychiatrist can help you correctly diagnose and effectively manage your symptoms.

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