Diagnosis with Mental Ill Health



  • Hi, I have awful brain fog so it’s hard to write, hopefully this will make sense…
    I’m confused about diagnosis because I have long standing MDD and anxiety disorders (sometimes thought to be Bipolar 2) and also ASD.
    My fatigue had a sudden onset after doing two low impact exercise classes about 9 years ago. I never recovered. I was started on Graduated Exercise Therapy sessions with an exercise physiologist and never recovered from that either.
    I meet the CCC and NAM criteria with flying colours but I think most ME/CFS criteria exclude people with psychiatric diagnoses.? Does this mean I am excluded from an ME/CFS diagnosis?

    I’m surprised that all these symptoms can be attributed to depression etc. eg Neuroendicrine, autonomic and immune symptoms.
    I also have hEDS & chronic pain among other things.
    I’d appreciate if anyone could steer me towards some information around this - or just impart some wisdom.

    Thanks, Zel.



  • Where did you learn that ME/CFS criteria exclude people with psychiatric diagnoses? I've never heard this myself. A lot of us actually develop psychiatric problems as a result of the immense stress of battling physical illness every day, so it wouldn't make sense to exclude people from being diagnosed with ME/CFS on the basis of them also having psychiatric conditions.



  • Thanks River,

    yes, I'm starting to think that perhaps it's not as black and white as it seems.
    The Oxford, Fukuda and ICC Criteria exclude primary mental illness.

    https://www.meaction.net/2019/11/14/demystifying-the-diagnostic-criteria/#Criteria_Comparison_Chart

    Has anyone come across this situation?


  • Community Moderator

    Welcome to the forum @ZeldaZonk 🙂 You make good sense, and it's a very reasonable question to ask.

    I hadn't noticed that exclusion in the 2014 ICC criterion before. One thing that comes to mind is that "primary psychiatric disorders" (the language used in the 2014 ICC ME criteria) may not mean all psychological illnesses but refer to something more specific. Medical language tends to be fairly precise. Have you tried Emerge's Infoline or Telehealth Nurse? They may well have more information about this kind of thing.

    I also wouldn't pay too much attention to the Oxford and even moreso the Fukuda criterion - they were put together a long time ago, when the understanding of the illness was far less refined.

    Emerge suggest the CCC and NAM criterion for use, and neither of them exclude psychological/psychiatric illnesses in a general sense (NAM doesn't exclude anything, and CCC only excludes illnesses which specifically cover most of the symptoms - I've no idea whether any psychiatric/psychological illnesses could do this).

    I'm aware that at least some psychological illnesses are common co-morbidities with ME/CFS, and as far as I'm aware (and I'm not an expert by any means) this is generally accepted. Given the strong and growing evidence that ME/CFS is physiological, the idea that having any possible psychological illness means it would be impossible to have ME/CFS doesn't really hold up to logic.



  • @ZeldaZonk Welcome here 💐

    I remember when they excluded CFS if you had any other condition where fatigue is a symptom. And fatigue is a symptom with so many mental disorders, and so many of the medications that are taken for them.

    The sudden onset of your fatigue does make you a different case. I hope you can find a practitioner who can sort through all those co-illnesses and diagnose you fully and properly. Daffy's suggestions would be good to follow up, if you haven't already.

    In the meantime, keep presuming you have ME/CFS, keep within your 'energy envelope' and do join in here: share and ask questions, and let us know how you are going. 🌻



  • Thank you Daffy and Dot,

    everything you say makes good sense. I'll definitely try the infoline tomorrow.
    My mental health problems started in childhood and, for me, there's a very clear difference between the lethargy that comes with depression, and this fatigue that I first experienced after the exercise classes, and still live with today.
    I'm grateful for this forum.
    Is there a list of doctors in Australia (I'm in Qld) who are competent in diagnosing ME/CFS?
    I actually see a holistic GP who "believes me", and I think would officially diagnose me.
    I remember when I told her that I couldn't hold my arms up to wash my hair she said, "that's CFS!"

    Thanks again, Zel.


  • Community Moderator

    Good luck with the infoline @ZeldaZonk 🙂

    In terms of lists of doctors, it's not appropriate to name doctors in the forum (as it might be seen as Emerge endorsing someone), but members are very welcome to contact you via the forum's "chat" system and share any names. I'm afraid I'm not in Queensland, so don't know any good doctors up there, but in the off chance it's helpful the group below might be worth a look (I'm not in it, and can't vouch for it, but it gets mentioned a bit in Facebook groups):

    Good Australian Doctors for ME/CFS/FM/EDS/POTS/Hashimotos - https://www.facebook.com/groups/287952358017187/


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