PHQ-9 Screening: “ Little interest or pleasure in doing things?”

I can empathize having energy in my brain to do things, but body is physically weak and unable to move from extreme weakness. It's an awful feeling. I think it's far easier for doctors to dismiss symptoms in challenging cases and easy to give up. But, as patients we are stuck with physical pain and relentless fatigue doctors can't measure Finding abnormal lab results with clear abnormalities they can't ignore and dismiss, keep searching. Don't give up trying to get answers, find new doctors. After 3 years of nerve torture, I saw a new provider who was more familiar with severe illnesses and complex cases was most helpful. I found out i have elevated EBV levels and don't have more than just lab results, I will find a doctor who will help. I can't give up trying to get my life back

I’m glad to hear you’re finding help with a new provider. My first appointment with a new LC clinic is next week. I wasn’t aware that EBV are measurable - I had asked my PCP about it a while back and she didn’t know of any tests.

I just completed my second affidavit for my third and final short term disability appeal. Here are some of my bullet points concerning doctors dismissing symptoms:
- Because standard tests typically return normal results, medical personnel may question the legitimacy of the debilitating fatigue experienced by people suffering from ME/CFS and Long Covid. Consequently, many patients are misdiagnosed with other conditions, such as depression and prescribed inappropriate treatments, such as cognitive-behavioral therapy (see Appendix F: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Essentials of Diagnosis and Management).
This has been my experience with the my current LC clinic.

- Women are affected by ME/CFS at a rate 3 times that of men, and an estimated 63.2% of individuals with Long COVID are female. (Estimated Global Proportions of Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters Following Symptomatic COVID-19 in 2020 and 2021. JAMA. 2022;328(16):1604–1615. doi:10.1001/jama.2022.18931)
- Per the Katz Institute for Women’s Health, women’s health concerns are continually blamed on stress, hormones, and even imaginations.

To anneb22 - I feel your anger and frustration. Here’s my take on all this. Yes, I am depressed! I’m a 78 year old, previously healthy, active senior who got mild case of COVID in Feb. 2023. Got all my shots and took the Paxlovid treatment. Since then, I’ve had severe pulmonary, cardiac and GI issues. When I was at my worst, I thought I wanted to die - I couldn’t imagine feeling the way I did for my remaining years. I mourn the loss of the person I used to be. I’ve lost all joy in doing the things I used to love - eating, traveling, swimming because, like you, I was physically unable to do those things anymore. My docs are understanding but haven’t been of much help so I’ve had to mostly advocate for myself. I was prescribed escitalopram (Lexapro) and was resistant to taking it but I read a study that suggested SSRIs like escitalopram may help in reducing inflammation. So I continue taking it along with Benadryl and Famotidine. It may be helping my anxiety and insomnia. I’m slowly getting better but have come to accept I will probably not get back to my old self. Also, I think depression is quite normal in people who have struggled with horrible physical issues for so long.

A Mt Sinai Long Covid paper on HOW to set up a LH clinic says: Long Haul is not a mental health problem ( although mental health issues can occur as a result of dealing with illness).

[of interest to me: the rec. for Long Haul clinic states it should NOT be run by a mental health professional ]

The Mt Sinai long covid
providers I have seen are not mental health providers. They attempt to treat symptoms with latest research and newest treatments. My providers at MS have been helpful. I think program at MS evolves over time with LC .

I do find drs like to blame symptoms in stress when they can't figure it out.

I see long Covid doctors too often for cognitive rehab. I started with a therapist and psychiatrist and it helps. I am also diagnosed and treated as clinically depressed after over a year of Covid struggles and trying to accept it has become a disability and I have to adapt. Like losing a leg, I need to get to a new normal.

Yes. Ten minutes into the Intake interview at the LC clinic, a *social worker* said I needed psychiatric care. The case worker later relayed this to my PCP, via VM, and since then my PCP has lost all interest in treating me.

That’s awful! I’m so sorry you have to go through this. Are there any other medical options for you where you are?

Understood about your frustration but these are tools they use to assess based on other medical models. Be patient with care providers and yourself. They will need to rule out many things before they truly understand.