Suicidal ideation in non-depressed individuals: The effects of a chronic, misunderstood illness

Objective There is no consensus on recovery from myalgic encephalomyelitis and chronic fatigue syndrome, which has spawned debates when interpreting outcome research. Within these debates, the patient voice is often neglected. This study aimed to understand how patients conceptualize recovery – regarding the definition and possibility of recovery. Method We conducted in-depth, semi-structured interviews with 10 older (above age 50) female patients with myalgic encephalomyelitis or chronic fatigue syndrome. Data were analyzed using a deductive thematic analysis. Results Our sample viewed recovery as functioning without fear of relapse, returning to previous roles and identities, and achieving a sustained absence of symptoms. Participants expressed skepticism that reaching recovery from myalgic encephalomyelitis and chronic fatigue syndrome exists but working toward significant improvement through coping is a viable goal. Although many accepted they would never reclaim full functioning, participants continued to experience uncertainty about their future with unclear prognostic goals and limited treatment options. Discussion Recovery is more than just symptom reduction. Outcome research should incorporate well-being measures like identity, meaning and quality of life, and personal empowerment to enhance recovery definitions. When communicating treatment goals, providers might convey cautious optimism for complete symptom remission, while emphasizing that living a fulfilling life through effective coping strategies is possible.

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“…Indeed, previous research has found these circumstances are risk factors for suicidal ideation in this population. 21…”

Section: Discussionmentioning

confidence: 99%

Patients’ hopes for recovery from myalgic encephalomyelitis and chronic fatigue syndrome: Toward a “recovery in” framework

2018

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“…See Table 1 for a list of risk factors and their classification. Factors marked with an asterisk are especially relevant to ME/CFS patients, based on one study in Spain [6] and another in the United States [17]. Demographic and historical characteristics [12,18] are often chronic and not modifiable.…”

Section: Risk Factors For Suicidementioning

confidence: 99%

“…Maria's marital status, solo living situation, poor financial state, and lack of consistent social contact (whether via family, friends, or work) also place her at higher risk. In the United States, among non-depressed patients with ME/CFS, lack of resources, including social/financial support and occupational engagement, was the most cited reason (by 79%) contributing to suicidal ideation [17]. Among Spanish patients, lack of resources was linked to suicidal ideation, depression, and hopelessness [6].…”

Section: Risk Factors For Suicidementioning

confidence: 99%

“…Devendorf et al qualitatively analyzed the open-ended responses of people with ME/CFS who endorsed suicidal ideation but did not meet criteria for depression. Reduced ability to participate in daily life was a common theme, with one person remarking [17]: "When crashed, I can do nothing but lie in my bed in total agony and in silence and darkness, trying not to move-sometimes for weeks on end. So, yes, that can be distressing and depressing and make it hard to concentrate or feel hopeful.…”

Section: Risk Factors For Suicidementioning

confidence: 99%

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Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2021

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Adult patients affected by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are at an increased risk of death by suicide. Based on the scientific literature and our clinical/research experiences, we identify risk and protective factors and provide a guide to assessing and managing suicidality in an outpatient medical setting. A clinical case is used to illustrate how information from this article can be applied. Characteristics of ME/CFS that make addressing suicidality challenging include absence of any disease-modifying treatments, severe functional limitations, and symptoms which limit therapies. Decades-long misattribution of ME/CFS to physical deconditioning or psychiatric disorders have resulted in undereducated healthcare professionals, public stigma, and unsupportive social interactions. Consequently, some patients may be reluctant to engage with mental health care. Outpatient medical professionals play a vital role in mitigating these effects. By combining evidence-based interventions aimed at all suicidal patients with those adapted to individual patients’ circumstances, suffering and suicidality can be alleviated in ME/CFS. Increased access to newer virtual or asynchronous modalities of psychiatric/psychological care, especially for severely ill patients, may be a silver lining of the COVID-19 pandemic.

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“…6 Addressing such concerns will not only prevent the common problems such as burn out, undue anxiety, fear, depression, but can also decrease the rate of suicide, drug dependence and addiction among the young doctors. 7 The rationale of this study is to investigate the prevalence of stress, anxiety and depression and its relation with chronic fatigue among medical students of CMH Lahore Medical College, taking gender differences into account. Two questionnaires were used for this study.…”

Section: Introductionmentioning

confidence: 99%

Mental Health and Chronic Fatigue Syndrome: Is Mental Health the Culprit Behind Your Fatigue?

Raza¹,

Chaudhry²,

Masu³

et al. 2020

BIOMEDICA

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Background and Objective: Mental health has proved to affect the physical and emotional aspects of one's life. Appreciation of its influence on the physical functionality and efficacy of an individual may provide better treatment plans and coping strategies. This study was designed to find out the frequency of depression, anxiety, and stress among medical students at different levels of education, taking gender differences into account and its relation to chronic fatigue syndrome. Methods:This cross-sectional descriptive study was carried out from October 2017 -March 2018. Standardized questionnaire was given to 270 MBBS students of Combined Military Hospital (CMH) Medical College, Lahore. The sampling method was non probability convenience sampling. The participants gave free consent. The data was analyzed using SPSS version 23.Results: Out of the 270 candidates, 246 had fatigue. Females scored higher on both questionnaires and showed greater frequency of fatigue and mental health problems like stress [P = 0.004]. Over all mental health traits showed statistically significant association with chronic fatigue (P = 0.001). Conclusion:Frequency of chronic fatigue among medical students suffering from anxiety, depression and stress is higher as compared to normal students. Female students suffer more from chronic fatigue syndrome, depression, anxiety and stress as compared to males. Strategies to evaluate and rigorously review medical student's mental problems, and devising appropriate coping mechanisms is essential for their well-being and optimum health.

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Suicidal ideation in non-depressed individuals: The effects of a chronic, misunderstood illness

Cited by 22 publications

References 49 publications

Patients’ hopes for recovery from myalgic encephalomyelitis and chronic fatigue syndrome: Toward a “recovery in” framework

Patients’ hopes for recovery from myalgic encephalomyelitis and chronic fatigue syndrome: Toward a “recovery in” framework

Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Mental Health and Chronic Fatigue Syndrome: Is Mental Health the Culprit Behind Your Fatigue?

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