Chronic fatigue syndrome is NOT the same as depression. Have you read about it? For example, CDC: http://www.cdc.gov/cfs/
Or for a personal account, Laura Hillenbrand (best-selling author): http://well.blogs.nytimes.com/2011/02/04/an-author-escapes-from-chronic-fatigue-syndrome/?_php=true&_type=blogs&_r=0
I was in a similar boat in my late teens. Came down with an unknown virus, developed extreme fatigue, was in bed most of the time, couldn't function normally. You become extremely jaded with traditional medicine and people who think 'it's all in your head' when it's a very real physical issue.
You can also become extremely socially isolated because you're unable to function like you used to, which is beyond frustrating. Family support was essential for me. Pushing someone in this situation to get out, go it alone, and fully support themselves could be a death sentence.
If your brother was diagnosed with CFS and is unable to work, he can apply for disability benefits (http://www.cdc.gov/cfs/news/features/disability.html), but would need to be working with a doctor.
Have you asked him how you can help/support him? Honestly, when I was really ill, there wasn't a whole lot except having a smiling supportive family around who realized I wasn't crazy, wanted the best for me, and helped me seek out treatment. I wish your family the best. If you'd like to message further privately, feel free.
My hesitancy to say he's diagnosed with CFS is that the doc basically said yes, since you've been fatigued for a period of more than 3 months you'd qualify for this diagnosis. That sounds to me like something that could easily be caused by depression or any other number of issues, but then classified as CFS so I'm hesitant to say he's been properly diagnosed with CFS. I also just went through the diagnosing criteria on your link, and given the 4/8 symptoms listed here -
http://www.cdc.gov/cfs/diagnosis/step-5.html - I'm now doubtful that the doctor was officially diagnosing him as CFS anyway. He maybe has the first two symptoms. There doesn't appear to be anything wrong with his memory, no pain complaints, etc.
When the issue of disability was brought up at that appointment the doc said he didn't even want to go there, that prognosis for my brother was excellent, and he wanted to see what they could do with treatment (which included the CBT, seeing a nephrologist to rule out kidney problems (he had frequent UTIs as a kid), exercising daily, taking various vitamins, and getting back into the world to recondition his over-sensitivity to the stimulation of the outside world). It was also suggested that there were drugs he could go on, but this wasn't pushed because of my brother's steadfast refusal to take any medication. He hasn't completed any of these things except that he finally saw a nephrologist last week.
What treatment did you receive? I will definitely PM you, I appreciate you offering and have a lot of questions and really want to understand my brother's perspective of things.
I too would consider whether he also has a schizo-affective disorder. Your description fits the symptoms: http://www.mayoclinic.org/diseases-conditions/schizoaffective-disorder/basics/symptoms/con-20029221
It's terrifying to even consider, but he fits almost all of these symptoms. I don't believe he's having any hallucinations, and I'm not sure that I would describe his moments of increased energy as manic, but the other 5 symptoms all fit him.
If your brother had debilitating cancer, would you be here wondering if your parents should continue paying for his essentials?
Depression is a disease. It's obvious from this thread that many still consider mental illness to be some kind of character flaw or a way to weasel out of working. Your brother is one of them.
http://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=3047
[Totori beat me to it.]
I ABSOLUTELY believe that depression is a disease, and his family is more than willing to support him in it the same way we would if there was a physical illness. This has been expressed ad nauseum to him, and only angers him. The problem is that he needs more than love and financial support, his disease (if that's what he has) needs to be treated! I look at it like a drug addiction, that he's not going to admit to the problem and get help until he's at rock bottom.
And if he's right, that he's not depressed, then he does need to snap out of the mental idea that he's incapable of exerting himself at all. As long as we're not talking about the current state of his life, he is capable of having energetic, interesting, happy conversations. In fact I think he's become very bored and lonely in his life - when we do chat he perks up momentarily and is a completely different person. Then when I have to hang up the phone it's like he flatlines. Voice goes dead, etc.
Basically the options are 1) depression/anxiety/mental disorder of some kind; 2) physical illness; 3) lazy. The first two he needs to seek medical help for, the 3rd he needs a good kick in the ass. I do not think that it's option number 3, but if he won't properly seek medical help, does he need a good kick in the ass to get him to seek medical help?
The point is not making a diagnosis here but looking at what the next reasonable steps might be given the impact the behaviours are having.
Do you have any suggestions? This issue has been the central focus of the whole family for almost 3 years now. My mom is an MD (general practice) with plenty of experience in helping patients get the help they need, but is not having any success with my brother. He sort of hates her the most as a result of her efforts. There have been various (very soft) ultimatums given to try to coax him into getting help (which is why he's seen therapists half a dozen times) but none of these have been effective. He has also been given plenty of "hands off" periods to try to sort it out on his own, but nothing has come of this. What are we supposed to do, besides loving him (we all do), talking to him, etc.?
And thanks to everyone for all of your responses. Every time I go to respond, more are posted, and I appreciate how supportive everyone is.