Reasons why, when doctors suggest my #mecfs is anxiety or depression, I firmly disagree. It's not because I deny that anxiety and depression are valid and debilitating conditions. It's not because I would be ashamed to admit if I had either.... 1/
... It's not because I am delusional. It's because my mood is good in general, I feel calm in general, and there is very little correlation between my mood, mental state and physical symptoms. Here is my mood diary vs physical symptoms scores. Green is good, red is bad: 
Occasionally when my symptoms are really bad it dampens my mood. Occasionally I get anxious about accessibility issues, or upset about not having the career I would like, or having to fight to access dignified healthcare. But in general, my mood and mental state are good. 3/
I deny that my #mecfs is a mental illness, and I deny that it is perpetuated by psychological factors, simply because I have no evidence to suggest that it is. That's the reason. Not delusion, not stigma against mental illness, not "false illness beliefs", not health anxiety.
If I had any reason to believe that my symptoms were caused by mental ill health or by other psychological factors, I would not hesitate to seek psychotherapy and to discuss medication options with my doctor.
There is one psychological factor that makes my symptoms worse, which I openly admit and discuss with my doctor. That is my personality which is naturally active and motivated. It causes me to push my limits too often, which triggers PEM. But this is not a psychological illness.
Being motivated and desiring to be active are healthy and normal human traits. The limits that it causes me to surpass are perfectly normal desires, like wanting to cook myself a meal or weed the patio. Not running multiple marathons while working 80 hour weeks.
I fully acknowledge that being a naturally motivated person makes it hard for me to pace myself to the extent that living with ME demands, which is highly restrictive. That doesn't mean I have a mental illness or an unhealthy psychology. It's perfectly normal given the context.
I wish more doctors and psychiatrists would understand this about people with ME. The illness is difficult, stigma is difficult, isolation is difficult, so yes it affects our mental health. But the condition itself is not caused by mental illness.
