Hi Prudence and welcome to the forum. It is nice to meet a new member, even a tired one lol. Don't worry about the doctor. Just go in and tell it like it is. If you can go with someone who serves as an advocate and second pair of eyes and ears for you, that would be helpful. It is hard when you feel doctors are blowing you off, or downplaying your very real problems. Keep a journal of your symptoms, write down your questions and what your doctor says at each visit. If you feel like your doctor is "blowing you off" ask him or her point blank if they have ever dealt with someone with CFS before. If the doctor is not familiar with it, or thinks it doesn't exist! then he or she is not the best person for you to see.
As far as knowing when to go for help, that you aren't imagining things, other members can maybe speak better to that. My problems began when I was hit by a car, so it was very clear for me. You didn't say what symptoms you are experiencing that make you believe you have CFS, but I guess I think that if those symptoms have gone on for some time and are significantly impacting your daily life, it is important to find out what is going on. there are many illnesses that have very similar symptoms to CFS, including thyroid problems, hypotension, lupus, lyme's, fibromyalgia, and depression, as well as others.
As far as seeing a psychiatrist, suggesting that as part of a whole bunch of other testing is not a bad thing, and actually it would show your doctor was being thorough. But make it someone of your choosing. I say this becasue CFS and depression do have several crossover symptoms, and since CFS is primarily diagnosed through process of elimination, then they will see that you are covering your bases. But, the tricky part is that people see through their own set of prisms, so chances are they'll declare you depressed just for showing up. On the other hand, CFS can bring on situational depression becasue it is a depressing illness to have. What I think is clear is that many doctors and psychiatrists don't see that the underlying illness is CFS, which brings on depression, not the other way round. Anyway, I know exactly how infuriating that can be when you KNOW there is something wrong with you, but no one can tell you what so they start saying you are just cuckoo. Just stick to your guns and be clear without getting too emotional if you can help it.
Let us know how it goes, and what the doctor says. Hopefully it will be the first step in finding out what is going on with you and healing.
co-moderator CFS forum