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I have been suffering form tiredness the last five years with treatment based on exercise.

Exercise is the only thing that doctors recommend me. They don't prescribe me any drug because they said that labs analysis doesn't show anything wrong.

My problem is that my fatigue is always there with my obesity and my hypertension .
I have also depression and anxiety . Is everything related ?
Do you know something that could help me with this fatigue?



Dear Ron,

You should only consider a mental health problem if a skilled doctor has not found any physical disease like moderate or severe anemia (lack of iron), diabetes, chronic disease (including kidney diseases, rheumatoid arthritis), chronic pain, severe chronic infections (e.g. hepatitis, tuberculosis, HIV) or cancer.

More than half of the patients suffering chronic fatigue syndrome suffer also from depression.

CFS (chronic fatigue syndrome) is a state of chronic fatigue, exhaustion and tiredness during the day that lasts more than six months and that cannot be explained by a physical pathogenic cause.

It is common to see depression symptoms and anxiety disorders. Due to the number and non-specific nature of these symptoms, it can be difficult to develop a differential diagnosis.

Treatment can be directed toward the most problematic symptoms as prioritized by the patient.

Acupuncture, aquatic therapy, gentle massage, meditation, deep breathing, biofeedback
-the technique of making unconscious or involuntary bodily processes (as heartbeats or brain waves) perceptible to the senses (as by the use of an oscilloscope) in order to manipulate them by conscious mental control -, yoga, tai chi and massage therapy have been found to help some patients and are often prescribed for CFS symptom management.

Research shows that CFS is not a form of psychiatric illness or depression.

However, many people with chronic illnesses, including those with CFS, may suffer from secondary depression as the patient makes the multiple adjustments to having a debilitating, chronic illness.

Although treating depression can reduce anxiety and stress, it's not a cure for CFS.

While symptom management is critical to the care of patients with chronic fatigue syndrome, it is also important for clinicians to address the emotional and psychosocial consequences of CFS.

Like other debilitating chronic illnesses, CFS can have a profound impact on daily life, requiring patients to make therapeutic lifestyle changes including adaptation to prevent life-altering limitations.

The overall treatment plan should acknowledge the limitations of this illness, and the patient’s emotional reactions to them.

While patients are justified in their emotional response to such a devastating illness, educating them about the link between stress and symptom exacerbation is an important adjunct to validating their feelings and subsequent clinical improvement.

What can you actually do to help yourself? If you cannot do all the steps below at once, then begin with one activity, then when this works, continue with another activity (one or some days later).

-Find out the causes behind your stress by keeping a diary. If you see connections between the situations causing stress, try to avoid those situations.

-Think about what is important for you in your life in the long run. Compare your life situation today with how you wish it would be and see if there is something you can change immediately.

-Try to create a normal life style: eat and sleep at regular times.

-Try to stimulate your social life (even outside work) and try to be in environments or groups where you feel appreciated.

-Spend some time on your hobbies.

-Learn to relax through meditation or yoga.

-Exercise more than a couple of days a week. Try to find a sport that suits you.


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