Struggling with Mental Health: Seeking Solutions for Chronic Fatigue and Anxiety - Psychiatry

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Hello, I have been feeling unwell for over three years and living in great pain.
I have consulted traditional Chinese medicine, psychiatry, and internal medicine, but there has been no improvement.
I don't understand why these treatments haven't worked.
Could you please provide me with some methods to improve my condition? Thank you.
I have been diagnosed with thalassemia and somatic symptom disorder.
I am receiving treatment for depression, but there has been no progress.
My greatest suffering comes from feeling fatigued every day, feeling groggy all day long.
When I wake up from sleep, I feel very dizzy and a bit of pain, and it takes a lot of effort to fully wake up.
After that, I gradually feel better, but I still feel tired.
In the evenings, I tend to feel more energetic.
Regarding my mental health, I sometimes feel very depressed and suddenly feel lonely, especially after going out with friends.
I also get anxious easily.
My biggest issue is that I become so nervous when speaking to others that I can't get the words out.
These are my symptoms.

kenny, 20~29 year old female. Ask Date: 2003/08/05

Dr. Lin Yanhong reply Psychiatry


Hello: Your question: Thalassemia and psychogenic depression.
There is treatment for depression, but there has been no progress.
The most distressing part is feeling weak every day, being lethargic all day long, and feeling very dizzy upon waking up, with some pain.
It takes a lot of effort to wake up, and only then do I start to feel better, but I still feel fatigued.
In the evenings, I feel somewhat more energetic.
It sounds like depression is the main issue and the biggest concern for you.
You mentioned that there is treatment, but it seems ineffective.
Have you tried several medications? Are the dosages adequate? Has the treatment duration been sufficient? Have you combined it with psychotherapy or other treatment modalities? If you cannot answer these questions, please consult your psychiatrist.
If their answers are also unclear, I suggest seeking another physician.
Depression has a 70-80% chance of improvement as long as the right medication is taken, the treatment duration is adequate, and psychological stressors are addressed.
It should not be too difficult.
Wishing you a speedy recovery.

Reply Date: 2003/08/05

More Info


It sounds like you have been going through a very challenging time with your mental and physical health. Chronic fatigue, anxiety, and feelings of depression can significantly impact your quality of life, and it’s understandable that you are seeking solutions. Given your diagnosis of Mediterranean anemia and psychogenic depression, it’s crucial to approach your situation holistically, considering both your physical and mental health.

Firstly, it’s important to recognize that chronic fatigue can stem from various sources, including medical conditions like anemia, which can lead to feelings of weakness and tiredness. Anemia can cause reduced oxygen delivery to your tissues, leading to fatigue and weakness. Therefore, managing your anemia through appropriate medical treatment, dietary changes, and possibly supplementation is essential. Consulting with a hematologist or your primary care physician about the best ways to manage your anemia could be beneficial.

In terms of your mental health, it’s good to hear that you are receiving treatment for depression. However, if you feel that your current treatment isn’t yielding the desired results, it may be worth discussing this with your psychiatrist. Sometimes, it takes time to find the right medication or combination of therapies that work for you. Additionally, if you are experiencing side effects from medications, it’s crucial to communicate this with your healthcare provider, as they may be able to adjust your treatment plan.

Cognitive-behavioral therapy (CBT) is often effective for anxiety and depression. It focuses on identifying and changing negative thought patterns and behaviors. If you haven’t tried CBT yet, consider asking your psychiatrist for a referral to a therapist who specializes in this approach. Engaging in therapy can provide you with coping strategies and tools to manage your anxiety, especially in social situations where you feel nervous.

Incorporating lifestyle changes can also play a significant role in improving your mental health. Regular physical activity, even light exercise like walking, can help boost your mood and energy levels. Exercise releases endorphins, which are natural mood lifters. Additionally, practicing mindfulness or relaxation techniques, such as meditation, yoga, or deep-breathing exercises, can help reduce anxiety and improve your overall well-being.

Nutrition is another critical aspect of managing both physical and mental health. A balanced diet rich in vitamins and minerals can support your body’s needs and may help alleviate some symptoms of fatigue. Foods high in iron, such as leafy greens, beans, and lean meats, can be particularly beneficial for managing anemia. Staying hydrated and avoiding excessive caffeine or sugar can also help stabilize your energy levels.

Social support is vital as well. It’s common to feel isolated when dealing with mental health issues, but reaching out to friends or family members can help alleviate feelings of loneliness. Consider joining support groups, either in-person or online, where you can connect with others who understand what you’re going through. Sharing your experiences and hearing from others can provide comfort and reduce feelings of isolation.

Lastly, if you find that your symptoms persist despite these efforts, it may be worth exploring alternative treatments. Some individuals find relief through acupuncture, herbal medicine, or other complementary therapies. However, always consult with your healthcare provider before starting any new treatment to ensure it’s safe and appropriate for your situation.

In summary, managing chronic fatigue and anxiety requires a multifaceted approach that includes medical treatment, therapy, lifestyle changes, and social support. It’s essential to communicate openly with your healthcare providers about your symptoms and treatment progress. Remember, you are not alone in this journey, and there are resources and strategies available to help you regain your health and well-being.

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