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Anthony Bray, MD
Anthony Bray, MD, Doctor
Category: Medical
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Experience:  14 years experience in the field of Family Practice
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I am 24 and have been suffering from depression for about 10

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I am 24 and have been suffering from depression for about 10 yrs. Recently (over the past month) I have been experiencing on a daily basis incapacitating fatigue. It started off with not being able to get to sleep and generally being quite tired but now I am sleeping about 10 hours a night and without fail I have to sleep for at least a further 2 hours during the day. It's affecting every part of my life as i struggle to do daily tasks. I have been to visit my GP today who has changed my depression medication and requested blood tests. I just want to know if any body has any idea as to what could possibly be wrong? Thank you in advance Amy

Anthony Bray, MD : Hello !
Anthony Bray, MD : with the combination of symptoms that you have an under active thyroid would be high on the list as a possible culprit.
Anthony Bray, MD : Hypothyroidism is associated with fatigue, increased sleep requirement and depression....
Anthony Bray, MD : So I am sure that thyroid function tests ---TSH = thyroid stimulating factor ( low thyroid function corresponds with high number here greater than 4.5...) as well as the main thyroid hormones themselves = T4 and T3....
Anthony Bray, MD : The potential causes of fatigue are many and can include different types of problems... Your dictor's evaluation may need to progress in steps to evaluate and find the cause...

In your professional opinion do you think that worsening depression could be the cause of the fatigue if the tests come back normal?

Anthony Bray, MD : I hope this information is helpful for you! Let me know as you get results back and other information that will be of any help. Let me know too of further questions that you may have. I will be happy to get back with you.

In your professional opinion do you think that worsening depression could be the cause of the fatigue if the tests come back normal?

Anthony Bray, MD : Well - yes that is very possible. Fatigue is a common symptom of depression and so is sleep disturbances....
Anthony Bray, MD : I would be interested to know if worsening depression corresponded with you sense of fatigue?

It has done yet but it's hard to say which came first

Anthony Bray, MD : To say that if a particular batch of tests returns normal then it HAS to be from depression is an over-simplification however....
Anthony Bray, MD : Well it is common for depression to be a CAUSE of fatigue. It is also possible that something else might be the cause.... What do you take for your depression? Does your fatigue include a sense if lacking motivation? That would be a clue as to depression being more likely related to cause....

I am taking 150mg of sertraline which as of tomorrow will be changed to citalopram 20mg for a week or two to see how that goes and then increased as necessary ( GP doesn't think 20mg of citalopram will be enough)


And it's not that I am lacking motivation as I want to get out and do stuff I just literally can't because I am so exhausted

Anthony Bray, MD : the antidepressant Wellbutrin for one increases dopamine levels and norepinephrine levels--- it is helpful to help with fatigue and low motivation that may be associated with depression. It may be combined with the common SSRI class as well....

which is the sertraline and which is the citalopram or are they niether of those?

Anthony Bray, MD : I see . Ok well the sense of feeling exhausted is more open--- many possible causes and not necessarily depression... Hypothyroidism, anemia, iron deficiency, B12 deficiency, low sodium( hyponatremia) ....
Anthony Bray, MD : I would screen for CBC ( complete blood count) and inflammatory markers... Sed rate, C-reactive protein --- screens too for autoimmune disease such as lupus( ANA, Anca, rheumatoid factor)
Anthony Bray, MD : pulmonary problems such as asthma for example can cause easy fatigue with exertion in particular... Heart problems could though not seeming likely at your age .... Neuromuscular disease could present with extreme fatigue with exertion for example too...

Gp said he was going to run thyroid tests and hormone tests. I guess if they all come back ok then it would be more tests. iron came back normal recently as that was re tested after i came off my iron pills as my levels were low towards the end of last year

Anthony Bray, MD : So keep me updated if you like as you get pieces of this puzzle in... I will be happy to help you review results and follow your progress....

Can i just repond to your response when i get my results then?

Anthony Bray, MD : I see -- yes if you we're anemic or iron deficient last year then it would be important to recheck that ...
Anthony Bray, MD : Yes you may continue to reach me on this thread and that is fine! You may reach me any time regarding this or any further questions to go to my profile page and post question in. Box on that page----

Thank you for your help and I will keep you updated when I get my results.

Anthony Bray, MD : so let me know today or at later date if you have further questions! I will be happy to get back with you!
Anthony Bray, MD : Ok then that would be great! I hope that you feel better soon!
Anthony Bray, MD : Best regards,
Anthony Bray, MD : Anthony Bray MD
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