[30F] Experiencing extreme fatigue, memory issues, and lack of motivation

Patient Description

A 30-year-old female is reporting extreme fatigue and exhaustion that has been persistent for about 2.5 weeks. The fatigue is constant, not alleviated by sleep, and is associated with a sensation of being in a fog. Memory issues have been long-standing but have recently worsened, with particular difficulty in remembering names and details unless written down. The patient also reports an increased appetite that has not been as prominent in the last few days due to overwhelming tiredness. There is a lack of motivation, described as an inability to do most tasks and a tendency to watch TV in bed when not working. The patient feels down and numb emotionally but denies any thoughts of self-harm. Additionally, there is a sensation of swelling in the feet upon waking up in the last few days, described as heavy but not red, painful, or warm. Past medical history includes migraines, anxiety, and depression, with current medications including Aimovig for migraines, birth control, and supplements (vitamin D, omega 3, triphala, and xyzal for allergies). The patient has seasonal allergies and allergies to animals and lavender but no known medication allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that can't be explained by any underlying medical condition. The fatigue worsens with physical or mental activity, but doesn't improve with rest. This condition is also known as systemic exertion intolerance disease (SEID) or myalgic encephalomyelitis (ME). Sometimes it's abbreviated as ME/CFS. The cause of chronic fatigue syndrome is still unknown.

    • There's no single test to confirm a diagnosis of chronic fatigue syndrome. You may need a variety of medical tests to rule out other health problems that have similar symptoms.
  • Depression: Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. It can lead to a variety of emotional and physical problems and can decrease a person's ability to function at work and at home. Depression can cause fatigue, difficulty concentrating, changes in appetite, and feelings of hopelessness.

    • Treatment for depression often involves a combination of medication and psychotherapy.
  • Hypothyroidism: This is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones. Hypothyroidism may not cause noticeable symptoms in the early stages. Over time, untreated hypothyroidism can cause a number of health problems, such as obesity, joint pain, infertility and heart disease. Symptoms of hypothyroidism can mimic those of depression and include fatigue, weight gain, and difficulty concentrating.

    • Treatment for hypothyroidism usually involves daily use of the synthetic thyroid hormone levothyroxine.

What you can do

  1. Schedule an appointment with your primary care provider to discuss your symptoms. They may be able to provide a formal assessment and order relevant tests if necessary.
  2. Try to maintain a regular sleep schedule, going to bed and waking up at the same time each day. This can help regulate your body's natural sleep-wake cycle.
  3. Engage in regular physical activity, which can help boost your energy levels and improve your mood.
  4. Try to eat a balanced diet, rich in fruits, vegetables, and lean proteins, to ensure your body is getting the nutrients it needs.
  5. Consider seeking support from a mental health professional, such as a psychologist or psychiatrist, who can provide strategies to help manage your symptoms.

What you should look out for

Reasons to seek immediate medical attention:

  • If you have thoughts of suicide or self-harm
  • If your symptoms significantly worsen or you develop new symptoms
  • If you experience severe physical pain or discomfort
  • If your fatigue becomes so severe that you are unable to perform your daily activities

Remember, while I strive to provide accurate and helpful information, I am not a doctor. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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11 mo ago

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People Also Ask


What are the common symptoms of Chronic Fatigue Syndrome (CFS)?

Common symptoms of Chronic Fatigue Syndrome (CFS) include extreme fatigue that doesn't improve with rest, sleep disturbances, muscle or joint pain, headaches, sore throat, and cognitive difficulties such as memory problems or difficulty concentrating.


How can depression affect physical health and daily functioning?

Depression can lead to physical symptoms such as fatigue, changes in appetite, sleep disturbances, and aches or pains. It can also affect daily functioning by reducing motivation, causing difficulty concentrating, and leading to a loss of interest in activities once enjoyed.


What are the signs and symptoms of hypothyroidism?

Signs and symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, dry skin, hair loss, muscle weakness, depression, and difficulty concentrating. It can also cause swelling in the face and extremities.


What lifestyle changes can help manage fatigue and improve energy levels?

Lifestyle changes that can help manage fatigue and improve energy levels include maintaining a regular sleep schedule, engaging in regular physical activity, eating a balanced diet rich in nutrients, and managing stress through relaxation techniques or therapy.


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