[37F] Experiencing constant head and eye heaviness, brain fog, and mood disturbances

Patient Description

A 37-year-old female is reporting constant head and eye heaviness, rated as 7 out of 10 in severity, exacerbated by bright lights and screen use, and associated with a feeling of motion sickness. The patient has a long-standing history of brain fog, which has become constant, severely impacting concentration and task completion. There is also a profound lack of motivation and a consistently low mood, with a history of depression diagnosed in teenage years, previously treated with medications and counseling. The patient has been off antidepressants and is not currently receiving treatment for depression. Additionally, the patient experiences muscle tightness and mild pain in the neck and shoulders, possibly related to the head heaviness. The patient has a history of asthma and ADHD, currently managed with Advair, albuterol, and Adderall. There is also a history of unexplained hives treated with ice baths. The patient suspects a hormonal or thyroid issue, although tests have returned normal. Other relevant medical history includes a peanut allergy and an adverse reaction to Strattera. The patient has recently discontinued birth control and reports unexplained weight gain.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • 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. The cause of CFS is unknown, but it can be triggered by a combination of factors such as viral infections, immune system problems, and hormonal imbalances.

    • There's no single test to confirm a diagnosis of CFS. You may need a variety of medical tests to rule out other health problems that have similar symptoms. Treatment for CFS focuses on symptom relief.
  • Depression: You've mentioned that you have been diagnosed with depression in the past. The symptoms you're experiencing, such as lack of motivation, constant tiredness, and feeling hopeless, are common in people with depression.

    • Treatment typically involves a combination of medication and psychotherapy. It's important to work with your healthcare provider to find the treatment that works best for you.
  • Hormonal imbalances: Conditions such as hypothyroidism can cause symptoms like fatigue, depression, and weight gain. However, you mentioned that your tests have come back normal. It's still worth discussing this with your doctor, as sometimes symptoms can occur before your hormone levels become abnormal enough to show up on tests.

What you can do

  1. Schedule an appointment with your healthcare provider to discuss your symptoms. They can help determine the cause of your symptoms and develop a treatment plan.

  2. Try to maintain a regular sleep schedule. Go to bed and wake up at the same time every day, even on weekends. This can help regulate your body's natural sleep-wake cycle.

  3. Eat a healthy diet and get regular exercise. Even light activities like walking can help reduce feelings of fatigue.

  4. Consider seeking help from a mental health professional. They can provide strategies to help manage your depression and improve your mood.

What you should look out for

Seek immediate medical attention if:

  • Your depression symptoms worsen or you start having thoughts of suicide.
  • Your fatigue becomes so severe that you can't perform your usual daily activities.
  • You develop new or worsening physical symptoms.

Please remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago


People Also Ask


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

Common symptoms of Chronic Fatigue Syndrome include extreme fatigue that doesn't improve with rest, sleep disturbances, muscle or joint pain, headaches, and difficulty with memory or concentration. Symptoms can worsen with physical or mental activity.


How can depression affect daily life and what are the treatment options?

Depression can lead to a lack of motivation, persistent sadness, difficulty concentrating, changes in appetite or sleep patterns, and a loss of interest in activities. Treatment often involves a combination of medication, such as antidepressants, and psychotherapy.


Can hormonal imbalances cause symptoms even if test results are normal?

Yes, hormonal imbalances can cause symptoms even if test results are normal. This can happen because hormone levels fluctuate and may not always be captured accurately in tests. It's important to discuss persistent symptoms with a healthcare provider.


What lifestyle changes can help manage symptoms like fatigue and low mood?

Lifestyle changes that can help manage symptoms include maintaining a regular sleep schedule, eating a balanced diet, engaging in regular physical activity, and seeking support from mental health professionals. These changes can help improve energy levels and mood.

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