[40F] With chronic pain, fatigue, depression, and anxiety

What might be happening

Based on the information you've provided, it seems like your symptoms could be related to multiple underlying conditions. Here are some possible explanations:

Chronic Pain and Migraines

• Fibromyalgia: This condition often causes widespread musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. The chronic pain in your arms, neck, back, shoulders, feet, and lower back, along with fatigue and depression, could be indicative of fibromyalgia.
• Chronic Migraine: Given your history of migraines and the throbbing pain in your forehead, chronic migraines are a likely diagnosis. Chronic migraines can be debilitating and often require specialized treatment.

Fatigue, Depression, and Anxiety

• Chronic Fatigue Syndrome (CFS): This condition is characterized by extreme fatigue that doesn't improve with rest and may worsen with physical or mental activity. Your symptoms of fatigue, depression, and anxiety could be related to CFS.
• Major Depressive Disorder: Chronic sadness, crying, and difficulty performing daily tasks are common symptoms of major depressive disorder. This could be contributing to your overall sense of fatigue and anxiety.

MTHFR Mutation

• MTHFR Mutation: This genetic mutation can affect how your body processes folate and homocysteine, potentially leading to a variety of symptoms, including fatigue, depression, and migraines.

Hidradenitis Suppurativa and Other Conditions

• Hidradenitis Suppurativa: This chronic skin condition causes painful lumps under the skin, which can become infected. While it may not directly relate to your pain, it can contribute to your overall discomfort and stress.
• Obesity: Obesity can exacerbate pain, particularly in weight-bearing joints like the lower back and feet, and can also contribute to fatigue and depression.

What you can do

Chronic Pain and Migraines

• Consult a Specialist: See a pain specialist or neurologist for a comprehensive evaluation and tailored treatment plan. They may recommend medications, physical therapy, or other interventions.
• Lifestyle Modifications: Engage in low-impact exercises like swimming, which you mentioned helps. Gentle stretching and yoga can also be beneficial.
• Medication Management: Continue taking your prescribed medications (Pristiq, Xanax, Ajovy) and discuss any adjustments with your healthcare provider.

Fatigue, Depression, and Anxiety

• Mental Health Support: Consider seeing a mental health professional for therapy or counseling. Cognitive-behavioral therapy (CBT) can be particularly effective for managing depression and anxiety.
• Healthy Lifestyle: Maintain a balanced diet, stay hydrated, and get regular exercise. These can help improve your overall mood and energy levels.
• Symptom Tracking: Use MDandMe to journal your symptoms, track progress, and share insights with your healthcare provider.

MTHFR Mutation

• Nutritional Support: Discuss with your healthcare provider about taking supplements like methylated folate and B12, which can help manage symptoms related to MTHFR mutation.
• Regular Monitoring: Keep regular appointments with your healthcare provider to monitor your condition and adjust treatments as needed.

Hidradenitis Suppurativa and Other Conditions

• Dermatological Care: Follow up with a dermatologist for your hidradenitis suppurativa. They can provide treatments to manage flare-ups and reduce discomfort.
• Weight Management: Work with a nutritionist or dietitian to develop a weight management plan that suits your needs and helps alleviate some of the pain in your lower back and feet.

What you should look out for

Given the complexity and severity of your symptoms, it's important to seek medical care regularly. Here are some specific signs to watch for:

• Worsening Pain or New Symptoms: If your pain becomes more severe or you develop new symptoms, consult your healthcare provider immediately.
• Mental Health Crisis: If you experience thoughts of self-harm or suicide, seek emergency medical help immediately.
• Severe Migraine Symptoms: If your migraines become more frequent or severe, or if you experience new neurological symptoms (e.g., vision changes, weakness), seek medical attention.

Remember, while I can provide information and suggestions, it's crucial to consult with real healthcare professionals for a formal diagnosis and treatment plan. If you have more questions or need further assistance, feel free to continue the conversation.