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Easy, Excess and Early Fatigue Problem. Cause.

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Hello Sir,

I am suffering with Easy, Excess and Early Fatigue Problem.

Please see the attached document.


Category: Psychiatrist

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Thanks for posting your query at
I have gone through your question in detail and I can understand what you are going through.
If you analyze your problem you seem to have increased fatigue, reduced capacity to concentrate, taking more time than usual for getting the activity completed, reduced interest in the studies or academic work, reduce study performance, reduced memory, forgetfulness, reduced confidence, vague body aches. All these symptoms go in favour of the diagnosis of Major Depressive Disorder.
Depression can occur with regular stress and it can also occur biologically without any stress as well. Depression may be present event without a sad mood. Moreover no diagnostic test can rule out depression. You need proper treatment for the same. There are various effective therapies for depression like fluoxetine, venlafaxine, bupropion, mirtazapine or escitalopram and they are all very effective and mostly safe. You may also require some benzodiazepines like clonazepam or lorazepam for a short period like 2-3 weeks to reduce the anxiety and help with your sleep.
If you are averse to the drug therapies then there is also an option of cognitive behavioural therapy. This therapy is taken by either a psychologist or a psychiatrist in which the therapist identifies impaired cognitions (Thoughts) and try to correct them. They are 15-20 min weekly session and there should be around 8-10 sessions to help you with your illness.
You are right that it has something to do with the neurotransmitters. It cannot occur with the toxicity of the food. You dont need to stop your studies, but need to seek treatment. Yes, it can be genetically present and a bad childhood can always precipitate such symptoms.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you.

Patient replied :

sir, I referred webmd major depression will have syptoms like
Recurring thoughts of death or suicide, Significant weight loss or gain (a change of more than 5% of body weight in a month) which I dont have.
Byw, why do i have sleep apnoea attack? why do i feel the excess muscle fatigue? I used antidepressant for an year but no use ...
If I am diagnosed with major depressive disorder, what is the best treatment for it ? How we can get out of it permanently?
I thought I have chronic fatigue syndrome or adrenal fatigue as I cant bear any small stress item in my life..
Also, I am unable to wear a gold chain on my neck.. how this disease supports that symptom?

Thanks for all the follow-up details and the question.
The presentation of depression is very very variable and the presence of 'Recurring thoughts of death or suicide, Significant weight loss or gain (a change of more than 5% of body weight in a month)' is not essential for the diagnosis of depression. Feeling that the usual clothes and accessories as very heavy is very commonly noticed among people who have depression. I agree that the use of antidepressant for a year has not helped you, but that doesnt mean that you dont have depression. There are various different antidepressants and if you have not responded to one doesnt suggest that you wont be responding to any one.
The best treatment in your case, where fatigue is the major issue will be venlafaxine which starts in a dose of 37.5 mg and then gradually increased to 225mg over 1 month or so depending on the response. Further you will also require to undertake cognitive behavioural therapy along with medicines. We need to gauze the response over a period of time.
Hope this helps,
Kind regards
Dr. Srikanth Reddy MD

Patient replied :

hello sir, I used venlafaxine for 3 months but havent got any good response. Also I used fluxetine for an year. Presently my main symptom is muscle weakness. can u plz look at this article n guide me -
sir, I feel any muscle related investigations might be necessary to rule out the cause for easy, excess and fast fatigue... because I showed my case to some psychiatrists but none helped me.
Also, i am experiencing memory problem too. This is not just the routine depression case we usually see.
I will try venlafaxine but how many days treatment of venlafaxine, we can get out of this problem (fatigue, muscle pain,,,)?

Thanks for the follow up.
Sorry for the delay as there were some technical problems.
I have gone through the link that you have given. The fact is that you don't have only muscle weakness, there are gamut of other symptoms that fit you into the diagnosis of depression. Memory disturbance is a common symptom of depression and it is called as pseudo dementia. I understand that venlafaxine has not helped you. In that case you may use a combination of mirtazapine with lithium or may even consider desvenlafaxine.
Please let me know if you have any further doubts.

Kind regards
Dr. Srikanth Reddy MD

Patient replied :

ok sir. will do.
From last 10 days I am suffering with shortness of breath during rest sometimes, taking, walking also. My serum magnesium levels are 4.9mg/dl which is above the normal. What should I do ? my ECG is normal..

Thanks for the follow-up. The breathlessness at rest could be an anxiety issue and ones your depression comes down, the anxiety issue will also settle down.
The levels of magnesium 4.9 mg/dl are certainly high but if you are not having significant symptoms, I would suggest that you get the test repeated again. Manytimes mild dehydration may sometimes lead to increased levels of magnesium and hence a false result. So its advisable not to rely on a single test result and get it repeated.

Dr. Srikanth Reddy
Category: Sexologist
Doctor of Medicine (MD), Psychiatry Residency Program,2001 – 2012
M.B.B.S,Mahatma Gandhi Institute Of Medical Sciences, Sevagram

Certificate Course in sex Therapy and Counselling, Sexology and Counselling, A
Sexology,Medikon Sexual Sciences, Mumbai

Training in Advanced Neurology at a leading corporate hospital (CARE hospital) in Hyderabad

Child Psychiatry Training in National Institute of Mental Health and Neuro-Sciences, Bangalore

Sex Therapy and Counsellingat MEDIKON Sexual Sciences, Mumbai.
Dr. Srikanth Reddy and 4 other Medical Specialists are ready to help you

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