Depression is Only One Possible Cause of Long-Term Fatigue

Q:  I have been feeling fatigued for quite some time but am unsatisfied with the diagnosis of depression. This is what most physicians think I have. I don't feel depressed, I'm just tired all the time. What are some other causes of fatigue?

A:  The medical profession is routinely assailed for its alleged failure to diagnose and treat depression. Some authors quote statistics suggesting that 60 percent of patients with depression are untreated. Knowing that fatigue is a major component of depression, we tend to use that symptom as a marker to initiate anti-depressant therapy. There are screening tests (questionnaires) for depression that are not routinely used that would help to draw a better distinction.

There are many other causes for fatigue. A few of the most common include:

1. Anemia, or a low blood count, is a very common cause of fatigue. Menstruating women, those with diets lacking in vitamin B-12 and chronic blood loss from the stomach (ulcers) and intestines (inflammatory bowel disease and cancer) are just a few of the causes. A simple blood count or testing one's stool for blood are first steps in the investigation.

2. Poor physical condition is a major cause of fatigue. A body at rest tends to stay at rest. If all you do is move from one seated position to another, you can expect your muscles to weaken and that your endurance will be minimal. The only cure is regular exercise.

3. Various forms of chronic disease and undiagnosed cancers are less likely but significant causes of fatigue. Hepatitis is increasing in frequency, due to either excessive alcohol consumption or viral infections. Chronic Fatigue Syndrome is often used to explain otherwise unjustified chronic tiredness.

Often the most valuable "test" is a good discussion with your doctor that may need to occur over several appointments. A word of caution is in order on many of the dietary supplements available to boost energy. Carefully review the ingredients with a physician or pharmacist, as many contain stimulants that may have great short-term benefits but are unhealthy for long-term use.

"Your Health" provides easy-to-understand information about common health conditions.