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Ask Dr. K: Chronic fatigue is often a sign of depression

Dr. Anthony L. Komaroff, M.D.: Hundreds of diseases can cause chronic fatigue and depression is one of them.
BY Dr. Anthony L. Komaroff, M.D., For The Oklahoman Published: April 16, 2013

Several therapies, including medication and psychotherapy, can relieve the symptoms of depression. Lifestyle changes, such as exercise, also help.

• Medication: Antidepressants work by adjusting levels of brain chemicals that play a role in depression. Selective serotonin reuptake inhibitors (SSRIs) increase the brain's level of serotonin, which affects mood, arousal, anxiety, impulses and aggression. SSRIs are the most commonly prescribed medicines for depression.

Tricyclic antidepressants are an older class of medication. They increase brain chemicals that affect mood, anxiety and drive. These drugs are often the best choice if you have trouble sleeping.

• Psychotherapy: Therapy with a psychiatrist, psychologist or social worker can also help treat depression. Combining psychotherapy with an antidepressant is often effective.

• Exercise: A sustained exercise program can improve your mood if you have mild or moderate depression. It can also increase your energy level.

Anxiety can be treated with medications, psychotherapy or both. Cognitive behavioral therapy is especially helpful.

So in answer to your question, fatigue is a common manifestation of depression. Why depression is linked to fatigue, and what causes depression in the first place, remain mysterious. Many research scientists are spending their lives trying to find answers to those questions.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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