Fatigue: MedlinePlus Medical Encyclopedia

Fatigue is a feeling of weariness, tiredness, or lack of energy.

Fatigue is different from drowsiness. Drowsiness is feeling the need to sleep. Fatigue is a lack of energy and motivation. Drowsiness and apathy (a feeling of not caring about what happens) can be symptoms that go along with fatigue.

Fatigue can be a normal and important response to physical activity, emotional stress, boredom, or lack of sleep. Fatigue is a common symptom, and it is usually not due to a serious disease. But it can be a sign of a more serious mental or physical condition. When fatigue is not relieved by enough sleep, good nutrition, or a low-stress environment, it should be evaluated by your health care provider.

There are many possible causes of fatigue, including:

• Anemia (including iron deficiency anemia)
• Depression or grief
• Iron deficiency (without anemia)
• Medicines, such as sedatives or antidepressants
• Persistent pain
• Sleep disorders such as insomnia, obstructive sleep apnea, or narcolepsy
• Thyroid gland that is underactive or overactive
• Use of alcohol or drugs, such as cocaine or narcotics, especially with regular use

Fatigue can also occur with the following illnesses:

• Addison disease (a disorder that occurs when the adrenal glands don’t produce enough hormones)
• Anorexia or other eating disorders
• Arthritis, mainly adult or juvenile rheumatoid arthritis
• Autoimmune diseases such as systemic lupus erythematosus
• Cancer
• COVID-19
• Diabetes
• Fibromyalgia
• Heart failure
• Infection, especially one that takes a long time to recover from or treat, such as bacterial endocarditis (infection of the heart muscle or valves), parasitic infections, hepatitis, HIV/AIDS, tuberculosis, and mononucleosis
• Kidney disease
• Liver disease
• Malnutrition

Certain medicines may also cause drowsiness or fatigue, including antihistamines for allergies, blood pressure medicines, sleeping pills, steroids, and diuretics (water pills).

Chronic fatigue syndrome (CFS) is a condition in which symptoms of fatigue persist for at least 6 months and do not resolve with rest. The fatigue may be worsened with physical activity or mental stress. It is diagnosed based on the presence of a specific group of symptoms and after all other possible causes of fatigue are ruled out.

Here are some tips for reducing fatigue:

• Get enough sleep each night.
• Make sure your diet is healthy and well-balanced, and drink plenty of water throughout the day.
• Exercise regularly.
• Learn better ways to relax. Try yoga or meditation.
• Maintain a reasonable work and personal schedule.
• Change or reduce your stressors, if possible. For example, take a vacation or resolve relationship problems.
• Take a multivitamin. Talk to your provider about what is best for you.
• Avoid alcohol, nicotine, and drug use.

If you have long-term (chronic) pain or depression, treating it often helps the fatigue. Be aware that some antidepressant drugs may cause or worsen fatigue. If your drug is one of these, your provider may have to adjust the dosage or switch you to another drug. DO NOT stop or change any medicines without first talking to your provider.

Stimulants (including caffeine) are not effective treatments for fatigue. They can make the problem worse when they are stopped. Sedatives also tend to worsen fatigue.

Contact your provider right away if you have any of the following:

• Confusion or dizziness
• Blurred vision
• Little or no urine, or recent swelling and weight gain
• Thoughts of harming yourself or of committing suicide

Call your provider for an appointment if you have any of the following:

• Unexplained weakness or fatigue, especially if you also have a fever or unintentional weight loss
• Constipation, dry skin, weight gain, or you cannot tolerate cold
• Wake up and fall back to sleep many times during the night
• Headaches often
• Are taking medicines, prescribed or non-prescribed, or using drugs that may cause fatigue or drowsiness
• Feel sad or depressed
• Insomnia

Your provider will perform a complete physical examination, paying special attention to your heart, lymph nodes, thyroid, abdomen, and nervous system. You will be asked about your medical history, fatigue symptoms, and your lifestyle, habits, and feelings.

Tests that may be ordered include the following:

• Blood tests to check for anemia, diabetes, inflammatory diseases, and possible infection
• Kidney function tests
• Liver function tests
• Thyroid function tests
• Urinalysis

Treatment depends on the cause of your fatigue symptoms.

Tiredness; Weariness; Exhaustion; Lethargy

Clauw DJ. Fibromyalgia, chronic fatigue syndrome, and myofascial pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 258.

Lindemann JC. Fatigue. In: Kellerman RD, Rakel DP, eds. Conn’s Current Therapy 2021. Philadelphia, PA: Elsevier 2021:14-15.

Seller RH, Symons AB. Fatigue. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 14.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

4 Signs To Look For

Written by WebMD Editorial Contributors

• What Is Exhaustion?
• Signs of Exhaustion
• Treating Exhaustion

Feeling tired is a common experience. It can be caused by disrupted sleep habits, a change in routine, or the appearance of stressors in your life. No matter the reason, tiredness can push us to our limits emotionally and mentally. In some cases, extreme tiredness sets in. This is called exhaustion.

How can you tell if you’re tired or exhausted? Learn the signs of exhaustion and ways to prevent it from affecting your life and the lives of those around you.

Exhaustion, also known as fatigue, becomes a problem when it continues day to day, affecting your health and safety.  

Exhaustion isn’t a mental disorder. But it can be caused by anxiety, depression, bipolar disorder, neurological and sleep disorders, anemia, electrolyte abnormalities, diabetes, obesity, and/or an infectious disease or cancer.

Common reasons for fatigue could be lifestyle choices you should address. Here are frequent reasons for fatigue: 

• Alcohol or drug use 
• Too much physical activity with no rest
• Jet lag disorder
• Lack of physical activity
• Shortage of sleep
• Some medications, like cough medicines or antihistamines
• Unhealthy eating habits

Exhaustion isn’t normally a cause for concern. But it is when accompanied by: 

• Lack of physical or mental energy
• Inability to stay awake or alert
• Accidentally falling asleep, such as when driving or operating heavy machinery
• Inability to maintain or complete an activity
• Tiring easily
• Difficulty concentrating, memorizing, or maintaining emotional stability

If exhaustion starts affecting your daily life, it’s time to talk to a doctor to determine underlying causes.  

Exhaustion can impact your daily activities, especially if you’re too tired to take care of average tasks. The good news is that exhaustion is treatable; however, here are some signs that you or someone you may know is experiencing it: 

Symptoms of Depression or Anxiety

When you or a loved one is dealing with depression and/or anxiety, it can have a draining effect. 

Depression can affect your sleep cycle. It may make you unable to sleep. Or you may not be able to sleep for long periods. A lack of energy associated with depression may keep you from completing normal activities.

Anxiety can be crippling for people who experience uncontrollable worry all day long. The symptoms include irritability and extreme fatigue.

Lack of Goal Making

Exhaustion can leave you tired and without energy to set goals and stick with them. You might be able to make goals, but you’ll set them aside and be unsure of when you’ll return to them.

Lack of Concentration

Lack of concentration happens when you’re exhausted and can’t focus on a task you had started. You may have a big task to complete, but you can give it only five minutes before you become frustrated and give up.

Disconnecting Relationships

Exhaustion can lead to inability to nurture relationships. This could mean giving your children time-consuming activities so you don’t have to deal with them. Or perhaps your significant other is requesting attention you don’t have the emotional capability to give.

If exhaustion begins to leave you drained and unable to complete anything, you should talk to your doctor. They may run tests to find underlying health causes.

Determining the cause of your exhaustion will help you identify what you need to do to alleviate its symptoms. Common treatments include: 

Sleep Habits

Getting enough sleep is extremely important. Make sure you’re sleeping enough for your body to feel rested. Keep a normal sleep schedule, and go to bed only if you’re tired.

Make sure your bedroom is prepped for deep sleep — a dark room, comfy furniture, and minimal distractions. You might also try writing about your worries in a journal before bed, so you can let them go while sleeping.

Dietary Changes

Cut out caffeine to reset your body. It’s found in coffee, tea, soft drinks, energy drinks, and some pain killers and herbal remedies. After a month, take note of how you feel. Caffeine withdrawal can include headaches and irritability at first.

Physical Changes

Consistent physical activity can improve symptoms. Beginning to exercise can seem like a big obstacle if you feel exhausted, but moving for just 15 minutes a day can boost your energy levels.

Carrying excess weight exhausts your body. Eating healthier, exercising, and weight loss can improve your symptoms too.

Psychotherapy

Psychotherapy, or talk therapy, might include counseling to discuss the underlying causes and stressors in your life. These could include stress, anxiety, or low mood.

Top Picks

Wasting – Causes, Diseases, Diagnosis, Prevention and Treatment

Description

Wasting, also known as cachexia, is a condition in which the body is severely wasted and loses muscle mass, fat stores and overall body weight. This can be due to various causes such as chronic diseases, cancers, infections, mental disorders, malnutrition, or other factors that prevent the body from properly absorbing and using nutrients.

Wasting is often accompanied by a number of characteristic symptoms, including weight and muscle loss, weakness, fatigue, loss of appetite, changes in appearance (thin face, visible bones, etc.), deterioration in general health and immune function.

This condition requires medical intervention, as malnutrition can lead to serious complications and a decrease in quality of life. Treatment for malnutrition often includes renutrition and nutritional balance, treatment of the underlying disease, physical therapy, psychological support, and other measures to strengthen the body and restore its functions.

Why wasting is dangerous

Wasting is a serious condition that can have a number of dangerous consequences:

1. Weakening of the immune system: Depletion can lead to a decrease in the body’s immune function, making it more vulnerable to infections and other diseases. As a result, this can lead to increased frequency and severity of infections, as well as making them difficult to treat.

2. Organ and system deterioration: Nutrient deficiencies and loss of muscle mass, which are characteristic of wasting, can lead to deterioration in the functioning of various organs and systems of the body. This can affect the functioning of the heart, lungs, kidneys, liver and other organs, leading to serious complications.

3. Slowing down rehabilitation and recovery: Exhaustion can slow down the process of rehabilitation after injury, surgery or illness. Nutrient deficiencies and weakness complicate recovery and can lead to prolonged recovery time.

4. Impaired quality of life: Wasting is accompanied by a significant decrease in strength and energy, which can lead to limitation of physical activity and increased fatigue. This can significantly limit a person’s capabilities and worsen his quality of life.

5. Increased risk of complications and mortality: Wasting is a risk factor for the development of various complications and may increase the risk of mortality, especially in severe cases of malnutrition.

Physiological causes of wasting

Physiological causes of wasting can be related to various physiological processes in the body. Here are some of them:

1. Malnutrition: Insufficient food intake or malnutrition can lead to malnutrition. Lack of important nutrients such as proteins, carbohydrates, fats, vitamins and minerals can adversely affect the functioning of the body and lead to loss of body weight and muscles.

2. Faster Metabolism: Some people may have an increased metabolic rate, which means their bodies burn energy quickly. As a result, they may have difficulty gaining and maintaining sufficient weight.

3. Physical activity: Intense physical activity or increased physical demands can lead to increased energy expenditure and malnutrition, which can contribute to malnutrition.

4. Aging: As we age, the body may experience changes in metabolism and loss of muscle mass, which can lead to malnutrition. Decreased appetite, poor digestion, and decreased overall physical activity can also contribute to malnutrition in the elderly.

5. Pregnancy and lactation: Pregnancy and the breastfeeding period may require additional nutrients and energy, and if these are not sufficiently satisfied, this can lead to malnutrition.

Pathological causes of wasting

Pathological causes of wasting are associated with various diseases and conditions that can cause weight and muscle loss. Some of them include:

1. Cancer: Various types of cancer can lead to malnutrition. Cancers can consume large amounts of energy and nutrients, and cause metabolic changes that lead to weight loss and malnutrition.

2. Chronic Inflammatory Diseases: Chronic diseases such as rheumatoid arthritis, inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) and systemic vasculitis can cause weight loss and wasting due to inflammation, indigestion and increased energy metabolism.

3. Infectious diseases: Some infectious diseases, especially in advanced stages, can cause malnutrition. For example, HIV/AIDS, tuberculosis and sepsis can lead to weight loss, muscle mass loss and wasting.

4. Psychiatric disorders: Some psychiatric disorders, including anorexia and bulimia, can cause severe weight loss and malnutrition due to poor dietary habits, dietary restrictions, and metabolic disorders.

5. Chronic renal failure: In chronic renal failure, the functioning of the kidneys is reduced, resulting in impaired metabolism, appetite and nutritional status. This can lead to weight loss and malnutrition.

6. Metabolic Disorders: Some metabolic disorders such as hyperthyroidism, metabolic syndrome, and diabetes can contribute to wasting due to changes in energy metabolism and digestion.

Accompanying symptoms

Wasting symptoms may vary depending on the cause of the wasting and how severe it is. However, some common accompanying symptoms may include:

1. Weight Loss: Significant and involuntary weight loss may be one of the most noticeable signs of exhaustion. This may be due to loss of adipose tissue, muscle mass, or both.

2. Fatigue and Weakness: People suffering from malnutrition may feel constantly tired and weak. They may tire quickly from even light physical exertion and have difficulty performing normal tasks.

3. Loss of appetite: Wasting may be accompanied by decreased appetite and loss of interest in food. People may experience food aversion or loss of desire to eat, leading to inadequate nutrient intake.

4. Digestive changes: Some people who are malnourished may have digestive problems such as nausea, vomiting, diarrhea or constipation. This is due to metabolic disorders and insufficient nutritional status of the body.

5. Weakening of the immune system: Depletion can reduce the body’s immune function, making a person more vulnerable to infections. An increased frequency of colds, flu, or other infections can be a sign of a weakened immune system.

6. Mood changes: Exhaustion may be accompanied by mood changes such as depression, anxiety or irritability. Weight loss and malnutrition can affect the chemical balance in the body, affecting the emotional state.

7. Dry and pale skin: Inadequate nutrition and dehydration, which may be associated with malnutrition, can cause dry and pale skin.

What are the scenarios

The course of events of wasting can be varied and depend on the cause of wasting, the presence of complications and the effectiveness of treatment. Some possible scenarios include:

1. Continued wasting: If the cause of wasting is not removed or treated, the state of wasting may continue and worsen over time. This can lead to further weight loss, poor overall health, and complications.

2. Weakening of the immune system: Depletion can weaken the immune system, making a person more vulnerable to infections and other diseases. This can lead to frequent colds, inflammation and infectious complications.

3. Organ damage: Prolonged exhaustion can cause damage to various organs and body systems. The lack of nutrients and energy can affect the function of the heart, liver, kidneys and other internal organs, which can lead to their dysfunction.

4. Impaired mental health: Wasting can have a negative impact on a person’s mental health. Depression, anxiety, and other mental disorders are often associated with nutritional deficiencies and physical changes in the body.

5. Impairment of Physical Functionality: When exhausted, physical strength and endurance are reduced, which can lead to limitation of normal activities and poor quality of life. The person may experience weakness, fatigue, and difficulty performing simple physical tasks.

6. Development of pathological conditions: Wasting can increase the risk of developing various pathological conditions, such as osteoporosis, cardiovascular disease, digestive disorders and others. Nutritional and energy deficiencies weaken the body and impair its ability to cope with illness and stress.

What diseases cause wasting

Wasting (as a result of weight loss and muscle loss) can be associated with various diseases and conditions. Some of them include:

1. Cancer: Various types of cancer can cause malnutrition, as the tumor can consume a significant amount of energy and nutrients, as well as cause loss of appetite.

2. Chronic diseases: Chronic diseases such as chronic obstructive pulmonary disease (COPD), heart failure, kidney disease, and others can lead to malnutrition. This is due to the high energy consumption of the body while maintaining the function of diseased organs.

3. Infectious diseases: Some infectious diseases, especially severe or prolonged ones, can cause emaciation. This is due to increased energy expenditure to fight infection and loss of appetite.

4. Psychiatric disorders: Some psychiatric disorders, such as depression, eating disorders (eg, anorexia nervosa), or anxiety disorders, may be associated with wasting. Patients may have decreased appetite, eating disorders, or other factors affecting nutrition and digestion.

5. Chronic stress: Prolonged or repeated stress can lead to exhaustion due to high levels of stress hormones, reduced appetite and sleep disturbances.

6. Autoimmune Diseases: Some autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, or Crohn’s disease, may be accompanied by malnutrition due to inflammation, increased metabolism, and indigestion.

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Tests to be done

In case of exhaustion, it is important to conduct a comprehensive examination to determine the cause and develop an appropriate treatment plan. Survey options may include:

1. Blood Tests: Examination of hemoglobin levels, blood cell counts, electrolytes and general health.

2. Blood chemistry: Determination of the level of nutrients such as proteins, fats, carbohydrates, vitamins and minerals.

3. Immunological tests: Detect the presence of autoimmune antibodies or other immunological disorders.

4. Organ Function Examination: Includes an electrocardiogram (ECG) to assess heart activity, lung function tests to assess respiratory function, and an examination of liver and kidney function.

5. Thyroid Exam: Includes measurement of thyroid hormone levels (T3, T4, TSH) to check for possible thyroid problems.

6. Examination of the digestive system: Includes gastroenterological examinations such as gastroscopy, colonoscopy, or abdominal ultrasound to check for digestive disorders or the presence of inflammatory diseases.

7. Psychological assessment: If psychiatric disorders such as depression or anxiety are suspected, a psychologist or psychiatrist may be consulted.

Remedies

Removing exhaustion requires a comprehensive approach that includes several aspects. Here are some methods and recommendations that can help relieve exhaustion:

1. Nutrition: Proper and balanced nutrition plays an important role in the restoration of an exhausted body. It is recommended to increase the intake of nutrients, including proteins, fats, carbohydrates, vitamins and minerals. Consult a dietitian or doctor to develop an individual nutrition plan.

2. Vitamins and Supplements: Vitamin or mineral supplements may be needed in some cases, especially if you are deficient in any of the nutrients. However, check with your doctor or dietitian before taking any supplements.

3. Psychological support: If exhaustion is due to psychological factors such as depression or anxiety, psychotherapy or psychological counseling may be helpful to support emotional well-being.

4. Physical activity: Moderate physical activity can help improve appetite, strengthen muscles, and increase energy. However, before starting any physical activity, be sure to consult your doctor.

5. Treatment of the underlying disease: If malnutrition is associated with a particular disease, then treatment of this disease may lead to the removal of symptoms of malnutrition.

6. Regular sleep and rest: Good sleep and regular rest play an important role in the recovery of the body. Take enough time to rest and sleep.

Which doctor to contact

In case of exhaustion, it is recommended to consult a general practitioner (family doctor) or general practitioner. They will be able to conduct a preliminary examination, assess your general health, find out the possible causes of malnutrition and offer appropriate recommendations.

Depending on the specific symptoms and suspected cause of the wasting, your doctor may recommend a consultation or referral to specialists. For example:

• Endocrinologist, if there is a suspicion of dysfunction of the thyroid gland or other endocrine glands.
• To a gastroenterologist if there are signs of digestive disorders or abnormal weight loss.
• See a hematologist if there are symptoms related to blood disorders.
• Psychologist or psychiatrist if exhaustion is related to psychological problems such as depression or anxiety.

Your specific referral will depend on your symptoms, medical history, and results of a preliminary examination. A GP will help determine which specialist is most appropriate for your case and provide appropriate referral.

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Cachexia: symptoms, causes, treatment

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Cachexia has been known in medical circles since the time of Hippocrates. This term refers to the extremely severe depletion of the human body, complicating the course of a number of diseases, leading to death. A person has a strong weight loss, metabolism is disturbed, physiological processes slow down. Against the background of a deterioration in well-being, the mental state also changes. Regardless of the causes of the development of the disease, the manifestation of symptoms remains the same. Cachexia is mainly discussed in the last stage of serious diseases. We are talking about AIDS, oncology, tuberculosis, sepsis, severe burns, and chronic heart failure.

Disease information

Cachexia occurs due to a strong decrease in the amount of food consumed and reactive weight loss. According to statistics, about 20% of cancer patients die from this diagnosis, and not from a carcinogenic tumor. The disease manifests itself in the form of a decrease in the mass of adipose and muscle tissue. The diagnosis is made to the patient subject to a loss of body weight within 50% of the initial values ​​during the year. Such a lack of weight is considered fatal in medicine.

Symptoms of disease

The symptoms of cachexia are as follows:

• sleep disorder;
• rapid weight loss to a critical level;
• dehydration;
• disruption of organs and the immune system;
• muscle weakness;
• low blood pressure;
• mental problems;
• low skin elasticity;
• severe brittle nails;
• hair loss;
• stomatitis.

Causes of disease

Causes of cachexia disease can have the following:

• oncological diseases;
• starvation, strong desire to lose weight with malnutrition;
• endocrine disorders;
• heart failure;
• purulent processes in the body, intoxication;
• metabolic disorder;
• prolonged psycho-emotional stress;
• acute and chronic infections;
• diseases of the gastrointestinal tract;
• taking medications;
• cerebral strokes, etc.

Description of disease types

Signs of cachexia need to be known in order to have an idea about a possible change in a person’s condition. In the medical classification, there are different forms of the disease with different pathogenesis and mechanism of development. There are such types of cachexia:

• cancer;
• terminal;
• senile;
• cerebral;
• alimentary;
• cardiac;
• pituitary;
• cachechtinic;
• hypothalamic;
• anorexic.

Cancer cachexia is a common effect of an evolving carcinogenic process. It is characterized by rapid weight loss, and tumor growth occurs at the expense of the body’s resources. Terminal cachexia occurs due to malnutrition, but regardless of the causes of the disease, infections, dysbacteriosis, muscle weakness, etc. are always observed. Pituitary and cerebral cachexia occur as a result of impaired functioning of the brain. If a person seeks to lose weight, doing it abruptly and aggressively, the risk of disease is doubled. Alimentary cachexia develops precisely because of malnutrition. Such a diagnosis can be avoided if the body is not provoked.

Cardiac cachexia is characterized by a decrease in the ability of the heart muscle to provide normal blood circulation. Senile cachexia develops in old age and is accompanied by weight loss. This form of the disease is a sign of aging. The cachechtin variety is a consequence of disturbances in the body due to tuberculosis or a history of cancer. The hypothalamic form of the disease is a consequence of a violation of protein metabolism and fat transport. The diagnosis of anorexic cachexia is made to patients when there is a malfunction in the small intestine and neoplasms appear, the blood sugar level drops.

Is it possible to prevent cachexia

Cachexia is a disease that can be prevented. Prevention is the timely treatment of various pathologies and diseases. They can be the motivating factor.

Diagnosis and treatment

To make a diagnosis and analyze the patient’s condition, a number of tests and studies are prescribed:

• general clinical blood and urine tests;
• blood glucose test;
• blood test for the quantitative content of insulin;
• blood test for tumor markers;
• blood test for adrenal hormones;
• colonoscopy;
• radiography;
• fluorography;
• electrocardiogram;
• tomography.

How is cachexia treated

For the disease of cachexia, treatment is carried out in a complex manner. First of all, the doctor needs to ensure that the lack of nutrients in the body is replenished. This is a difficult task, given that patients have a disruption of the digestive tract and lack of appetite. If the patient has cancer, a high-calorie diet is of particular importance for replenishing energy. The treatment system includes different types of therapy, depending on the underlying disease. These can be antibiotics in the presence of an infection, antifungals for the treatment of stomatitis, drugs to restore digestive enzymes, and increase appetite. One of the important stages of treatment is tube feeding. To control medication, appetite, nutrition, eliminate side effects, therapy is carried out under the supervision of doctors in a hospital.

FAQ

What are the main causes of cachexia?

Cachexia is a form of severe wasting of the body. The provoking factor is various serious diseases: oncology, metabolic disorders, starvation, AIDS, tuberculosis, heart failure, gastrointestinal diseases, etc.

Which doctors treat cachexia?

Doctors treat the disease in a complex way. The main tasks are to improve the patient’s quality of life by restoring nutrition, replenishing energy levels, eliminating nausea, vomiting, dehydration, etc. Drug therapy includes antidepressants, enzymes, and steroids. A more precise form of treatment is selected on an individual basis, depending on the form of the disease and the complexity of its course.