Conversation: The conversation between human and AI assistant.
[|Human|] I have CHF along with Past episodes of blood clots to my lung, i am 45 and have type 2 dieabtes, my heart surgury was about 7yrs ago. i have lost about 60lbs in the last 1 and a half. lately i have not been able to focus and stay awake, i am very tired all the time and have little to no energy. i have sleep apnea and i sleep fine but after about a hour awake i feel i could go back to sleep. i have a history of bi-polar OCD PTSD and anxiety and i dont feel depressed just no energy, i eat a fairly good diet and get plenty of exercise but it is very difficult to get motivated. please give me some direction to feel better
[|AI|]  Hello thanks for asking can understand your concern. First I'd like to tell you that a lot of individuals with chronic illness develop worsening of depressive symptoms. You have CHF and been diagnosed with OCD, PTSD and anxiety in the past. Persistent depression could be the reason for your symptoms. But some nutritional deficiencies like vitamin D deficiency, vitamin B12 deficiency could also cause similar symptoms, so the levels of these vitamins should be checked. Get your vitamin D and B12 levels done to rule out any deficiency and if these levels come normal then the persistent demotivation, reduced energy, fatigue are due to depression. Modafinil or Armodafinil can be utilized to improve the fatigue and tiredness. If depressive symptoms persist then talk to a psychiatrist for help. Thanks and Take care