Although the causes of fatigue may be physical, the effects are psychological. In fact, depression not only causes fatigue but is also caused by it. Dean said he has had good days and bad days. On the good days, he has more energy. After a rough night and diarrhea, he will be tired the next day: he said, “Those are the crying days.” “Fatigue is my son’s biggest obstacle,” said June. “He sleeps 18 hours. By ten in the morning, he’s done. He says to me, ‘Why aren’t I beating this?’ I don’t think he could get through a work day. He loses motivation and courage. Sometimes he stops caring for himself, stops eating. He’s too tired to eat.”     Another psychological effect of fatigue is irritation. Lisa Pratt’s husband “had always been a go-getter,” she said, and resented his fatigue. “For my husband,” Lisa said, “AIDS was a series of little deaths. He had to give up little things he liked because he had no stamina. For years, he had been an actor in our local community theater. After he got AIDS, he couldn’t keep up with the rehearsal schedule and thought he was going to have to quit. It hurt to not go. And it made him mad to give in.” Dean said that until he learned to pace himself, he regularly worked fourteen hours a day running a small newspaper, came home angry, then “got the blues.”
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