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A 38-year-old woman comes to the office due to an 8-month history of fatigue and difficulty performing work-related tasks. The patient works as a cashier and is unable to stand for a long time due to exhaustion and muscle aches. After unloading stock, she feels tired and has no energy for hours. The patient tries to rest at home after her shift but doesn't think this helps. She gets 7-8 hours of sleep a night but awakens feeling unrefreshed. Other than a viral infection 3 months ago, the patient has been in good health and takes no medication. She does not use tobacco, alcohol, or illicit drugs. She has no depression or anxiety. Family history is significant for hypertension in her father and depression in her mother and brother.
Vital signs and physical examination are unremarkable.
Laboratory results, including complete blood count, comprehensive metabolic panel, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, TSH, and rheumatoid factor, are negative.
Which of the following is the most effective treatment for this patient's symptoms?
Fundamentalists
Individuals or groups who strictly adhere to any set of basic ideas or principles, often used in the context of religious fundamentalism with a literal interpretation of sacred texts.
John Scopes
John Scopes was a high school teacher in Dayton, Tennessee, who was charged in 1925 for teaching evolution, leading to the famous Scopes Monkey Trial.
Theory of Evolution
A scientific theory that explains how species evolve over time through natural selection and genetic variations.
Patronizing Casinos
The act of visiting casinos to gamble, which can contribute to local economies but also raise concerns about promoting gambling addiction.
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