How to start exercise and other daily routines when severely fatigued and depressed?

Just a brief thing: don't expect to want to. Do it for a certain period of time only because you promised yourself you would and only because you really want to see whether there's any truth in the idea that things will improve through this. Make yourself do it. Allow yourself to hate it. Don't expect yourself to be raring to go. Just go through the steps of preparation, and whatever you do, don't give yourself an out. It's not "Do I feel like exercising tonight?" it's "i'm exercising tonight." If you hear yourself say "I don't feel like it," bargain. Just say to yourself, "OK, put on your exercise clothes, and then we can have this conversation again." Put on the clothes. If you still hear yourself saying "i don't want to exercise," say "Well, let's just go out the door and walk. We can talk again after we've walked for a few minutes." Bargaining and stalling work really well, because they let you complain at the same time you're actually not backing down on yourself. When you're starting a new habit you don't love it already. That comes later. Starting a new habit takes nothing but promising yourself you're doing it and then, hook or by crook, just doing it.

Can you / would you cancel your cable? I swear, when I cancelled cable you better believe I was at the gym religiously so I could watch My Stories. You mean I get to watch an hour of Project Runway AND I just banged out an hour of cardio? But seriously, if you find yourself getting sucked in to bad t.v., why not make it work for you?

i agree to double-check the lab values. optimal levels of vitamin D are much higher than the lab cut-off for abnormally low (i take 1,000IU a day and still can't quite get up to optimal levels, so your supplementation doesn't mean you're A-OK). last year i was dealing with similar fatigue issues and found a doctor who put me on thyroid meds even though my labs were normal -- just enough to keep them within the normal range but to boost them. helped me a ton, but it can be hard to find a doctor who works this way. did you get tested for mono? i had to argue to get the test since it's rare in grown-ups, and it turned out to be positive. also do you drink coffee? i stubbornly refused for a year of dealing with fatigue on the grounds that i wanted to honor my body's lack of energy, but i now accept that i'm just someone who needs caffeine to function. regarding exercise, the only thing that consistently works for me is to sign up for a fun class that i actually look forward to going to, one where there's a sense of community and people will miss me if i'm not there. similarly, of course, find a workout buddy who will be really sad if you bail. in my experience binge-eating totally fuels depression, fatigue, and lack of routine (for me binge-eating goes hand-in-hand with grazing and overlooking normal meals, while eating three sensible meals a day helps me keep other kinds of structure in my life). overeaters anonymous was my way out (of both binging and depression, actually), even though i'm an atheist. it's not for everybody but i'm happy to talk to you about it more if you're curious.

For the exercise thing: have that super supportive boyfriend help you get out and do things. I do much, much better on the exercise thing when someone's with me, saying "yes, we're planning to do this thing now." For routine stuff - I have ADHD and so rely VERY heavily on automation and timers and putting things physically in my way so I have no choice but to interact with them in my pre-planned manner. Like, my pills sit out where I'm going to eat, my toothbrush is where I would be grabbing for soap, etc. For getting myself to do things at work, this is inadvertent, but after that whole "two months off work due to a depressive meltdown" thing, I've now got scheduled meetings with my supervisor weekly, where we talk about every single thing I've been up to, where I am on all the projects I'm overseeing, etc. I also have a status board in my office, that says things like when the last time I took care of any filing, etc. I'm thinking of expanding this to my home environment, with a list of the last time I did laundry, took out the trash, etc. BUT I MUST CAUTION YOU. Your expectations may be out of sync with what you can realistically accomplish given your current limitations. Do not get sucked into the "I'm a bad person because you can't see the kitchen table under all the mail I haven't opened" trap. Remember that your home's cleanliness is as much the responsibility of whoever you're living with as it is yours. And, you may not be able to contribute as much as others could given your schedule and such. The limitations are not fun, but that doesn't mean you can ignore them, or that you should feel bad for acquiescing to them. Also do not mistake "excellent bloodwork" for "healthy." Your brain chemistry is sick right now, and that's real, and it matters just as much as a broken leg would. (I have a similar sort of situation to you - lots of struggles finding the right meds, total mess of an apartment, BMI of 41. Bipolar II, mostly depressed, always the http://en.wikipedia.org/wiki/Atypical_depression where you gain tons of weight and can't figure out why other than that you're eating nothing but carbs all the time. Feel free to MeMail if you want to talk, or join me at one of the mental-health oriented message boards out there. I'm partial to http://mentalearth.com/ at the moment.)

oh also the doctor i saw for fatigue treated me for candida yeast overgrowth, which i'm still skeptical about but i went along with it (it cleared up my dandruff, huh), and also tested my sex hormone levels and prescribed progesterone cream, and tested my cortisol levels and prescribed adrenal support supplements. i'm not suggesting you run out and do all this, just pointing out that "all your labs are normal" is not the same as "there is no medical treatment that may help you."

Sigh. This is the second time I am saying this tonight, but going on anti-anxiety/depression meds completely sapped me of all energy and basically made me narcoleptic. Going off all the meds sucked at first but ultimately put me back to normal. I never would have believed meds could be so damaging but they nearly destroyed me and truly made everything worse. As for going to the gym, here's what I did to keep up motivation at first: I announced to everyone on Facebook that I had joined a gym. Everyone "liked" it. Then I checked into the gym on Foursquare (which posts to my FB) every time I went. I am motivated to go frequently because I'll feel ashamed if people notice I'm no longer checking in to the gym. Totally weird and silly, I know, but it's working for me!

IANAD, but following up on what dawkins_7 said above, you may want to double check with your doctor that not only the thyroid levels themselves but also the TSH pituitary levels were OK, since the pituitary is the thermostat for the thyroid. What works for me with exercise might not work for you (money, space, personal preference). I ride my elliptical in my basement for 35 minutes a night, while watching movies on Netflix on my laptop sitting on a stack of heavy boxes in front of the machine, and hooked up to the audio input to the machine's speakers. The 35 minutes is picked intentionally to be about one third of a standard movie (so every 3 days I start a new movie). I only watch action movies since the fast paced scenes help distract me from the boredom of the workout. Since the machine is in my basement there's never a commute, I never have to wait until someone else finishes with the machine, I don't avoid going to the gym due to weather or because their hours aren't long enough to suit my schedule. But the up front cost was about $1100. After I do my aerobics I am often (not always) revved up enough to then follow up with some dumbbell or body weight exercise. YMMV.

The only way I can make myself get regular exercise is to do it first thing in the morning before I've had time to distract myself. I walk, I leave my house within a few minutes of waking and walk for 40 to 60 minutes. One foot in front of the other, down the street, several blocks to the park, around the park and back, I think I might be half asleep when I do it, it's like a dream sometimes. When I don't do it I get cranky and lethargic.

Ok, I would suggest for the exercise part, forget gyms, they require motivation and that’s something you don’t have (neither do I). Best advice is to find someone to do sport with (and here I’ll suggest mountain biking because it’s a sport where you have fun/adventure first and the exercise part is just a side effect, oh and you’re sitting down while doing it which takes weight off the knees). When you find the person to do that sport with, commit yourself to picking them up (I find it’s way harder to back out that way) and when you finish the ride, set a date and time for the next one (oh and join a mtb club to meet some new people as well – even though one-on-one is a way better motivator). Btw, if you have water nearby, I’ve heard that rowing is the best motivator, as if you’re part of a four person boat, you can’t not turn up, cause they can’t row with 3, and also once the 4 of you start rowing, you can’t stop in the middle of it. For the home life, go extreme minimalist, get rid of all the clutter of life, paint everything bright white and let the light in. Get lots of bins (or recycling bags) in the kitchen so you can instantly sort paper, cardboard, plastic, glass and organic stuff. If you have recycling bags then they’re easy to take to the car/recycling centre. Get a landing strip bin for the hall, so all the “crap” you bring in goes straight into it. Same with clothes washing – get various laundry bags and sort clothes when you take them off. Put away everthing except one 2 plates, 2 bowls, 2 glasses and 2 knives and forks, then washing up sorts itself out. Go minimalist on the shopping too by bingeing before you shop, so you don’t by rubbish. Cook up industrial quantities of stews, and separate this healthy stuff into freezable then microwaveable meal quantities - just add boil in the bag rice. In the evening, I’m often scavenging, but find that an apple satisfies my cravings more than biscuits/potato chips. Top tip is putting your fruit at the top of the fridge where you see it first – less good stuff goes in the fridge draws. Extreme self help? Cut through the cable TV cable (the coaxial, not the power cable) and disconnect the internet. You really don’t need it. If you can’t handle total disconnection from the net, find a program that limits computer time and automatically shuts the computer off between certain times, set up a non administrator account on your computer (so you don’t have administrative rights to uninstall the program) create very complicated passwords for the administrator account and the time limiter program, email them to your mom and delete your sent mail (PM me if interested, because I can’t remember the name of the program at the moment). Tell her you want to stop over-surfing and if you ask her for the passwords, she shouldn’t give them to you. Get a library card and go read outside in a park. Great summer evenings coming up…. For the morning routine, get an alarm clock that can wake you up with your favorite music, leave the curtains open at night so morning light streams in. Reading instead of internet games will mean you fall asleep faster and sleep better. Would you be interested in getting a happy dog to motivate you to get up and take him for a walk? Only use the bedroom for sleeping, and as I once read, if you only do one thing, make your bed. There’s nothing I can think of to get you to brush you teeth, but I hope that if you get the other stuff sorted, the teeth brushing might come along naturally. In the meantime, chew gum and eat raw fruit/veg. Flossing is also a pain, so think about getting a water jet machine and just add a drop of mouthwash to the water reservoir. This is how I'd try and deal with it. Good luck