I don't take anything for my fatigue. I have found that rest and/or naps are vital to my functioning and I allow myself that time to do so.

As a psychotherapist you know that fatigue and being tired are a symptom of depression. Depression is common in MS as well. Could some of the fatigue you are experiencing be depression as well.

You are dealing with a lot right now and I think it would be safe to say that mild depression is adding to you fatigue. Can you increase your anti-depressant at least for the time being? Can you take another one in addition to your current one?

As for your doc - I really don't know how he can predict your course with MS when you have only been diagnosed for a few weeks. My 1st flare was my worst, I was down for 3 months and was diagnosed as having a clinically isolated case of MS. I had one good month and then I had another flare at which time I received the definite diagnosis. And so began a year of flares every 6 weeks.

What is he basing his decision on? How did he determine that you have SPMS and/or PPMS? I was under the impression from my own research and reading that one is usually diagnosed as RRMS at first and SPMS and PPMS after there are indications of no periods of remission.

Bird and Snoopy were both correct; same ideas stated differently. Exercise is important and should be done everyday and it should be based on your limitations on that particular day. Diet, as I have found, is just as important. Although I do not fully follow it, the Swank Diet for MS has proven to be so beneficial for many MSers. I did follow it strictly for a couple of months and felt great. Then I broke down and ate some thing that weren't on the "diet" and felt worse.

Your emotional well being is important too. The more emotional you become the worse your symptoms are. The worse your symptoms are, the more emotional you become. And so the cycle continues.

Please take care of yourself. We are all here to help you along the way.