I didn't mean to cause anyone any offense in stating that a subset of patients presenting with fatigue alone will respond to antidepressants and exercise, but in my career I have seen many patients with depression, which is also a real illness and can have fatigue as a symptom, that have improved greatly with these treatments (who have returned and confirmed this, not just disappeared). Of course many with fatigue will have other underlying physical illnesses, whether currently diagnosable or not, but this is not the group I am talking about. I think part of the persistence of the belief in antidepressants and exercise as a blanket treatment for conditions featuring fatigue including ME, is due to the fact that SOME fatigued patients do benefit. If these measures had been trialled and helped NOBODY, this belief would not have arisen. The problem lies in correct identification and selection of patients. I also agree that physical symptoms even in the absence of any currently identifiable pathology should not be assumed to be psychogenic in origin, and I held this belief even before I became ill myself, having seen the very wide range of strange things the human body can do. Medical science still does have a long way to go.