### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
hello. i am writing on behalf of my boyfriend whose health has been rapidly deteriorating over the past 8 months or so. He is desperately seeking answers, but is running out of the physical stamina to do so. Tonight he said he can t go on any longer and wishes to die and I just didnt know where else to turn. His symptoms are getting progressively worse and are extensive, but include extreme fatigue, cognitive deficits, headaches, dizziness, loss of appetite, nausea, shortness of breath, and a sense of unreality. He had a sleep study done a few months ago and was diagnosed with narcolepsy but didnt respond well to the medication (Zyrem). He d also had a finger amputated in December, which is approximately when he started feeling ill. He initially felt his decline in health may have been related to an adverse reaction to the anesthesia, but because his symptoms have persisted and have even worsened, and because new ones have emerged he no longer feels this is the case. We just don t know where to turn or what even to look for. He s terrified. We both are.

### output:

Hello, I passed carefully through your question and would explain that the symptoms could be related to depression or a panic disorder.  Coming to this point, I would recommend consulting with a psychiatrist for a careful mental evaluation.  Some blood lab tests are necessary too (complete blood count, PCR, ESR, vitamin D and vitamin B12 plasma levels for possible deficiency, thyroid hormone levels for possible thyroid dysfunction).  You should discuss with your doctor on the above tests.  Hope I have answered your query. Let me know if I can assist you further. 