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

### input:
I am 17 years old. I have major depressive disorder. I get headaches almost everyday (not my eyesight). I am ALWAYS tired. I do have a history of anemia but whenever I get blood tests now my iron level is fine. I also used to have low blood pressure but that is also fine now too. I am taking pristiq (for my depression). Ive been on it for almost a year now. i used to take iron pills and I currently also take birth control to regulate my periods. Recently (for the past month) every time i stand up and start walking I cannot see for a second or so and then i can only see through the centre of my eye for another next few seconds (the perimeter of my vision is black). my eyesight is very unfocused and i get very dizzy everytime i stand up. it focuses and im fine after about 5-7 seconds. Another problem I have (and have been having for years now) is trouble breathing. Every second of the day I feel like something is in my chest and throat blocking my breathing. I take a deep breath every minute or so and that lasts me till the next deep breath. i dont know if that makes sense or is even possible since im still alive but my mum doesnt really take me seriously. however, im constantly having breathing problems, heart aches and my doctor says its because of depression. i literally feel like my throat is blocking air from going in and coming out but i know its obviously not. I am tired all 24 hours of the day and i have no motivation to study for university, no energy and no concentration. whenever i try to concentrate my head hurts (I learnt that after trying a concentration meditation exercise. it just made my head hurt and didnt help my breathing). thanks. sorry for the long message..

### output:

! I have read your question carefully, and must say that it is very well written. From what you wrote and from my clinical experience, I can say that you have symptoms of lethargy, depression, breathing problems (most probably due to anxiety), visual problems. You used to be anemic but now fine. Now, according to me - you have two sets of problems ---1. Psychological and 2. Organic. The psychological or psychiatric illness looks like combination of anxiety and depression. You have been on desvenalafaxine (prestige) but looking at your symptom profile, I must say that it is not working at all. Had I been treating you, I would have gone for some other Chat Doctor. ...there are many better and effective choices available, which also donor carry any major side effect. Second problem is organic / physical problem. It looks like that you have postural hypotension, as you feel almost black out, dizziness occasionally, and weak. Every time you get up, you take few minutes to gain some balance. You need to get some test done like-blood pressure reading both sitting and lying down position, thyroid, hemoglobin.  They would check the cause behind this symptom. Your breathing difficulty and heart aches is actually due to psychiatric problems, as your doctor says. I can understand that you really problem in breathing and you feel choked, but it has a psychological basis rather than physical one. Such breathing problems are frequently seen in such patients in our clinic. With proper medicine this will certainly go away. ### You could not proceed with medication as it needs a silent state of mind, and it is not concentrating on something.....meditation is relaxing....when you have so many issues, you have breathing difficulty, etc., how can you relax? This result in strained meditation and there is headache....ok, so first get better with 