The level of occlusion of your carotid arteries may have produced the stroke like symptoms you had in the past, possibly a transient ischemic attack (TIA). However, this is not likely to fully explain your present symptoms of progressive fatigue. TIA's would also not show anything on scans (MRI, CT or SPECT), unless a full blown stroke was completed.
I believe that you and your doctors should take a multidimensional approach in the treatment of your depression. Drugs like the SSRI's are only one aspect of the treatment and it is important to have a sociological approach to it (like peer groups or support groups). Depression can indeed cause sensation of severe fatigue that is very hard to explain.
Regards and God bless.
I was diagnosed with carotid stenosis about 40 per cent of the artery, i am so worry about it, and, i want to know how dangerous its 40 per cent narrowing would be and which threatment is better. I am feeling so fatigued after excersicing and I had a brain stroke last year during the cerebral arteriography, it caused to me force lost from the right side of the trunk, disartria and propioception alteration. Now I am doing therapy, but just until now I had the doopler carotid image, then the next week I wil consult the physician. Please tell me what you know about. Thanks