Have you considered the perhaps part of feeling very tired physically and mentally is due to depression? I think that is what your sister is suggesting. IK don't think I'd take her advice before seeing a good therapist for an evaluation as to whether or not you are depressed and is that adding to your fatigue? Those are the questions I'd be asking, and then I'd ask if anxiety and depression are part of the problem what is recommended to do about it. I also wouldn't just accept a pill, though that may help significantly; I'd also be discussing therapy to learn how to recognize anxiety and depression and then how to deal with it on your own.

The Dr. Put me on Cymbalta about 6 months ago and it has made a big difference for me. The anxiety of being breathless when you are getting dressed etc. and having to go somewhere was just overwhelming for me. While it does not give me extra breath or anything like that, it does ease the stress that comes with COPD and going somewhere doesn't cause me to hyperventilate. You see the stress of dealing with the COPD can be very harmful and it will lead to heart problems. Do I still get anxious, of course, but it goes away and I can cope with the situation. I am on oxygen 24 7, advair, spiriva, flutecasone nasal spray, singulair, and musinex and Allegra.

I take Lexapro which is for anxiety. I believe that this keeps me mentally balanced and does not allow me to get depressed. This is a life saver for me.

I use Buspirone 5 mg twice a day..helps me..inhalers make me feel worse don’t use any now..but on oxygen 24/7 rest of my life.
Hope you find a solution, Anxiety is a terrible thing to have

Hapoloti, my apologies for focusing on just one aspect of you question. A low-dose prednisone prescription might very well help you deal with the fatigue, especially if you have felt better with prednisone for more than just the initial "boost" we get with it. That's something you might seek a second opinion on. You don't say whether your doc is a pulmonologist or not; if not, you might ask for a referral to one, and if he is, you might try another pulmo to see if the answer is the same. As you know deciding to take any med is a balancing at between the perceived benefit and the potential downsides.

I can't tell for sure, but I interpreted your response to me as knowing that depression is indeed part of the problem, and thinking that I was suggesting a pill and seeing someone may once every six months. If that's the impression I left you with, I really do apologize. My suggestion would be to find a good cognitive behavioral therapist who can help with meds if necessary, but also see you on a regular basis to help you learn how to recognize, manage and control your depression without meds if possible. I know whereof I speak: I see someone every month. She really helps me stay focused and on track. It's well worth it! If I misread your post, ignore this.