I've struggled with it on & off for about 20 years. In the last 3 years I've found Zoloft works remarkable well for me. I'd tried other SSRIs in the past but didn't get much out of them.

Also, for the fatigue, my psych diagnosed me with adrenal fatigue and put me on some vitamins and supplements. I have never felt more energetic in my life. Adrenal fatigue is a common side effect of stress and my doctor says it's really common among entrepreneurs.