I've had crushing fatigue, disordered sleep and brain fog for over 20 years. I believe dermatitis [severe at first, now persistent and hard to keep under control] to be the "stressor" Martin Pall talks about, or the "fuse blower" you do.
Does this sound likely?
The dermatitis is likely to be simply one more symptom of an underlying process contributing to the fatigue, rather than the cause. I would see what the dermatologist says, and do the SHINE option. My assistant and I do phone consultations, which you may want to consider as well (you can email firstname.lastname@example.org for more information or to schedule a consultation).
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of eight research studies on their effective treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia From Fatigued to Fantastic! and The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.