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Why Depression Makes You Tired

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You wake up in the morning, but instead of feeling refreshed, you’re still tired, as if you haven’t slept. This fatigue clings to you throughout the day, making even the simplest tasks feel like monumental efforts. And yet, you’re often brushed off with comments like “You’re just lazy” or “Everyone gets tired.” But it’s more than that. This tiredness seeps into your bones, a relentless weariness that doesn’t make sense. It’s not just physical but mental and emotional too. This overwhelming tiredness is a common, yet frequently misunderstood, symptom of depression. It’s not a reflection of laziness or a lack of effort; it’s a legitimate and challenging aspect of the condition.

The Physiological Link Between Depression and Tiredness

Depression doesn’t just reside in the mind; it brings about tangible physical changes in the body and brain that contribute to feelings of tiredness:

Neurotransmitter Imbalance and Energy Levels

The fatigue often associated with depression can be significantly attributed to an imbalance in neurotransmitters, particularly serotonin and dopamine. These chemicals in the brain are crucial for regulating mood, energy levels, and motivation.

When you’re depressed, levels of serotonin and dopamine can be disrupted, leading to a reduction in energy. This imbalance can manifest as physical and mental fatigue and overwhelming routine tasks.

The diminished energy levels can exacerbate other depressive symptoms, creating a cycle where low energy contributes to deeper depressive states, which in turn leads to further energy depletion. Addressing this imbalance through appropriate treatment can be a key step in alleviating fatigue and improving overall energy levels in those living with depression.

The Role of Stress Hormones in Depression-Induced Fatigue

Depression and stress hormones like cortisol are intricately linked, with this relationship playing a significant role in the fatigue often experienced in depression.

Chronic stress, a common feature of depression, elevates cortisol levels (stress hormone). While cortisol is essential for various bodily functions, prolonged elevation due to ongoing stress can lead to energy depletion. This hormonal imbalance not only exacerbates the emotional symptoms of depression but also physically drains your body’s reserves.

Over time, this constant state of heightened stress response can leave you persistently tired, further affecting your everyday life.

Psychological Aspects of Depression-Induced Fatigue

Depression-induced fatigue extends far beyond just a physical sense of tiredness.

  • Emotional exhaustion: The intense and persistent emotions associated with depression, like sadness, hopelessness, or a constant state of worry, can be mentally draining. This emotional toll takes up significant mental energy, leaving you feeling exhausted.
  • Loss of interest and motivation: Depression often leads to a loss of interest in activities once enjoyed, and this apathy contributes to mental fatigue. Without the motivation or pleasure to engage in activities, even thinking about starting a task can feel overwhelming.
  • Cognitive overload: Depression can lead to overthinking, rumination, and a constant barrage of negative thoughts. This cognitive overload can be mentally taxing, significantly contributing to feelings of tiredness and lack of energy.
  • Impact on decision-making: The mental fatigue that accompanies depression can also affect your decision-making abilities and concentration, making everyday choices seem daunting and exhausting.

Depression and Sleep Disturbances

The link between depression and sleep is reciprocal, with sleep disturbances being both a symptom and a contributor to depressive conditions:

Insomnia and Depression

  • Sleeplessness and mood: Insomnia is a common issue in depression. Difficulty in falling asleep, staying asleep, or experiencing restless sleep can exacerbate depressive symptoms. Lack of restorative sleep leads to worsened mood and heightened irritability, creating a challenging cycle where sleep issues and depression feed into each other.
  • Anxiety and night-time worries: Often, anxiety can become more pronounced at night, contributing to insomnia. Lying awake with troubling thoughts can further disturb sleep patterns and reinforce depressive states.

The Impact of Poor Sleep Quality

  • Non-restorative sleep: Even if you manage to sleep, you may find that you do not get the necessary rest and recovery the brain and body require, leading to fatigue and exacerbating the symptoms of depression.
  • Disruption of sleep architecture: Depression can alter the stages of sleep and the duration spent in each stage, leading to tiredness upon waking.
  • Sleep disorders and depression: Conditions like sleep apnea and restless leg syndrome, which can disturb sleep, are also linked to increased rates of depression.

Lifestyle Factors Contributing to Tiredness in Depression

Your lifestyle can also impact depression-related fatigue, often creating a feedback loop that exacerbates both tiredness and depressive symptoms:

Physical Inactivity

  • Reduced activity levels: Depression can lead to decreased motivation for physical activity, contributing to a decline in overall energy levels and exacerbating feelings of fatigue.
  • Muscle weakness and stamina loss: Prolonged inactivity can lead to muscle weakness and reduced stamina, further contributing to constant fatigue.

Diet and Nutrition

  • Poor dietary choices: Depression can increase cravings for high-sugar, high-fat, or low-nutrient foods, which results in energy spikes followed by crashes, exacerbating feelings of lethargy.
  • Appetite changes: Whether it’s a loss of appetite or overeating, both can impact energy levels.

Substance Use

  • Alcohol and drug use: It’s not uncommon for those with depression to turn to substances like alcohol or drugs, which can disrupt sleep patterns and lead to poor quality sleep, increasing tiredness.
  • Caffeine overuse: Relying on caffeine to combat fatigue can lead to disrupted sleep cycles and increased anxiety, further contributing to the cycle of fatigue.

Social Isolation

  • Withdrawal from social activities: Depression can lead to social withdrawal, reducing engagement in activities that could otherwise boost energy and mood.
  • Lack of stimulation: Reduced social interaction can lead to a lack of mental and emotional stimulation, contributing to tiredness and disinterest in daily life.

Poor Sleep Hygiene

  • Inconsistent sleep schedules: An irregular sleep schedule can disrupt the body’s natural circadian rhythms, leading to poor sleep quality and increased fatigue.
  • Environment and habits: Factors like an uncomfortable sleep environment or engaging in stimulating activities before bed can also contribute to sleep disturbances.

Coping With Fatigue and Depression

Managing the fatigue that accompanies depression involves a holistic approach:

  • Consult with health care professionals for potential medication adjustments or therapies specifically targeting fatigue in depression.
  • Engage in regular, moderate exercise to boost energy levels and improve mood. Exercise has been proven to change overall brain structure and can significantly impact physical and mental health.
  • Focus on a balanced diet rich in nutrients to enhance overall energy.
  • Prioritize good sleep hygiene to improve sleep quality and reduce tiredness.
  • Embrace any activity or technique to manage stress and enhance mental energy.
  • Create a structured daily routine to bring consistency and reduce feelings of overwhelm.

When to Seek Professional Help

Professional guidance can provide tailored treatment options and support to navigate through depression and fatigue more effectively. Immediately seek support from a health care provider when:

  • Feelings of fatigue and depressive symptoms persist despite self-management efforts.
  • Fatigue and depression significantly interfere with your daily activities, work, or relationships.
  • You notice a worsening mood, increased irritability, or feelings of hopelessness.
  • You experience physical symptoms like chronic pain or severe sleep disturbances.

Making changes to your lifestyle, especially when it comes to diet and exercise, can feel like an impossible task when you’re already grappling with the weight of depression. The idea of being proactive, of finding that sliver of motivation to eat healthily or engage in physical activity, can seem overwhelming when you’re exhausted and devoid of energy. It’s a paradoxical situation — actions that can help alleviate your fatigue might seem the hardest to undertake.

It’s OK to take small steps, and it’s OK to rest. Every small change, be it a short walk, a nutritious meal, or a regular sleep schedule, can gradually lift the fog of tiredness.

Getty image by Oleg Breslavtsev

Originally published: November 17, 2023
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