Depression

Why Does Depression Make You Tired

“I can’t seem to have the energy to do things. I’m just getting by.”

“I did not do anything much but why am I so tired?”

“I’m tired of being tired.”

Short Overview

These thoughts point to one of the core symptoms in clinical depression – fatigue. With over 95% of people with depression experiencing it, fatigue is tiredness or a loss of energy even when no physical effort is made. Depression and fatigue are connected in various ways, and here are 5 possible reasons why depression makes you tired.

1. Sleep

Depression can interrupt sleeping patterns in several ways. People with depression may experience insomnia, which is the difficulty sleeping, thus causing more fatigue during the day. It may take longer for a person with depression to fall asleep (i.e., onset insomnia) or have difficulty sleeping through the night without awakening (i.e., maintenance insomnia). But not only does the lack of sleep cause fatigue, oversleeping or excessive daytime sleepiness or sleep (i.e., hypersomnia) may also cause loss of energy over a period.

2. Stress

Having depression can be stressful. Like a vicious cycle, depression can lead to chronic stress, and stress can be a contributing factor to one’s depression. In addition to one’s personal, family, work, and social responsibilities, having to deal with a mental health condition can drain anyone’s energy level. When each of us has a finite amount of energy each day, juggling between depression and external demands can be exhausting.

3. Diet

A person’s eating habits may also be affected due to depression. You may have a poorer appetite that leads you to eat less or skip meals. On the flip side, you may have an overwhelmingly increased appetite for sweet cravings with poor nutritional value. Large amounts of processed foods, added and refined sugars, and fried foods can lead to lethargy and grogginess.

4. Brain Activity Dysregulation

Depression affects the chemicals in the brain (e.g., dopamine, norepinephrine, acetylcholine, and histamine) that influences how alert and awake a person is. Neurological research also found reduced brain activity at the prefrontal cortex in people with depression with fatigue.
As such, antidepressant medications that increases the levels of neurotransmitters play a role in managing depressive symptoms.

5. Medication

Fatigue can also be a side effect of some antidepressant medications (e.g., selective serotonin reuptake inhibitor (SSRI), serotonin–norepinephrine reuptake inhibitor (SNRI), tricyclic antidepressants (TCA). Do consult your psychiatrist if you think the medication is causing
your tiredness and disrupting your daily functioning.

How To Manage Depression Fatigue

As fatigue is found to be one of the main symptoms that severely impact our daily functioning, here are some ways that could possibly address your depression fatigue.

1. Make Effort to Get Good Quality Sleep

As depression may cause disruption in sleep, it can be helpful to develop good sleep hygiene. The following outlines several strategies to develop good sleeping habits:

  • Set a fixed time of getting up on most days, if not every day.
  • Only use the bedroom for sleep and sexual activity. Do not read, eat, or watch TV in bed.
  • Make your bedroom comfortable and free of disturbing noise and light. Insulated curtains and closing the door can help.
  • Keep room temperature moderate. A room that is too warm or too cold can disturb sleep.
  • Eat regular meals and do not go to sleep hungry. A light snack before bedtime (especially carbohydrates) may help sleep. Avoid greasy or heavy foods.
  • Avoid alcohol and caffeinated beverages in the evening.
  • Avoid daytime naps. Staying awake during the day increases chances of you sleeping better at night.

2. Practice Self-Compassion

Being kind to yourself especially in times of distress is of utmost importance, and that includes when one is experiencing depression fatigue. Self-compassion has three core components – mindfulness, common humanity, and self-kindness. In practice, you can notice that you’re having loss of energy (mindfulness), be reminded that you are not alone and as close to 95% of people with depression have fatigue too (common humanity), and be gentle and patient with yourself (self-kindness). Self-compassion can be practiced by asking the quintessential question, “What do I truly need?”, and then provide yourself that.

3. Make Effort to Exercise

It is common that having depression can make it more challenging to workout. At the same time, having a realistic and consistent exercise routine can help to reduce depression fatigue can deepen sleep. Try not to exercise too close to bedtime and plan to finish at least four hours before you sleep.

References

  1. McIntyre R, Kennedy S, Bagby RM, Bakish D. (2002). Assessing Full Remission. Journal of Psychiatry Neuroscience.
  2. Fatigue in Patients with Major Depressive Disorder: Prevalence, Burden and Pharmacological Approaches to Management. (2018). https://link.springer.com/article/10.1007/s40263-018-0490-z 
  3. Why Does Depression Make You Feel So Tired?
    https://psychcentral.com/depression/depression-and-fatigue#tips-for-coping
  4. A Harvard nutritionist and brain expert avoids these 5 types of foods that can make you ‘tired and stressed’
    https://www.cnbc.com/2022/05/14/harvard-nutritionist-and-brain-expert-avoids-these-foods-that-make-you-tired-and-stressed.html
  5. Reasons Depression Makes You Tired
    https://saltlakebehavioralhealth.com/blog/5-reasons-depression-makes-you-tired/
  6. Frank, E. &Swartz, H. A. (2011). Rules for Better Sleep.
    http://static1.1.sqspcdn.com/static/f/1238217/24590936/1395433002380/Rules+for+Better+Sleep.pdftoken=VpydPLkhoyM4VJW5WHsHnsEhW8Y%3D
  7. Definition of Self-Compassion
    https://self-compassion.org/the-three-elements-of-self-compassion-2/
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