Fatigue and Depression: 7 Tips on How to Fight with Fatigue If You've Depression

Fatigue can be a very distinctive symptom of depression. Just imagine a girl named Sarah. She has been experiencing symptoms of depression for the past few months. Before she started having depressive symptoms, she would wake up at 6:00 AM daily and go for a jog. 

Ever since Sarah has been affected by depression, she barely goes for a jog. This is because she struggles to get a good night’s sleep and is exhausted even if she manages to steal a few hours of sleep. Even at work, she is drained by midday and often has to take breaks. She is too tired to go out or do anything creative. Most evenings, she just lies on the couch watching TV and retires to sleep soon. 

Imagine having a good night’s sleep. You dream of becoming the richest person in the world. The sun rises and so do you. But soon after waking up, the first wave of fatigue hits you. You realize that even after sleeping for 8 hours, you are tired. 

You might opt to go to sleep again but if you feel this every morning, there is a possibility that you are experiencing fatigue that is not usual. 

If you feel the same, stick with us throughout this article. It will help you understand the link between fatigue and depression and provide you with 7 tips to tackle it. 

What Is Fatigue? 

Fatigue is a broad term used to describe unexplained and persistent exhaustion. The lingering feeling of tiredness may effect the routine work of an individual. 

For example, if you experience fatigue, simple tasks like making a coffee or fetching the newspaper in the morning may feel like an uphill battle. Most importantly, this feeling of tiredness doesn’t go away even after a good night’s sleep. You may feel as if you have not slept at all even though you’ve got enough rest.  

Fatigue is a common symptom of many medical conditions including:

1. Medical conditions like heart disease, diabetes, thyroid disease, etc. 
2. High levels of stress or anxiety
3. Obesity
4. Lack of adequate nutrition
5. Lack of exercise

What Is Depression? 

Depression is a mood disorder that affects the way you think, act, and feel. It is characterised by feelings of hopelessness and tiredness, which may interfere with an individual's day-to-day activities. There are various types of depression, depending on the severity of the disorder. 

For example, a month ago, Akhil lost his job due to the layoffs. He had worked extremely hard to earn that job. After losing his job, Akhil isolated himself in his apartment, avoiding social interactions and neglecting his once-loved activities, such as running. This behavioral shift, coupled with a pervasive sense of sorrow and emotional numbness, highlights the profound impact of his loss on his mental health.

While a detailed assessment of a person is required to pinpoint the exact cause of depression, certain causes are common to people suffering from depression. 

1. Stressful life events like the death of a loved one
2. Genetic predisposition
3. Medical conditions like cancer, diabetes, eating disorders, etc. 
4. Alterations in the brain chemistry

The symptoms of depression can manifest mentally as well as physically. A person suffering from depression might experience low levels of energy, lack of motivation to perform tasks, and have prolonged period of sadness that causes them to close off from the world. 

Is Fatigue a symptom of Depression? 

According to the research, up to 95% of patients may experience fatigue as a symptom of depression. The primary link between depression and fatigue is the affected signalling in the brain. Signaling molecules called neurotransmitters, which are responsible for alertness are affected. The severity of the fatigue depends upon the extent of neurotransmitter dysregulation. It also depends on the sleep cycle and diet of the individual. 

Neurostimuation and How it Works?

Are Fatigue and Depression two different mental health disorders?

Depression is a mental health disorder while fatigue is primarily a physical health disorder. There can be some overlap between the two. The reason is that fatigue can be a symptom of depression. They also occur as a comorbidity and share some similar features. People suffering from depression and other mental health disorders are at a greater risk of developing chronic fatigue. 

Does Depression cause Fatigue? How are they linked?

Fatigue shows a strong association with the depressive syndrome. People suffering from depression are more likely to develop chronic fatigue. It is an endless loop and can affect your routine life severely. From a study of subjects, 73% of people with depression reported tiredness. In a study comprising 512 subjects suffering from Dysthymia, investigators reported fatigue as the most common symptom. These studies prove that fatigue is a side effect of depression. (12)

Why Does Depression Make You Tired and Fatigued?

There is no single answer to this question.  The causes of fatigue vary in everybody but certain general causes have been seen in multiple people. The physical and mental indicators help to understand why depression leads to fatigue.

These have been seen to particularly affect the energy levels of an individual. They are:

1.Poor diet:

Depression affects your appetite. While some people overeat, others may not want to eat at all. Irrespective of your appetite, anything on the extremes - may it be overeating or undereating, affects your energy levels. A study reveals that people with obesity are at a higher risk of experiencing fatigue than normal individuals. (9)

2.Neurotransmitters:

Neurotransmitters are the chemical messengers in our body responsible for emotions, alertness, and body processes. Serotonin, the “feel-good” chemical of our body affects the emotional state of our body. Serotonin, together with another neurotransmitter dopamine, plays a role in the quality of your sleep (how well and how long you sleep).

Low levels of serotonin and dopamine reduce the amount of energy in your body and also sadden your mood. Depression is a possible outcome of dysregulation of these neurotransmitters. Since there is low energy, experiencing fatigue during depression is common. 

3.Side-effects of medication: 

One of the most helpful ways to deal with depression is with medications. Medication can help lead a normal life. However, certain anti-depressants’  side effect is fatigue. Around 10-38% of people experience fatigue due to the prescribed medication. Sometimes, the symptoms of fatigue pass after certain weeks. 

4.Substance abuse:

 People suffering from depression have a high likelihood of resorting to substance abuse to self-medicate or manage their emotions and stress. It is to be noted that using drugs or alcohol as an aid to resolve depression brings along a barrage of side effects.

One of the side effects is the fatigue that is caused by substance abuse. It is often overlooked because of the impact these substances have on us. The fatigue accompanied by substance abuse can affect the quality of your sleep. It also reduces the dreaming stage of sleep which is important for memory, learning, and regulating nervous system activity and mood.

 It might help you sleep faster but it affects the quality of your sleep considerably. 

5.Excessive stress:

Stress, both physical and psychological, can also influence fatigue. Living in a constant state of stress depletes your energy levels, leading to fatigue.  Studies show that patients experiencing fatigue because of depression have a dysfunctional Hypothalamo-pituitary-adrenal (HPA) axis which is a stress response regulator. 

6.No exercise:

Exercise, though may feel like effort, is a source of energy. However, depression can take away that joy from you. People with depression may find it difficult to feel motivated or get started with some exercises. This is especially the case for people who experience fatigue - exercise, which can make one feel better, feels difficult to do. This becomes a cycle, wherein fatigue may make exercise difficult, but exercise is one important strategy to feel more energized. Breaking this cycle can help relieve both, fatigue and depression.  

7.Insomnia or hypersomnia:

Depression can disrupt your sleep cycle. Experiencing insomnia or hypersomnia is one of the most common symptoms of depression. Being awake when the brain is programmed to sleep can lead to fatigue. On the other hand, sleeping excessively increases your daytime sleeping which in turn again disturbs your routine sleeping schedule, contributing to fatigue. 

How to tell if your fatigue is a sign of depression or something else  

Everybody experiences fatigue from time to time. However, diagnosis of fatigue syndrome requires the presence of the symptoms for more than six months as well and the intensity of the symptoms should be moderate or severe for at least 50% of the time. These symptoms are Fatigue, Post-exertional malaise (worsening symptoms and function after exposure to physical or cognitive stressors), and Unrefreshing sleep. 

In many mental and physical health conditions, experiencing fatigue is common. To know whether your fatigue is a result of depression requires confirming the source of fatigue.

One should note that just because you are feeling tired does not mean you have depression. Similarly, if you have feelings of loneliness and have no energy to perform tasks does not mean that you are experiencing fatigue. It can be temporary tiredness for which an afternoon nap might just do the job.

To know for sure if your fatigue is indicative of depression, lab tests can be conducted.  It will confirm if fatigue is not a result of any other health conditions like diabetes, anaemia, or thyroid disease. Once lab tests are ruled out, clinicians can focus on assessing an individual’s medical and mental health history. Sleep studies and psychiatric examinations will confirm if you have depression or not. A mental health professional can help you with the assessment and offer a diagnosis that might help you resolve fatigue that is caused by depression. 

How to Treat Fatigue in Depression? 

If depression is the cause of your fatigue, it is important to address the depression so that the problem is solved at the root level. Currently, there are multiple therapies available to treat depression and fatigue.

1.Medications:

Anti-depressants prescribed by psychiatrists can help you treat depression and in turn, reduce fatigue. Once the effects of the depressive episode start to get better, the energy levels will bounce back. 

2.Psychotherapy:

Also known as “talk therapy”, this approach uses different ways to treat depression. There are many types of therapies currently in use to treat depression. They are:

A.Cognitive Behavioral Therapy (CBT):

Cognitive behavioral therapy (CBT) explores the links between thoughts, emotions, and behavior. It is a directive, time-limited, structured approach used to treat a variety of mental health disorders.

The therapy challenges the patients by encouraging them to set goals, maintain sleep hygiene, face their fears, and practice the implementation of tasks routinely. In a study conducted by Adamson et al., 72% of participants experiencing fatigue showed improvement in their symptoms. 

In adolescents with MDD, Cognitive Behavioral Therapy (CBT) has been explored as a treatment, with findings suggesting that a collaborative therapeutic relationship and manageable therapeutic goals are crucial for the effectiveness of CBT in fatigued individuals ^[d].

B.Mindfulness-Based Cognitive Therapy:

Mindfulness-based cognitive therapy (MBCT) is a type of psychotherapy that involves a combination of cognitive behavioral therapy (CBT), meditation, and the cultivation of mindfulness. It teaches patients to meditate and consciously pay attention to their thoughts and acknowledge them.

Using this therapy can help to bring mental clarity and provide a sense of direction for patients. The efficacy of the MBCT was tested on patients with fatigue and it revealed that an 8-week therapy plan reduced the fatigue scores in patients considerably. 

C.Interpersonal therapy:

Interpersonal therapy, also known as IPT, is an evidence-based approach to treating depression. It is an effective form of psychotherapy that focuses on improving relationships between individuals and their environment. The premise of this therapy is based on the fact that a lot of psychological problems stem from strained relationships. Resolving them might bring relief to people troubled with depression-related fatigue. 

D.Behavioral activation therapy (BAT):

Behavioral activation is an approach to mental health that involves someone using behaviors to influence their emotional state. It is quite understood that one gains motivation when their action is rewarded.

For example, you adapt a new fashion style. If you get praised for it, there are high chances that you will continue with it but if you face criticism, you might drop the idea of wearing the same clothes again. 

Encouraging behaviors can improve motivation and push people to overcome their difficulties. They can come out of their inertia and work to their full potential. BAT has been used in many clinical settings to treat fatigue. It has been used to break the vicious cycle of depression and fatigue. Research showed that BAT successfully reduced the effect of fatigue in patients who received 5-week-long treatment sessions. 

3. Other therapies:

Besides these, there are other therapies like Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Integrative and holistic approaches (e.g., exercise, nutrition). Apart from these therapies, home therapies can also be quite useful. 

Therapies like:

1. Guided imagery
2. Meditation
3. Exercise
4. Herbal remedies
5. Acupuncture
6. Music therapy

We've covered Neurostimuation and How it Works? and tDCS

7 Tips on How to Fight Fatigue if You Have Depression

1. Talk to a mental health professional:

If depression is at the core of your fatigue, consulting a mental health professional can be helpful. They can help you resolve issues at the root level and also help you work through difficult emotions get too hard. Depending on the severity of depression, one may benefit from psychotherapy, medication, or a combination of the two. 

2. Exercise:

Exercising doesn’t only mean hitting the gym and following a strict schedule for performing squats. We understand that fatigue during depression makes simple tasks difficult. Getting short bursts of movement daily can help you build endurance. Research shows that even simple movements can improve your mood. 

Activities like gardening, cleaning your house, fetching groceries, and taking the stairs instead of a lift might also help improve your mood.

3. Get a good night’s sleep:

Developing a sleep routine is extremely crucial when you are experiencing fatigue. Make sure to keep these points in mind:

1. Have fixed sleeping and waking times
2. Make sure that your surroundings are dark and comfortable
3. Do not use electronic devices such as laptop, mobile, or TV before sleeping.  

4. Eating nutritious food:

Depression can disrupt your eating habits. Eating nutritious food that boosts your energy can help you reduce your fatigue. This includes consuming food that has more protein, unrefined carbs, green vegetables, healthy oils, and whole-grain food. Instead of taking three big portions of meals in a day, try incorporating small snacks in between to maintain the amount of food intake.  (10) (11)

If you are somebody who does not feel hungry when your mood is low, try to take one step at a time. Eat in small portions but do eat. Even if you do not feel like it. It might seem like a big task initially, but you will realize that your energy levels will improve once you start to consume the required amount of healthy food at the correct time. 

5. Manage your stress:

Stress is a contributing factor to the manifestation of depressive symptoms including fatigue. Taking too much stress might drain your energy more than normal if you have depression. 

You can take active steps to manage your stress. Relaxation and grounding practices practising breathing exercises, journaling, meditation, etc. can provide a buffer against some of the ill effects of stress. 

6. Connect with your family/ friends:

Research shows that connecting with your loved ones can reduce depressive symptoms and improve the scope of treatment. 

7. Learn a new hobby:

Trying something new or something that you’ve been wanting to do for a long can motivate you to get out of the slump. This hobby can be anything that motivates you to do better. 

Pick up that guitar, learn that new dance routine, paint your thoughts, write your heart out, or even learn a new skill for work. Once you realize that working doesn’t drain as much energy as you feel it does, you will feel energized and motivated to move forward. 

8. Online therapy options:

If you feel that reaching out to a person upfront is too overbearing, you can opt for consulting a doctor online. Consultation and counselling sessions can be provided. These sessions can help you to get started with your healing journey. May it be fatigue or any other problem, you can rely on doctors to help you out. 

Mave Health has a strong team of extremely skilled doctors to help you through your problems. If you are experiencing chronic fatigue, depression, or tiredness, you can always seek help via the consultation calls available to people online.

When to Consult your Mental Health professional

Depression can take a big toll on your health and relationships. Since fatigue might be a warning of depression, you must stay alert and observe your behavioral patterns and energy levels. If you find yourself tired even after a good night’s sleep or you have problems falling asleep, it might be indicative that your body needs extra attention. 

If your body is working fine physiologically, and the fatigue symptoms persist for more than two weeks, you must consider consulting a mental health professional. They are equipped to help you guide step by step and become a shoulder to lean on. 

Conclusion:

Though fatigue is the most visible symptom of depression, people often disregard it because of the lack of understanding of depression or its effects. Your low energy levels or inability to uplift your mood can be a sign of depression so do not let it go unnoticed. With the help of numerous modern-day therapies and other interventions, you can feel more motivated and energized to carry on with your routine life. With the right support, treatment, and consultations, you can find your way out of this problem. Just remind yourself that you are not alone in this journey and that life is meant to be colorful and energetic with lots of self-love.

REFERENCES:

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4. Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT. 2013;6(9):579-585. 
5. Behavioral Activation - an overview | ScienceDirect Topics [WWW Document], n.d. URL (accessed 6.4.24).
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8. What is Cognitive Behavioral Therapy?
9. Cross-Sectional Relationship of Reported Fatigue to Obesity, Diet, and Physical Activity: Results From the Third National Health and Nutrition Examination Survey 
10. Is it better to eat several small meals or fewer larger ones?
11. Understanding nutrition, depression and mental illnesses 
12. Delineating psychopathologic clusters within dysthymia: a study of 512 out-patients without major depression