Fatigue, like stress and busyness, has become a default state for many people. The feeling, characterized by extreme tiredness and low energy, usually occurs after an especially mentally, emotionally or physically draining experience. (Think: hectic work travel or an illness.)
But it’s not always temporary or circumstantial. Fatigue can also be a symptom of a bigger issue, like depression. In fact, fatigue occurs in over 90 percent of people living with the mental health condition, according to 2018 data. (Other signs of depression include a low mood, withdrawal and concentration issues.)
For someone to have depression, not just general fatigue, “several of these symptoms need to be present most days, for most of the day, for at least two weeks,” said Don Mordecai, a psychiatrist and the national leader for mental health and wellness at Kaiser Permanente.
Part of the reason depression and debilitating fatigue go hand in hand is because “depression affects neurotransmitters associated with alertness and the reward system,” Mordecai said. That means the illness physiologically has an impact on your energy levels.
Another reason is that depression negatively affects sleep, “whether it’s difficulty falling asleep, trouble staying asleep, waking up too early or just not sleeping as deeply,” said Sari Chait, a clinical psychologist based in Massachusetts.
Depression also takes a toll on motivation, making it physically and emotionally exhausting to carry out simple tasks, Chait said. Getting dressed for work, buying groceries or saying hello to co-workers can feel like monumental feats for someone with depression. Plus, depression can cause brain fog, Chait added, so someone who’s depressed has to expend even more energy to make decisions or focus on work.
The relationship between depression and fatigue can then become cyclical. “People with depression who push themselves to get through their day can, in turn, experience more fatigue, which can then make them feel even more depressed, and the cycle keeps going,” Chait said.
“People with depression who push themselves to get through their day can, in turn, experience more fatigue, which can then make them feel even more depressed, and the cycle keeps going.”
It’s important to remember that fatigue is “more likely to be a possible symptom of depression rather than a cause,” Mordecai said. However, being regularly tired due to chronic stress, chronic illness or a sleep disorder like sleep apnea or insomnia may make you more susceptible to depression.
“If someone is tired all the time for whatever reason, they likely are having a hard time fully engaging in their life,” Chait said. This could lead to less socializing, diminished focus at work, or changes in appetite or exercise routine, she added.
That’s why it’s crucial to take steps to improve your overall well-being, whether you’re experiencing extreme fatigue from depression or just feeling temporarily run down.
“If someone is tired all the time for whatever reason, they likely are having a hard time fully engaging in their life.”
To do this, first try to identify the root cause of your fatigue, Chait said. Take inventory of your recent habits, routine and state of mind. If you can tie your fatigue to a specific issue ― like stress, lack of sleep or sickness ― aim to start making healthy lifestyle changes.
The most critical adjustment is sleep. Most adults need at least seven to nine hours of quality sleep each night, Mordecai said. To get a restful sleep, try to avoid caffeine after noon and limit alcohol intake before bed, he advised. It’s also a good idea to stow technology before bed, since the blue light from smartphones can inhibit melatonin production and make it more difficult to fall asleep.
Next, examine your workload and calendar. If you feel stressed or burnt out, “try to set limits and make changes to make sure you aren’t overextending yourself,” Chait said. That might include saying no to social obligations and rigorous work projects, or initiating a weekly self-care practice.
Lastly, make sure you exercise a few times a week. It may seem counterintuitive when you’re tired, but “engaging in regular physical activity can ultimately lead to increased energy levels,” said Chait.
If you change your sleep, work and exercise habits and still feel exhausted after two weeks, “you should consider seeking professional help to determine if it is depression and to initiate treatment,” Chait said.
For some people, lifestyle habits ― like aerobic exercise and sleep ― can help with symptoms of depression, Mordecai said. But many other people may need a combination of treatments ― like talk therapy, cognitive behavior therapy and medication ― in addition to those lifestyle changes. And that’s more than OK. Keep in mind that it takes time to start seeing positive results, and you may need to experiment with a variety of options.
“Working with your primary care doctor or a mental health professional can get you started on a treatment path that works for you,” Mordecai said.
“Living With” is a guide to navigating conditions that affect your mind and body. Each month, HuffPost Life will tackle very real issues people live with by offering different stories, advice and ways to connect with others who understand what it’s like. In February, we’re covering depression. Got an experience you’d like to share? Email firstname.lastname@example.org.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.