Unless you’re living with depression (AKA major depressive disorder), it can be hard to understand just how all-encompassing it can feel. Those who are suffering understand that depression isn’t just another word for “sadness,” or a passing emotional state. It’s an extremely challenging—and exhausting—condition.
There are many reasons depression can make you feel tired: from chemical changes in the body to side effects from certain treatment options. Here, we explore depression and exhaustion in depth—including exactly how to boost your energy stores if you’re struggling.
If you’re dealing with depression, there are many reasons for the fatigue you may be feeling—from lack of sleep and poor sleep habits to hypersomnia, poor diet, and chemical imbalances.
Your brain is constantly releasing neurotransmitters—chemical messengers that control your body processes and emotional states. Three major neurotransmitters that contribute to your mood and functionality are dopamine, norepinephrine, and serotonin. These neurotransmitters play an important role in your mood, energy and alertness.
Researchers have found that in people with major depressive disorder (MDD), levels of these three neurotransmitters are out of balance. This imbalance is thought to contribute to the extreme fatigue and lack of energy that people with depression often feel.
Depression is known to affect appetite levels—for some people, this means eating less or not at all. For others, it might mean eating more, particularly if depression triggers “emotional eating,” or the tendency to overeat in response to negative emotions.
Whether your mental health condition is causing you to eat more or to eat less, having any type of imbalanced diet can negatively affect your energy levels and lead to exhaustion.
Depression and stress are inextricably linked—in fact, researchers have long studied the role of stress in causing chronic depression. Unfortunately, living in a state of chronic stress can also quickly deplete your energy levels, leading to physical symptoms like tiredness.
One of the most effective ways to control the symptoms of clinical depression is with medication. Unfortunately, all medications come with the potential for side effects, and a common side effect of many antidepressant medications is fatigue.
If you’re taking a medication to control your depression or another medical condition and are concerned about the side effects you’re experiencing, speak with your prescriber. For many people, fatigue is a common symptom early on in their course of treatment. Sometimes it passes after several weeks.
Those living with depression are at an increased risk of substance use disorders. Sometimes, people with depression turn to substances like alcohol or drugs to self-medicate, which can cause or exacerbate a substance use disorder.
Substance use disorders can also heighten many of the symptoms of depression, including fatigue, and make traditional depression treatments less effective.
If you’re dealing with so-called “depression fatigue,” there are some self-care strategies you can use to help improve your energy levels.
You may have heard the phrase “good sleep hygiene” before—basically, it’s any routine or environment that promotes consistent, peaceful sleep. For example, setting up a regular sleep and wake schedule and avoiding screens, alcohol, caffeine, and large meals or lots of fluids for a set period of time before bed can all help contribute to deeper, more restful sleep.
Using your bed only for sleep can also help you get a good night’s rest. Over time, your brain will come to associate lying in bed with sleep rather than mentally stimulating activities like reading, scrolling your phone, or even ruminating. If you find yourself lying awake at night, get up or move to the couch until you feel sleepy enough to go back to bed.
If this feels like a big ask, start with one change—like going to bed and waking up at the same time each day—and build from there.
Everyone’s sleep needs vary, but most experts agree that between 7 and 9 hours of sleep a night is appropriate for optimal mental and physical health.
We’ve long known that exercise is protective against depression. Plus, physical activity is energizing: the more you exercise, the better your muscle cells get at producing oxygen which can have a positive impact on your energy levels.
If you’re not already working with a qualified healthcare professional to manage your depression and related fatigue, it’s a critical first step in managing your symptoms. A healthcare professional, like a psychiatrist, will take a comprehensive history of your symptoms and offer a diagnosis. Getting a diagnosis can feel scary, but it can also feel validating to finally put a name to what you've been experiencing. Your psychiatrist will help you navigate any emotions that come up and work with you on a path to move forward.
Antidepressant medications fall into several categories based on their exact mechanisms of action, but they all generally work by affecting the levels of certain neurotransmitters—including serotonin, norepinephrine, and dopamine. This can help stabilize your mood.
A commonly prescribed class of antidepressants are SSRIs (selective serotonin reuptake inhibitors) and SNRIs. These include Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Lexapro (escitalopram), Celexa (citalopram), Effexor, Cymbalta, and Pristiq.
Most of these medications take several weeks to reach full effectiveness, and not all are appropriate for everyone with depression. All medications have a variety of side effects even as they improve symptoms of depression. There are also alternate classes of antidepressants that may be recommended depending on your specific needs. That’s why it’s so important to work with a qualified healthcare provider who can respond to the specifics of your condition as well as your body’s response to different treatment options.
With Talkiatry, you can see a psychiatrist from the comfort of your home, and you can schedule your first appointment in a matter of days. To get started, take our free online assessment, to see if Talkiatry is right for you and get matched with a psychiatrist.
Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, depression, trauma, ADHD, and more. Get started with a short online assessment.
The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
Dr. Glenn Occhiogrosso is board-certified in Adult Psychiatry and Addiction Psychiatry. He has been practicing in New York City for over ten years and is a lifelong New Yorker.
Dr. Occhiogrosso earned his medical degree from SUNY Downstate Health Sciences University in Brooklyn. He then completed his residency and an Addiction Fellowship at Mount Sinai Beth Israel in Manhattan.
After completing his fellowship, Dr. Occhiogrosso returned to Brooklyn to be Unit Chief for the inpatient Detoxification Service at Kings County Hospital Center. During his ten years at Kings County, Dr. Occhiogrosso served as the Psychiatry Clerkship Director for St. George’s University School of Medicine, Associate Program Director for the SUNY Downstate Residency Program, Medical Director of the Adult Inpatient Psychiatric Service, and Clinical Director of the Comprehensive Psychiatric Evaluation Program (CPEP). While working in these distinctly different areas, Dr. Occhiogrosso gained valuable experience treating a wide range of clinical presentations and pathologies. As a result, he is comfortable treating patients across the entire spectrum of mental and behavioral health conditions.
Dr. Occhiogrosso’s practice focuses on medication management, but his patients will also benefit from supportive therapy and motivational interviewing techniques. In some instances, where the addition of more in-depth therapy would better optimize treatment, Dr. Occhiogrosso will recommend potential therapists and collaborate actively with them to provide comprehensive care.
Dr. Occhiogrosso has held faculty appointments at SUNY Downstate Medical Center and St. George’s University School of Medicine. In addition, Dr. Occhiogrosso spent nearly all of his professional career teaching, mentoring, and supervising psychiatric residents and medical students alongside his clinical work.