Why does depression make you tired?

Why does depression make you tired?

Reviewed by:
Sophia Monsour, DO
Chief Psychiatrist, Pennsylvania
at Talkiatry
August 1, 2023

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.

What are some common symptoms of depression? 

Depression can cause a range of symptoms, many of which have a direct impact on energy levels. These include: 

  • Feelings of sadness, worthlessness, or hopelessness 
  • Loss of interest in hobbies or normal activities 
  • Tiredness and poor sleep or sleep problems
  • Loss of appetite 
  • Low energy
  • Chronic low mood
  • Headaches or other body aches 
  • Anxiety or restlessness 
  • Trouble concentrating or remembering things 
  • Thoughts of death or suicide

Why can depression cause tiredness? 

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.

Neurotransmitters

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.

Imbalanced diet 

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.

Stress levels 

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. 

Medication side effects 

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.

Substance Use 

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.

How can you cope with tiredness from depression?

If you’re dealing with so-called “depression fatigue,” there are some self-care strategies you can use to help improve your energy levels.

Practice good sleep hygiene

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.

Get enough exercise 

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.

Seek professional help 

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. 

From there, you can work on a treatment plan—often a combination of medication, like an antidepressant, and supportive therapy, like talk therapy or CBT (cognitive behavioral therapy).

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. 

Working through depression with Talkiatry 

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.

About Talkiatry

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.

Sources:

Depression (major depressive disorder) - Symptoms and causes | Mayo Clinic

Relationship of neurotransmitters to the symptoms of major depressive disorder | NCBI

From weight loss to weight gain: appetite changes in major depressive disorder as a mirror into brain-environment interactions | Frontiers

Depression, emotional eating and long-term weight changes: a population-based prospective study | BioMed Central

The Links Between Stress and Depression: Psychoneuroendocrinological, Genetic, and Environmental Interactions | The Journal of Neuropsychiatry and Clinical Neurosciences

Impact of stress on metabolism and energy balance | ScienceDirect

Antidepressants: Get tips to cope with side effects | Mayo Clinic

Adolescent Depression and Substance Use: The Protective Role of Prosocial Peer Behavior | PMC

Treatment of Depression With Alcohol and Substance Dependence: A Systematic Review | PMC

Substance use disorders and risk for treatment resistant depression: a population‐based, nested case‐control study | PMC

What Is Sleep Hygiene? | Sleep Foundation

Tips for Better Sleep | CDC

How Much Sleep Do I Need? | CDC

Exercise for the treatment of depression and anxiety | NCBI

Does exercise really boost energy levels? | Harvard Health

Dr. Sophia Monsour holds the position of Chief Psychiatrist for Pennsylvania at Talkiatry. After completing residency in 2013 at Albany Medical Center, she has spent the past 9 years fulfilling her passion for integrated and specialty care for adults suffering from mental illness. Her years of experience has included working as an integrated care Psychiatrist at a community health center, a medical director of a Partial Hospital and Intensive Outpatient Program (PHP/IOP), and also working for an Assertive Community Treatment Team (ACT) specializing in the Serious Mentally Ill (SMI) population.

Most recently, she has been serving our veterans as the Outpatient Section Chief, Primary/Mental Health Integration Medical Director and Resident/Medical Student Coordinator at VA Pittsburgh. Dr. Monsour has an approachable style when treating individuals who suffer from various diagnoses, especially those with prior trauma. She provides supportive psychotherapy and at times uses psychodynamic therapy skills to address her patient’s current stressors and to identify the root cause of their ailment. She believes in a holistic approach and utilizes mindfulness as a technique along with medication management.

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