Key takeaways
Low energy and fatigue are two of the hallmark symptoms of depression.
Fatigue occurs because of changes in brain chemistry, difficulty sleeping, stress or anxiety, dietary changes, and medication side effects.
Treating depression with medication, therapy, and lifestyle changes can alleviate fatigue.
Depression is not just “feeling down.” It is a serious mental health condition known for its hallmark symptoms, such as loss of interest in formerly enjoyable activities, feelings of hopelessness or worthlessness, and tiredness or lack of energy. When you’re depressed, fatigue affects your ability to function in the daytime and impacts your sleep schedule, diet, and exercise habits. Keep reading to learn how depression makes you tired, possible treatment plans, and how to overcome depression-related fatigue.
Why does depression make you tired?
There are many reasons people living with depression feel tired, including:
Brain chemistry
Neurotransmitters and hormones are chemical messengers that control the functions of your body. Certain neurotransmitters are linked to key brain functions that can impact your mood. For example, dopamine controls your memory, motivation, and reward systems. Studies suggest that low dopamine levels are linked to depression and that patients with decreased levels often feel tired because of their depression symptoms.
“This happens because the part of our brain that produces pleasure called the reward center becomes dysfunctional,” explains David Feifel, MD, Ph.D., an emeritus professor of psychiatry at the University of California at San Diego.
Depression can take away the pleasure (or the “reward”) in daily tasks, like going for a walk or doing your work. Without the positive feelings associated with certain activities, they can begin to feel overwhelming and tiring. In these cases, anything that requires effort can seem like a “monumental chore,” according to Dr. Feifel, and that can cause mental fatigue and sleepiness.
Difficulty sleeping
Depression can make you tired by keeping you awake and preventing you from getting the quality sleep your body needs. People with depression experience increased rapid eye movement (REM) sleep as opposed to slow wave sleep (SWS), which can lead to memory loss and concentration problems during the day—not to mention increased fatigue.
Existing sleep problems, such as sleep apnea, are also associated with the onset of depression symptoms, explains R.Y. Langham, Ph.D., a clinical psychologist at Impulse Therapy. “The alteration in sleep patterns not only affects physical energy levels but also has a substantial impact on mental alertness and emotional well-being,” Langham says.
Stress or anxiety
Dealing with day-to-day stress on top of a mental health condition can exacerbate feelings of exhaustion. Too many daily worries can make you feel drained of energy.
Additionally, anxiety is a medical condition that often co-occurs with depression. Unfortunately, anxiety can also disrupt your sleep patterns in a significant way. Anxiety can wake you up in the middle of the night, make you restless as you try to fall asleep, and keep you from falling asleep with spiraling thoughts, panic attacks, heart palpitations, or prolonged shaking or trembling.
Dietary changes
When you’re feeling depressed, it can disrupt your typical diet. You may find yourself skipping meals or eating junk food instead of balanced meals. Eating too little or consuming too much fat and sugar can make you lethargic.
Alternatively, some people with depression will resort to excessive caffeine consumption to wake themselves up during the day, but this can have an adverse effect on a person’s sleep schedule.
Medication side effects
Fatigue is a common side effect of many antidepressant medications. In fact, many patients experience fatigue as early as two weeks and for as long as three months after starting antidepressants. Medications that list fatigue as a side effect include Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), and Zoloft (sertraline).
Overcoming depression fatigue
Treating depression is the best way to alleviate its symptoms—especially fatigue or tiredness. There are many depression treatment options available. The best treatment plan usually involves a combination of medication, therapy, and lifestyle changes.
Medication
A few of the most common antidepressant medications for depression include:
- Selective serotonin reuptake inhibitors (SSRIs), such as Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as Effexor XR (venlafaxine ER) and Cymbalta (duloxetine)
- Serotonin modulators, such as Serzone (nefazodone) and Desyrel (trazodone)
Finding the right medication and dosage to alleviate your symptoms may take some time. Initially, these medications may exacerbate tiredness, but that reaction typically fades within the first few weeks. Different medications work for different people.
Therapy
Therapy involves discussing your symptoms and their effect on your mood or behavior with a mental health professional (a therapist, psychotherapist, or social worker) and learning new strategies to deal with them. Popular forms of therapy include:
- Cognitive behavioral therapy (CBT)
- Interpersonal therapy
- Talk therapy (psychotherapy)
Lifestyle changes
Along with prescription medication and therapy, committing to a few key lifestyle changes can increase the odds of overcoming common symptoms of depression. Although they may seem simple, fatigue makes even the easiest changes difficult. Make sure to approach each of these lifestyle changes at a pace that works for you.
Manage your schedule and stress
If you are stressed about work or school, try building in breaks throughout the day. Not only can breaks help you re-focus your energy on your work, but they can also help manage your fatigue. “Learning to conserve energy by prioritizing tasks and taking breaks can help in maintaining a balance and preventing exhaustion,” Langham says.
Eat a balanced diet
Caffeine and sugar intake can spike your energy levels and cause anxiety attacks, so it’s best to avoid those, especially closer to bedtime. Opting for a nutrient-rich, balanced diet can also help impact your mood and energy levels.
Exercise daily
Consistent exercise is another way to help overcome depression fatigue. Recent studies show that regular physical activity improves sleep quality and decreases sleep latency, allowing you to sleep earlier instead of tossing and turning.
Don’t jump right into an overly intense workout plan. It isn’t easy to exercise consistently. It’s even harder if you start by doing more than you can. Find the routine that works for you. Any form of cardio or weightlifting will work. “Additionally, engaging in mind-body practices like meditation and yoga can provide relief from stress and improve overall well-being,” Langham adds.
Improve sleep habits
Good sleep hygiene is key to combating depression-related fatigue. The following tips can all help improve your sleep:
- Cut out screens and blue light–emitting devices close to bedtime
- Upgrade your sleep environment by using blackout shades, closing windows, using a humidifier, or getting better bedding
- Develop a sleep schedule by setting a consistent bedtime and wakeup time
- Avoid stressors close to bedtime
The bottom line: Taking control of your depression takes time
Depression fatigue can drain your motivation to go about your daily routine. It can be even harder to seek help and make the changes necessary to improve your symptoms. However, the help is out there. If you begin to feel suicidal or have thoughts of harming yourself, call the National Suicide Prevention Lifeline by dialing 988 or go to the nearest emergency room. Progress is never a straight line, and it can take time to find the treatment plan that works for you, but with the proper consistency and planning, you can overcome depression fatigue and feel energized again.
Sources
- Reward processing dysfunction in major depression, bipolar disorder and schizophrenia, Current Opinion in Psychiatry (2015)
- Fatigue as a residual symptom of depression, Innovations in Clinical Neuroscience (2011)
- From stress to inflammation and major depressive disorder: A social signal transduction theory of depression, Psychological Bulletin (2014)
- REM sleep dysregulation in depression: state of the art, Sleep Medicine Review (2013)
- Breaks during the workday, Michigan State University
- The effect of physical activity on sleep quality and sleep disorder: A systematic review, Cureus (2023)
- Depression and sleep, International Journal of Molecular Sciences (2019)
- Toward achieving optimal response: understanding and managing antidepressant side effects, Dialogues in Clinical Neuroscience (2008)
- Prevalence and clinical correlates of co-occurring insomnia and hypersomnia symptoms in depression, Journal of Affective Disorders (2014)
- Fatigue in patients with major depressive disorder: Prevalence, burden and pharmacological approaches to management, CNS Drugs (2018)
- Effects of caffeine on anxiety and panic attacks in patients with panic disorder: A systematic review and meta-analysis, General Hospital Psychiatry (2022)
- Association Between Dietary Habits and Depression: A Systemic Review, Cureus (2022)