How Are Depression And Sleep Related
Depression and sleep are closely connected. Almost all people with depression experience sleep issues. In fact, doctors may hesitate to diagnose depression in the absence of complaints about sleep.
Depression and sleep issues have a bidirectional relationship. This means that poor sleep can contribute to the development of depression and that having depression makes a person more likely to develop sleep issues. This complex relationship can make it challenging to know which came first, sleep issues or depression.
Sleep issues associated with depression include insomnia, hypersomnia, and obstructive sleep apnea. Insomnia is the most common and is estimated to occur in about 75% of adult patients with depression. It is believed that about 20% of people with depression have obstructive sleep apnea and about 15% have hypersomnia. Many people with depression may go back and forth between insomnia and hypersomnia during a single period of depression.
Sleep issues may contribute to the development of depression through changes in the function of the neurotransmitter serotonin. Sleep disruptions can affect the bodys stress system, disrupting circadian rhythms and increasing vulnerability for depression.
Fortunately, people who are treated for major depression often report improved quality of their sleep.
Physical Effects Of Depression
Depression can appear physically via symptoms felt in the body. Examples of physical effects of depression include sleep disturbance, appetite changes, poor concentration or memory, and a loss of interest in sex. Some people with depression may also feel chronic pain, experience gastrointestinal issues, or have a higher level of fatigue.
Treating Depression And Fatigue
Therapy or counseling can help treat depression. It can also be treated with certain medications. These include antidepressants, antipsychotics, and mood stabilizers.
Taking antidepressants can sometimes make symptoms of chronic fatigue syndrome worse. Thats why your doctor should screen you for depression and chronic fatigue syndrome before prescribing any medication.
Several treatments can help people with chronic fatigue syndrome, depression, or both. These include:
People with depression and chronic fatigue syndrome should also try to develop good sleeping habits. Taking the following steps can help you sleep longer and more deeply:
- go to bed at the same time every night
- create an environment that promotes sleep
- avoid taking long naps
- avoid foods and drinks that can prevent you from sleeping well
- avoid exercising at least 4 hours before bedtime
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How Do You Treat Residual Fatigue In Depression
Dr. Fava: In clinical practice, evaluation of the treatment of fatigue as a residual symptom of MDD is complicated because it can be part of the symptom cluster of MDD, can be a prodromal symptom of another disorder distinct from MDD, or could be a side effect of antidepressant treatment., Furthermore, treating fatigue by adding more medications can be risky because of the possibility of inducing additional adverse symptoms as a consequence of the intervention. Baldwin and Papakostas describe the following three treatment strategies: 1) using antidepressant medications that are less likely to induce or exacerbate fatigue symptoms 2) using antidepressant medications that are more likely to resolve the fatigue symptoms or 3) using adjunctive treatments to specifically target residual fatigue and sleepiness in MDD patients.
How Is Mental Exhaustion Different From Stress Depression Burnout Or Physical Exhaustion
Mental exhaustion overlaps significantly with stress, depression, physical tiredness, and burnout. At a glance, they look very much alike. Some may even use the terms interchangeably. There are some key differences, however, between these experiences and how to best resolve them.
Stress versus mental exhaustion
Stress is a term that refers to anything that temporarily taxes a persons mental, physical, and emotional resources. Our bodies respond to both good and bad stress in similar ways. Ideally, were able to quickly resolve stressors and return our bodies to a state of balance. Long-term stress leads to mental exhaustion not the other way around.
Depression versus mental exhaustion
Depression is a mood disorder that is characterized by a persistent low mood. People that are mentally exhausted often feel depressed, and those that are depressed feel mentally drained. Many symptoms, like lack of pleasure, sleep disturbance, and cognitive impairment overlap. However, the terms arent interchangeable. Depression needs to be diagnosed by a qualified mental health professional.
Physical versus mental exhaustion
If youve ever left the gym feeling exhausted but exhilarated, youve felt the difference between mental and physical exhaustion. Physical fatigue, like mental exhaustion, comes from prolonged stress but from stress on the body. This could be due to not getting enough sleep, an illness, or other physical strain.
Burnout versus mental exhaustion
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You Have Unstable Blood Sugar
You dont have to be diabetic to have a blood sugar problem. We help many of our patients here at Parsley Health pull the brakes on the rollercoaster of symptoms theyve been experiencing from spikes and dips in blood sugar.
Take a typical on-the-go breakfast for many people: a pastry and sugary coffee drink. That wave of sugar creates a rapid spike in your blood sugar and causes your pancreas to release insulin to stabilize it. As your blood sugar returns to normal, you crash, feeling tired. Youll also feel hungry again pretty quickly, leading you to reach for carbs and perpetuating the cycle.
All that sugar adds up. When people consumed 40g of added sugar a day in the form of a can of soda for three weeks, they showed at least a 60 percent increase in high-sensitivity C-reactive protein, a marker for inflammation. Inflammation has been associated with many chronic diseases, including depression. Learning to eat a combination of , protein, and healthy fat at each meal and never skipping a meal can help you maintain steady blood sugar throughout the day and tame inflammation.
How Is Chronic Fatigue Syndrome Diagnosed
Before diagnosing chronic fatigue syndrome, a doctor examines a person and rules out other possible causes of their symptoms.
There is no specific test that conclusively proves the existence of chronic fatigue syndrome. Instead, testing may involve physical tests of blood, urine, thyroid function, muscle enzymes, gluten tolerance, and other analyses depending on the persons symptom profile.
The doctor also asks questions and may administer questionnaires, such as the Centers for Disease Control Symptom Inventory or the DePaul Symptom Questionnaire, for a better picture of the symptoms.
Symptoms of chronic fatigue syndrome can come and go, and they vary from person to person. This variability can make it difficult for diagnostic measures to capture how a person is affected by the disease, even if the effects are real and noticeable. Some experts argue that chronic fatigue syndrome should be further divided into different subtypes based on groups of symptoms.
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Does Depression Make You Tired
If youve ever wondered if there is a link between depression and feeling tired, there is. Depression can cause debilitating fatigue symptoms and make the simplest activities, such as getting out of bed, too difficult to manage. In fact, according to a 2018 report, fatigue affects over 90 percent of people with major depressive disorder. If you are feeling depressed, please get in touch with a therapy matching service, like Advekit, today.
Unfortunately, lack of sleep can exacerbate symptoms of depression. People with depression are more likely to experience fatigue, and people with chronic fatigue syndrome are more likely to become depressed, creating a cycle that can be hard to break.
Depression is a complex disease with many possible and interlinked causes, including genetics, medical conditions, stressful life events, and brain chemistry. It can be challenging to tell the difference between everyday tiredness and depression-related fatigue. Though, depression is likely associated with changes in brain neurotransmitters, such as dopamine, norepinephrine, and serotonin. These neurotransmitters play important roles in regulating energy levels, sleep, appetite, motivation, and pleasure. Fatigue and depression can look quite similar.
Diseases That Have Fatigue As The Main Symptom
When your immune system is grappling with a disease, that fight requires energy. So it’s probably not surprising that almost any disease you can name has fatigue listed among its symptoms.
“Fatigue may be the most common symptom people report, and in and of itself it can’t point you toward a diagnosis,” says Roxanne Sukol, MD, a preventive medicine specialist at Cleveland Clinic.
Also complicating matters: “There are so many different ways to measure fatigue,” says Anne Cappola, MD, of the University of Pennsylvania’s Division of Endocrinology, Diabetes, and Metabolism. “Does it mean you’re sleeping more? Or can’t exercise as long as you used to? Or don’t have energy at the end of the day?”
Fatigue comes in different flavors. “There’s physical fatigue, but also emotional fatigue and psychological fatigue,” she says. “People underestimate the effects of psychological stress on energy levels, but in retrospect, after that stress is gone, they realize that was making them so tired.”
Whenever a patient sees Cappola for fatigue, she says she talks with them about reasonable expectations. “Our society builds this belief that you should be on the run all the time, but that’s not sustainable for many of us,” she says. “If your schedule’s changed or you haven’t been sleeping enough or something else is going on, feeling tired is natural.”
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Aim To Exercise More And Start Small If You Need To
Though depressive attitudes may make it harder to work out, implementing an exercise routine thats realistic and attainable in your everyday life can ease depression fatigue.
Exercise has the added benefit of improving your sleep, too.
Its OK to start small even just walking for 30 minutes a day will likely boost your energy and mood. Exercise is truly an organic and reliable way to help address your depression fatigue.
Feeling Tired From A Depressive Condition
Anyone who has endured a major depressive episode knows full well the debilitating impact of the accompanying fatigue on daily functioning. This is not just a matter of feeling unmotivated or lazy. Fatigue that is associated with major depression is in a class all its own. This kind of fatigue gets into the bones, affecting not only physical functioning, but also psychological and cognitive functioning as well. In this pervasive state of exhaustion, apathy and despair are bedfellows.
So, can depression cause severe fatigue? You bet. It surely is not your imagination if you find yourself struggling with persistent feelings of sadness, the cornerstone of depression, while stuck in bed all day. Depression can truly demobilize a person, causing such severe fatigue that even the most basic tasks seem insurmountable. It isnt difficult to see how depression can have a significant impact on ones career and home life when considering the effects of fatigue on your ability to be a fully productive and functioning person.
When wondering if you may be experiencing depression, and asking can depression cause severe fatigue, the most important step to take is to schedule a physical exam with your primary care doctor. Severe fatigue is also a common symptom in various medical conditions, which should be ruled out as a potential cause. If no health issue is diagnosed, the doctor will likely refer you to a mental health practitioner.
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How Do You Define Fatigue In Depression
Dr. Fava: Fatigue is one of the identified symptoms of MDD listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria where it is defined as physical fatigue or loss of energy. However, in my opinion, fatigue is much more than that. We see apathy and considerable emotional disturbance occurring as a consequence of fatigue. We have also seen high rates of diminished focus, word finding difficulties, and recall problems in fatigued patients with MDD. Recently, Arnold described three distinct categories of fatigue that commonly occur within a population of MDD patients: physical, cognitive, and emotional symptoms. The physical symptoms of fatigue include reduced activity, low energy, tiredness, decreased physical endurance, increased effort to do physical tasks, general weakness, heaviness, slowness or sluggishness, nonrestorative sleep, and sleepiness. The cognitive symptoms include decreased concentration, decreased attention, decreased mental endurance, and slowed thinking. The emotional symptoms of fatigue include decreased motivation or initiative , decreased interest, feeling overwhelmed, feeling bored, aversion to effort, and feeling low. Given the broad range of related, comorbid symptoms, it can be difficult to differentiate between independent symptoms of fatigue from symptoms directly related to MDD.
Viral Or Bacterial Infection And Fatigue
Symptoms: Fatigue, fever, head or body aches.
Fatigue can be a symptom of infections ranging from the flu to HIV. If you have an infection, you’ll probably have other symptoms like fever, head or body aches, shortness of breath, or appetite loss.
Infections that may cause fatigue include:
Symptoms: Chronic fatigue, deep muscle pain, painful tender points, sleep problems, anxiety, depression
Fibromyalgia is one of the more common causes of chronic fatigue and musculoskeletal pain, especially in women. Fibromyalgia and chronic fatigue syndrome are considered separate but related disorders. They share a common symptom: severe fatigue that greatly interferes with people’s lives.
With fibromyalgia, you may feel that no matter how long you sleep, it’s never restful. And you may feel as if you are always fatigued during daytime hours. Your sleep may be interrupted by frequent waking. Yet, you may not remember any sleep disruptions the next day. Some people with fibromyalgia live in a constant fibro fog — a hazy feeling that makes it hard to concentrate.
Constant daytime fatigue with fibromyalgia often results in people not getting enough exercise. That causes a decline in physical fitness. It can also lead to mood-related problems. The best way to offset these effects is to try to exercise more. Exercise has tremendous benefits for sleep, mood, and fatigue.
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Risk Factors For Depression
Depression can affect anyoneeven a person who appears to live in relatively ideal circumstances.
Several factors can play a role in depression:
- Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
- Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
- Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
- Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
Most Common Depression Diagnosis Scales
Some of the most popular scales used to help clinicians diagnose depression include:
- Beck Depression Inventory
- Clinically Useful Depression Outcome Scale
- Geriatric Depression Scale
- Patient Health Questionnaire-9 and adolescent PHQ-9
- Plutchik-Van Praag Self-Report Depression Scale
- Quick Inventory of Depressive Symptomatology
- Rome Depression Inventory
- Zung Self-Rating Depression Scales
Some scales, such as the Beck Depression Inventory, are copyright protected and not available outside of a doctors office or mental health clinic . There are inventories, scales, and questionnaires that are in the public domain and, therefore, more accessible.
The PHQ, for example, is available for free online and in over 30 languages. It can be downloaded as a PDF or accessed as an interactive quiz on several reputable mental health websites.
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Thyroid Issues Are To Blame
Your thyroid gland produces hormones involved in metabolism and growth, releasing the hormones only when needed. But when your thyroid gets out of whack , your thyroid can overproduce or underproduce these hormones, leading to a range of physical and mental symptoms.
In a large 2015 study of people diagnosed with thyroid conditions, researchers linked an overactive thyroid to anxiety, while an underactive thyroid was associated with depression. Another study found that 60 percent of patients with hypothyroidism reported symptoms of depression, while 63 percent reported symptoms of anxiety.
Researchers still arent exactly sure what underlying mechanism links thyroid disorders with depression and anxietythere may be severalbut the relationship between thyroid hormones and mood regulation is likely stronger than previously thought.
Fatigue And Gi Symptoms
When your GI symptoms flare up, you might feel worn out, or like a battery that has lost power. Fatigue is a common side effect of any long-term or chronic illness. And this makes sense your body is devoting energy to fighting a disease or struggling with an inflamed or sensitive digestive tract. Even though this is a common experience, it is not a comfortable one. You may feel tired because your GI symptoms have kept you awake or in the bathroom all night. You may not be eating the right foods, which can cause both fatigue and troublesome GI problems.
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Suicidal Thoughts And Behaviors
Strong signs of suicidality include talking about wanting to die, making plans, or attempting to take ones own life. Warning signs of suicidal intention include:
- Acquiring the means to commit suicide
- Changes in eating or sleeping habits
- Engaging in risky or self-destructive behavior
- Extreme agitation or anxiety
- Getting one’s affairs in order
- Increased use of substances such as drugs and alcohol
- Intense changes in mood/mood swings
- Saying goodbye to friends and family as though for the last time
- Feeling trapped or hopeless in ones situation
- Talking a lot about death, dying, and violence
- Talking about suicide or wishing that one hadn’t been born
- Withdrawal from friends or family
Fatigue And Depression: When Is Tiredness A Warning Sign
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Sleep is an important part of overall health, but for many, it does not come easily. Millions of Americans report feeling fatigue a feeling of tiredness or exhaustion.
Many different factors, ranging from poor sleep to health conditions, can cause fatigue. Its also a common symptom of mental health conditions, such as depression.
Being fatigued doesnt mean youre depressed, but fatigue can be a warning sign. Learn more about the link between the conditions.
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