Does depression make you tired?

Clinical depression is formally known as major depressive disorder (MDD). It is a chronic mental health condition, but treatment options are available and effective.

To receive an MDD diagnosis, a mental health professional will explore if you present at least 5 of the 9 symptoms established in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

• Unexplained fatigue and low energy
• Changes in sleep patterns, including insomnia or sleeping more than usual
• Low mood including sadness, emptiness, or hopelessness
• Changes in appetite and weight
• Low self-esteem, shame, and guilt
• Decreased ability to enjoy regular and special activities
• Changes in how you move, including restlessness or slowed movements
• Cognitive challenges, including problems with memory, lack of focus, and difficulty making decisions
• Thoughts of suicide and self-harm, which may include attempts to end your life

These symptoms must be persistent across situations and be present for at least 2 weeks before confirming a diagnosis.

Other conditions that involve symptoms of depression, like bipolar disorder and postpartum depression, may also manifest with increased fatigue.

Why does depression make you tired?

Although researchers have not found an absolute answer to this question, some studies signal a few possible reasons for depression fatigue, low motivation, and decreased energy:

• neurotransmitter imbalances in the brain
• changes in sleep patterns
• chronic stress associated with living with depression

Neurotransmitters

Some research indicates that people with clinical depression may experience changes in the neurotransmitter systems in the brain. Neurotransmitters are natural substances that the nerve cells release to act as chemical messengers between them. They are essential in most body functions, including energy, alertness, and motivation.

The mechanisms underlying the link between neurotransmitters and depression symptoms are complex and not completely understood yet.

However, studies show that serotonin, dopamine, and norepinephrine neurotransmitters don’t perform their usual function in people with depression.

Serotonin plays a role in different functions, including your sleep cycle, appetite, sexual drive, and cognitive processes.

Studies suggest that low serotonin levels are linked to low energy levels and decreased ability to experience joy and pleasure. You may tire more quickly and take longer to recover when your serotonin levels are too low.

Dopamine is associated with movement regulation and the ability to experience pleasure and motivation. Experts believe dopamine disruption is associated with anhedonia, a clinical term for lack of interest, motivation, and enjoyment of activities that once felt rewarding.

Compromised dopamine signaling leads to low or high neurotransmitter levels. Studies show that changes in neurotransmitter levels have a link to increased fatigue and low motivation in people with neurological disorders.

Finally, norepinephrine or noradrenaline plays an important function in your stress response. It helps your body become and stay alert to face or flee a threat. This neurotransmitter also affects your memory and attention and promotes wakefulness and arousal.

Decreased norepinephrine signaling may compromise your ability to stay focused and vigilant and lead to symptoms of depression, like fatigue and sleeping more than usual.

More research is needed to understand better what causes neurotransmitter disruption and its effects on mental health, including mood.

Sleep disturbances

Sleep disturbances like insomnia (difficulty falling and staying asleep) and hypersomnia (feeling overly tired and sleeping more than usual) are common in people with depression, according to the DSM-5-TR.

The causes of sleep disturbances are not known yet. They may be a combination of genetics, environmental factors, and central nervous system abnormalities.

Experts theorize that these sleep disturbances, particularly sleep deprivation, may be both a symptom of depression and a contributing factor. In other words, experiencing sleep disturbances over time may lead to symptoms of depression.

Both insomnia and hypersomnia involve symptoms like fatigue, low ability to focus, reduced motivation, and low energy.

Chronic stress

Stress is a natural and necessary response to your environment. It helps you be ready to face or flee a possible threat by releasing hormones that increase your heart rate, respiration capacity, and alertness. This response requires your body to use a lot of resources.

When the stress response is persistently activated, your body does not have the chance to replenish its resources, which may lead to health challenges and over-exhaustion. This may be why chronic stress is often associated with fatigue and low motivation.

Living with depression may increase your psychological stress levels. The condition interferes with different aspects of daily living, including school, work, relationships, self-esteem, and thinking ability. You may also feel hopeless and lonely when you live with depression.

How to treat depression?

A possible first line of treatment for depression is cognitive behavioral therapy (CBT). CBT is also known as talk therapy. This type of psychotherapy helps you identify how your thoughts affect your mood and behavior so that you can reassess them.

If CBT is not enough to improve your symptoms, your healthcare professional may suggest depression medications. These may include:

• Selective serotonin reuptake inhibitors (SSRIs): Examples include paroxetine (Paxil), fluoxetine (Prozac), and sertraline (Zoloft)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): Examples include desvenlafaxine (Pristiq), venlafaxine (Effexor), and duloxetine (Cymbalta)
• Tricyclic antidepressants (TCAs): Examples include nortriptyline (Pamelor), imipramine (Tofranil), and amitriptyline (Elavil)
• Monoamine oxidase inhibitors (MAOIs): Examples include phenelzine (Nardil) and tranylcypromine (Parnate)
• Norepinephrine-dopamine reuptake inhibitors (NDRIs): Examples include bupropion (Wellbutrin)

Depression treatment may reduce fatigue and low motivation. However, lifestyle modifications are recommended as complementary tools to reduce stress and improve sleep disturbances. These may include:

• engaging in regular physical activity
• having a nutritious diet
• practicing relaxation techniques like deep breathing and meditation
• doing mind and body exercises like yoga

You may ask your doctor about other possible causes of chronic fatigue and low motivation. Anemia, thyroid dysfunction, and other conditions may also cause low energy levels.

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Summary

Fatigue, low motivation, and decreased energy levels are typical symptoms of depression. Neurotransmitter disruptions, chronic stress, and sleep disturbances in people with depression may contribute to these symptoms.

Depression treatment, including CBT and medications, may help alleviate depression symptoms, including persistent tiredness and difficulty going about your day.

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