Depression and Fatigue: A Vicious Cycle

How Are Depression and Fatigue Linked?

Depression and chronic fatigue syndrome are two conditions that can make someone feel extremely tired, even after a good night’s rest. It’s possible to have both conditions at the same time. It’s also easy to mistake feelings of fatigue for depression and vice-versa.

Depression occurs when a person feels sad, anxious, or hopeless for an extended period of time. People who are depressed often have sleep problems that involve sleeping too much or not sleeping at all.

Chronic fatigue syndrome is a condition that causes a person to experience continuous feelings of fatigue that don’t have any other underlying causes. According to an article published in The Primary Care Companion to the Journal of Clinical Psychiatry, doctors often misdiagnose chronic fatigue syndrome as depression.

What Are the Differences Between Depression and Fatigue?

The main difference between these conditions is that chronic fatigue syndrome is primarily a physical disorder while depression is a mental health disorder. There can be some overlap between the two.

Symptoms of depression can include:

  • continuous feelings of sadness, anxiety, and/or emptiness
  • feelings of hopelessness, helplessness, or worthlessness
  • disinterest in hobbies you once enjoyed
  • eating too much or too little
  • trouble concentrating and making decisions

There are also some physical symptoms that can occur with depression. People may have frequent:

  • headaches
  • cramps
  • stomach upset
  • other pains

They may also have difficulty going to sleep or sleeping through the night, which can lead to exhaustion.

People with chronic fatigue syndrome often have physical symptoms that aren’t commonly associated with depression. These include:

  • headaches
  • joint pain
  • tender lymph nodes
  • muscle pain
  • sore throat

Depression and chronic fatigue syndrome also affect people differently when it comes to their daily activities. People with depression usually feel very tired and aren’t interested in doing any activity, regardless of the task or the required amount of effort. Meanwhile, those with chronic fatigue syndrome usually want to engage in activities but just feel too tired to do so.

To diagnose either condition, your doctor will try to rule out other disorders that can cause similar symptoms. If your doctor thinks you have depression, they may refer you to a mental health expert for evaluation.

A Vicious Cycle

Unfortunately, people who have chronic fatigue syndrome may become depressed, and those who have depression can develop chronic fatigue syndrome. The two conditions often feed off each other in a cycle that’s difficult to break.

Many people with chronic fatigue syndrome experience sleep disorders, such as insomnia or sleep apnea. These conditions often make fatigue worse, because they prevent people from getting a good night’s rest. When people feel tired, they may not have the motivation or energy to perform their daily activities. Even walking to the mailbox can feel like a marathon. The lack of desire to do anything can put them at risk for developing depression.

Fatigue may also fuel depression. People with depression often feel very tired and don’t want to partake in any activities.

Diagnosing Depression and Fatigue

To make a depression diagnosis, your doctor will ask you about your medical history and give you a questionnaire that assesses depression. They may use other methods, such as blood tests or X-rays, to make sure another disorder isn’t causing your symptoms.

Before diagnosing you with chronic fatigue syndrome, your doctor will run several tests to rule out other conditions that cause similar symptoms. These may include restless leg syndrome, diabetes, or depression.

Treating Depression and Fatigue

Therapy or counseling can help someone with depression feel better. Depression 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. That’s why your doctor should screen you for depression and chronic fatigue syndrome before you take any medication.

Several therapeutic treatments can benefit people with chronic fatigue syndrome, depression, or both. These treatments include:

  • deep-breathing exercises
  • massage
  • stretching
  • tai chi (martial arts)
  • yoga

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 (such as a dark, silent, and/or cool room)
  • avoid taking long naps (limit them to 20 minutes)
  • avoid foods and drinks that can prevent you from sleeping well (such as caffeine, alcohol, and tobacco)
  • avoid exercising at least 4 hours before bedtime

When to See Your Doctor

Both chronic fatigue syndrome and depression cause changes that can negatively affect your personal and professional life. The good news is that both conditions can improve with the right treatment. Speak with your doctor if you’re struggling with prolonged fatigue or think you have depression. If you have thoughts of hurting yourself or committing suicide, call 911 immediately or have a loved one take you to the hospital. You can find additional resources for depression on the National Alliance on Mental Illness (NAMI) website.

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