Depression and Fatigue

One of the most common symptoms of depression is fatigue, which is often accompanied by irritability, lack of motivation, loss of energy, sluggishness, concentration problems, poor quality sleep, and others. This results from the complex interaction between hormones and neurotransmitters in your brain.

There are several types of depression. Most people have experienced an adjustment disorder ("situational depression"), a type of depression that occurs in response to a profoundly sad event, for example, after a loss, like a breakup or a death. This type of depression usually comes on between hours to several months after the stressful event has taken place and normally lasts for a matter of months. If it is severe or very long-lasting, it can become major depression.

The other type of depression is major depression (clinical depression), which sometimes has no ascertainable cause. It typically lasts a long time (months to years), often causes fatigue, and typically interferes with everyday functioning.

General Approaches to Depression-Related Fatigue

Treat the underlying depression (the section about depression has numerous approaches).

• Practice good and regular sleep habits: Make and stick to a sleep regimen in a comfortable place, dark, and cool. Find a good pillow. 

• Read.

• Try some journaling

• Listen to music, relax (practice relaxation techniques), or take a bath before bed

• Exercise every day. Do this several hours before going to bed

• Decrease alcohol – don’t drink it before bed.

• Avoid drinking caffeine several hours before sleep.

• Avoid long naps.

• Visit with friends or family.

• Consider getting some counseling (cognitive behavioral therapy-I or "therapy-insomnia"). Talking to someone can often help.

• Limit screen time for about two hours before going to bed (some say do not use the blue light screen for an hour before bed, or use a screen filter)

• Go to bed and wake up at the same time every day - this helps set your internal clock.

• Avoid interruptions in sleep: Consider using white noise or earplugs when sleeping.

• Use a sleep app - There are many available online, and some are free. Try one

Over-the-Counter Treatment 

To help with sleep:

• Antihistamines: diphenhydramine (common: Benadryl, Sominex), Doxylamine (common: Unisom)

• Melatonin

Considered Natural Remedies

• Valerian root

• Chamomile

• Lavender 

• Lemon balm

• Ashwagandha

• Ginseng

• Rosemary

• Rhodiola

• Magnesium

• Kava 

• 
  

Be careful of interactions with the above herbs if you take other medications.

Prescriptive Treatment

Some of these medications help with depression and underlying sleep issues, which, in turn, should help with fatigue:

• Serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and other classes of antidepressants (some known for treating insomnia in addition to depression). Trazodone is one of these, also effectively used off-label for sleep.

  These aim in improving the neurotransmission in the brain that sets off depression and, in many cases, insomnia.

• An atypical antipsychotic, Seroquel (off-label) taken in low doses, is also often effective for sleep and depression

• Zolpidem (Ambien), eszopiclone (Lunesta) - For short-term use. Controlled substance; potentially addictive. Not always a great choice for someone with depression because it can increase depression and can cause morning-after fatigue.

  
  

  Also, see the section on “Depression” to explore other approaches to depression.