Fatigue is a common and often debilitating symptom with a variety of causes. Because fatigue can be related to so many different ills it is important to rule out other diseases or conditions before diagnosing someone with Fatigue Syndrome.
Fortunately, the vast majority of people who suffer from fatigue ultimately find relief by treating their mental health.
While most people picture someone who has depression as an overweight middle-aged man seated on a couch wearing sweatpants and eating ice cream, anyone can become “depressed.”
Depression is actually one of the leading causes of disability in this country and is classified as such by the World Health Organization (WHO). Also known as Major Depressive Disorder (MDD), clinical depression may be diagnosed when a patient experiences five or more of the following symptoms during a two week period.
While depression causes fatigue to varying degrees, there are several other mental health issues that can cause the chronic condition as well.
For example, bipolar disorder is characterized by both depressive lows and manic highs. While mania provides an energy rush at first, it quickly turns to irritability, anger and paranoia which drain a person’s energy faster than anything else could.
Generalized Anxiety Disorder (GAD) carries with it constant worries about work or school, money troubles and relationship problems. It can eventually lead to feelings of hopelessness, lack of concentration and intense feelings of guilt over seemingly trivial things.
Post-Traumatic Stress Disorder (PTSD) presents most often following a terrifying event such as combat or domestic abuse. PTSD patients often show signs of hyper-arousal (jumpiness, edginess) and re-experiencing their trauma through nightmares or flashbacks.
Personality Disorders are less common but can also lead to fatigue over time. Issues with impulse control, interpersonal relationships and/or self-image can cause significant difficulty at home, school or work.
The most common personality disorders include: Antisocial (often referred to as ‘sociopaths’; do not experience guilt), Borderline (abrupt mood changes; frequent risk-taking behavior), Dependent (helplessness; submissive behavior), Histrionic (attention seeking; overly dramatic, emotional outbursts) and Narcissistic (excessive need for admiration; arrogance).
Mood disorders and other mental health problems can cause fatigue through a variety of mechanisms that affect both the brain and nervous system.
Fatigue may be either the primary symptom, causing individuals to develop depression or anxiety, or it can be secondary to their psychiatric condition. Whatever the mechanism, it is clear that fatigue is often overlooked in favor of well-known issues such as eating disorders or drug/alcohol addiction.
And while these conditions should always be ruled out before diagnosing someone with mood disorders, there are ways to treat mood conditions along with fatigue resulting from them:
Treatment tends to require regular follow up visits with a doctor, therapist or psychiatrist who will monitor for any changes in your treatment plan. Medications are typically used in an ongoing fashion along with therapy, although some clients also engage in alternative therapies such as meditation.
Mood stabilizers tend to carry the most risk for fatigue but can be helpful when treating disorders like manic depression or bipolar type II. Anti-anxiety medications (Benzodiazepines) can provide short relief from lack of energy but often leave patients feeling achey and tired the next day. Anti-depressants (SSRIs/SNRIS) may help with long term energy levels by improving neurotransmitter function in the brain (serotonin).
Exercise is another way to prevent fatigue or manage existing fatigue symptoms. Exercise releases endorphins which act on the nervous system to cause feelings of happiness and well-being. It helps to improve cardiovascular health as well as maintain proper weight and muscle tone.
A healthy diet is also important for maintaining energy levels. While some people require a great deal of caffeine, others cannot tolerate the jitters and sinkholes that follow it. Find what works for you and stick with it.
Expert Advice
Deborah Serani, MA , a psychologist who has struggled with depression herself, provides these tips: “I have been so fatigued from my MDD episodes that I was unable to work or do anything but sleep. But by participating in an outpatient treatment program where I received Cognitive Behavioral Therapy (CBT), medication management, group support and educational lectures on depression – I began to feel better mentally and.”
She cautions those who might be trying to cope with depression on their own “to watch out for the dangerous, but common pitfall of isolation. Depression can be a sneaky thief that steals our energy and motivation – making it seem easier to curl up under the covers than engage in meaningful activities.”
The key is finding what works for you – what makes you feel better physically, mentally and emotionally. If one thing isn’t working try something else until you find your rhythm.
Serani’s advice? “Exercise regularly. Take anti-depressants if prescribed by your doctor or therapist. Break free from negative people or situations whenever possible (divorce/death/job loss). Create an antidepressant toolbox filled with healthy coping strategies like positive self-talk, mindfulness, cognitive restructuring, sleep hygiene, etc.”