For many of us living with depression, it’s tricky to remember a time when exhaustion wasn’t part of our life. When we didn’t feel bone-achingly tired. Not just “I need a nap” tired. But totally, utterly, completely, depleted.
What does depression exhaustion feel like?
Depression exhaustion is unlike physical exhaustion. While we might be shattered after a good plod around the countryside, we’re often left with a little bit of energised buzz, despite our aching muscles. Depression exhaustion gives us all of the shattered and none of the energised buzz.
Our head is fuzzy. The fuzziness can reach our vision, making it fuzzy around the edges, and our hearing might feel similar. We might have a long-term headache. Our head can feel too heavy for our neck. Temperature control becomes a thing of the past. We either can’t warm up, can’t cool down, or both (sometimes at the same time). Our limbs feel like dead weights. It’s almost as though someone attached an invisible tap to our fingers and toes and drained every last bit of energy from our body.
We make an increasing number of mistakes. We’re more on-edge, more tearful, and possibly more irritable. Tiredness affects our executive functioning, so we start forgetting things, struggle to flex our thinking or problem solve, and might react to things without thinking. We often feel so far gone that it can almost feel like we’re living in a parallel world.
The usual exhaustion solution is sleep. But depression exhaustion can be a bit different.
Depression can make sleep difficult, which feels all kinds of cruel when it also makes us so exhausted. It can make it hard to get to sleep, stay asleep, and have a restful, refreshing sleep.
If we can eventually fall asleep, and magically stay asleep for a reasonable number of hours, we can still wake up feeling more exhausted than when we went to bed.
Food and Exhaustion
An inadequate diet can deplete our energy. At the same time, the more tired we become, the harder it is to manage an adequate diet.
Sometimes we might have to rely on freezer food, ready meals, deliveries, or support from friends or family. There is absolutely no shame in that – we do whatever we need to do to get through. On days when we don’t have the energy to cook, we could have “fallback” foods like cereal – little preparation, but often has nutrients intentionally added.
Money can be tight when we’re unwell, which can further affect our food intake. There is help available if that applies to us. Food banks up and down the country are helping people in our position. We’re not alone, and there are options.
Given that we often struggle to eat a varied diet and may struggle to leave the house much, we might develop deficiencies.
It’s worth going to our GP to have some basic tests done. Some more-common deficiencies, like iron, can massively increase how tired we feel. If we are deficient in something like iron, then our GP can support us to re-balance our levels.
If we’re someone who really struggles to get an adequate, varied, food intake, it could also be worth talking to our GP about how we can ensure that we’re getting the basic nutrients we need, within the realms of what is practically achievable for us at the time.
Depression, anxiety, and stress
Depression, anxiety, and stress often go together. Stress and anxiety can increase our fatigue because they deplete our energy. This means that any energy we have is burned very quickly.
There are things we can do to reduce our anxiety or stress levels. We might need support to do or access them, as making changes can be difficult when our mood and energy levels are at rock bottom. It’s always a good idea to reach out for some support if we need to.
Medication Side Effects
Mental health medications can cause drowsiness, sleepiness, insomnia, ‘spaced out’ feelings and fatigue. The tricky thing is, it’s often hard to tell whether something we’re experiencing is a medication side effect or depression.
If we’re able to make a note of our energy levels over time, it can help us to track whether there are any correlations between a new or altered medication and our levels of exhaustion. Sometimes it’s helpful to chat to a close friend or family member as they may have spotted, or be able to remember, changes that we haven’t noticed. If we have any concerns, we need to speak to our prescriber, as often there are options open to us, but they will be very individual.
Neurotransmitters and Hormones
Neurotransmitters continue to be researched, but evidence suggests links between depression, neurotransmitters, and hormones.
We all have hormones that regulate our sleep cycle, hunger levels, happiness levels, and other rhythms and systems within our bodies.
Depression can make these go haywire. This means that we might be sleepy during the day, but not at night, for example. Research around how all these things link continues, and there are often debates.
What is abundantly clear, though, is that depression isn’t our fault. We’re not being lazy; there are likely biological reasons why we feel so exhausted.
Motivation, Overthinking, and Brain Spirals
Depression and exhaustion often come with a lot of thinking.
Our motivation can be virtually non-existent. At the same time, we might overthink everything (which takes a lot of energy). Despite lack of motivation, we might continue to push ourselves beyond the point of exhaustion, to avoid perceived judgements from others, or to hide our struggles. We don’t need to hide our struggles, but it can be hard to say that we’re not okay.
The more tired we become, the harder it is to think straight. We can become increasingly paranoid. Our overthinking ramps up and our brain starts to spiral. If we don’t feel any motivation for the future, we can quickly spiral into “what is the point of me?” thoughts.
Overthinking spirals like this can constantly whirr in the background. Whether we’re cooking tea for the kids, sitting at work, awake at 2am, trying to watch some TV, or sitting on a bus, these thoughts whirr on. Whirring takes energy. So it worsens our exhaustion.
Talking Ourselves Round
Depression is often linked to negative thoughts. Negative thoughts can range from unpleasant and annoying to unsafe.
We will often spend a lot of mental energy on talking ourselves around. We might have tonnes of automatic thoughts each day. Thoughts like “my best friend hates me”, “my family would be better off without me”, “I should engage in a less-than-safe behaviour”, “I don’t deserve to eat/be warm/exist”, “I’m a rubbish parent”… and on, and on, and on. And on.
Each time we have one of these thoughts, we can either engage with it, ignore it, or challenge it. The option we take will depend on the thought, where we are, what we’re doing, how our mood is that day, and how much energy we have. But however the day is going, we will almost certainly challenge at least some of these thoughts. It’s a mental battle that can go on whilst we’re in a coffeeshop queue, babysitting our niece, sitting at our desk, or just about anywhere else, at any time of the day or night.
It’s so draining.
Exhaustion is Complicated
There are so many different factors that can feed into depression-level exhaustion. Often, they can create a “chicken and egg” situation: exercise can energise us, but we need the energy to exercise.
Different aspects of our illness can intermingle. It’s often tricky to tease apart the different strands of life, to figure out what’s going on. Sometimes we might end up playing ‘symptom whack-a-mole’ for a while.
One thing that’s certain is that depression isn’t our fault. We are not lazy. There’s nothing to be ashamed of. We deserve help and support. We deserve to rest as much as we need.
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