When You Are Always Tired

Sleepiness, fatigue, and depression interact and overlap a lot. We often use interchangeable terms to describe how tired we are. Far from exhaustive, there are some major differences.

Sleepiness
Sleepiness is an overwhelming desire to fall asleep. Sleepiness can look like:

  • struggling to keep eyes open
  • microbursts of sleep (the head bob)
  • low energy
  • heaviness in limbs
  • lapses in alertness
  • slower reaction time
  • difficulty making decisions
  • eyes tearing
  • ability to easily sleep when given the chance
  • feeling like you can fall asleep anywhere, on the sofa/ sitting on the toilet/at your desk 

Sleepiness can be caused by:

  • being awake for a long enough period of time
  • an underlying sleep disorder (narcolepsy, circadian rhythm disorders, etc)
  • lack of quality sleep
  • a medication side effect
  • drinking alcohol

Fatigue
Fatigue is a lack of both physical and emotional energy and motivation (tiredness, exhaustion, and low energy).

Fatigue can look like:

  • sluggishness
  • weakness
  • difficulty with concentration or memory
  • struggling to start or complete tasks
  • inability to complete regular chores
  • variable ability to fall asleep even when given the opportunity

Fatigue can be caused by:

  • physical and mental exertion
  • stress
  • depression
  • experiencing micro-aggressions
  • sleep disturbances
  • physical illness
  • medications
  • dehydration
  • poor nutrition
  • lack of physical activity
  • boredom

Fatigue is relieved by:

  • rest
  • activity reduction
  • mind-body activities (i.e. yoga, meditation, pranayama, mindfulness)
  • hydration
  • eating nutritious food
  • regular exercise

Fatigue after mental or physical exertion is normal. Ongoing fatigue for 6+ months with no known cause, that’s not improved with sleep or rest, and that worsens with physical or mental activity may indicate an underlying medical or mental health condition, such as chronic fatigue syndrome.

Depression
Depression involves persistent feelings of sadness, disappointment and hopelessness, along with other emotional, mental, and physical changes that interfere with daily activities.

Depression can look like:

  • a lack of interest and pleasure in most activities
  • restricted schedule; doing the bare minimum
  • easily irritable or frustrated (especially in children and teens)
  • feelings of worthlessness, excessive guilt, or hopelessness
  • constant low self-esteem
  • significant weight loss or gain
  • insomnia or excessive sleeping
  • lack of energy
  • inability to concentrate
  • physical problems like headache, stomachache, body aches and pains, or sexual dysfunction
  • recurrent thoughts (ideation) of death or suicide
  • diminished ADLs (not changing clothing, showering, or keeping up with daily chores)

Depression can be caused by:

  • a personal or family history of depression
  • major stressors or traumas
  • certain medications
  • specific illnesses

Depression is relieved by:

  • psychotherapy
  • medication
  • lifestyle management (regular exercise, quality sleep, a healthy diet, social support, avoiding alcohol)

We all experience sadness every now and then. When feelings of sadness continue for 2+ weeks and are felt nearly all day, nearly every day, they may indicate clinical depression. If you are experiencing symptoms of depression, it’s important to seek help from your doctor or mental health professional.

Also see my post on high functioning depression.

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Embolden Psychology
Embolden

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

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