Extreme fatigue

Hi,
I had a severe depression a couple of months ago. It seems to be a bit better now although I'm still quite anhedonic. But the worst part is that I am so extremely tired, day in day out. I sleep with medication (seroquel or promethazine/temazepam) and I sleep quite well and many hours. But when I get out of bed, I am hardly capable of doing things, even a short walk outside requires such an amount of energy. Before my depression I was kind of hypomanic for 9 months due to anti depressants. Could it be that I am still not recovered from the false energy that I got from those pills? Life like this is not worth it, I hardly call it life, it is survive...

Wow, that sounds awful. I haven't experienced it, but it is definitely worth bring up to your regular doc. There may be something medical going on. Best wishes for more energy soon!

Sent from my iPhone using Tapatalk

I found that I had extreme fatigue when I was depressed. It could still be part of the depression. Or it could be the effects of your medication.

I hope you feel better soon. My fatigue went away when my depression decreased.

I've had this as well. I knew there had to be something else going on though. I saw 3 doctors who took blood tests and when everything came back "normal" they wrote it off as symptoms of depression. My 4th doctor was an endocrinologist and after seeing my blood test results told me it was my thyroid. All doctors have their own take on what normal TSH levels are and for her it was too high. I started taking synthroid and noticed an improvement. I wasn't jumping off the walls or anything but at least I could walk the dog without feeling drained. Be persistent with your docs if you go. I think some are way too quick to blame it on the depression. Good luck!

I agree with shamon86 that getting your physical health care team to check out your thyroid function is a good idea.

The thyroid gland makes a hormone called thyroxine which comes in two forms (T3, relatively active) and T4 (relatively inactive). Production of thyroxine is controlled by a hormone called Thyroid Stimulating Hormone (TSH) which is made by the pituitary gland and production of TSH is controlled by a hormone called Thyrotropin Releasing Hormone (TRH), made by the hypothalamus.

Low levels of blood T3 are often associated with extreme fatigue.

Measurements of blood levels of T3, T4, TSH and TRH are easy to do. Your physical health care team should be able to interpret those measurements and (depending) suggest further investigations and appropriate treatment.

All the best.

Sometimes in depression I have severe fatigue, sometimes I do not. I played around a lot with hormones in an attempt to find some solutions for depression. It made no difference at all.

In september my TSH was measured it was 2.0. I think that is in the normal range. The other levels they didnt test (here not standard procedure). Next time I will ask however to test those other levels as well.
I also read something about adrenal fatigue or hypoadrenia in relation to fatigue. But that doesnt seem te be scientifically proven.

A TSH level of 2.0 is well within the normal range (it is 0.4 - 4.0 mIU/L of blood).

I think that you are right in being sceptical about "adrenal fatigue" - it is a fictitious label used by many evidence-free alt/comp med people to explain many vague signs which they are not competent to diagnose or treat. Importantly, those signs can indicate possible health issues which an evidence-based health professional can investigate.

Getting the other levels checked out by your care team is a really good plan.

I also experience extreme fatigue and exhaustion with depression. In fact, I pretty much stay tired all the time. It is worth checking with the doctor. Also, your medications might be making you tired. I have to take Amitriptyline to prevent migraines. This medicine makes me so tired, but then again, I can't stand to suffer migraines and it does help prevent them. Best of wishes.

As an experiment last night I took just a 20mg temazepam (normally either seroquel 25mg or combination of 20mg temazepam and 25mg promethazine). Although I still have a hangover effect, it seems that I was a bit less tired today. I slept well. I will try it again tonight.

Last night I didn't take meds at all. I slept very bad, 5-6 hours max. and woke up a lot of times. But I feel less tired and exhausted than when I take those meds. I hope I don't take a nap today and that I will sleep better tonight.

Would wellbutrin be an option for me? At them moment I don't take medication at all, just as I wrote above for sleep but Im tapering it off. I read that wellbutrin has a stimulating effect as well but I don't want to slide into hypomania which happened before on paxil and on mirtazapine. I don't like this "fake" energy since Im afraid it could exhaust me even more on the long term. But staying at home, not being able to work or other activities isn't pleasurable either.

Ow, and I read wellbutrin isn't particularly good for sleep... how does that correlate to my sleeping problems? Since depression causes sleeping problems as well. If wellbutrin could alleviate my depression, I might sleep better. But if wellbutrin alleviates my depression but doesnt make me sleep better, I fear that after a while I collaps anyway.
Any experiences on this?

since a couple of nights i don't take meds. the first night i slept very bad, woke up a lot and had just 4-5 hours sleep. second night i woke up twice and last night i woke up just once and had some 7 hours sleep. i hope this trend will continue.

I have extreme fatigue too, it is a sign of major depression. Take care of yourself. As you get better, it does go. You have to find ways to cope with it and dont over exert yourself.

8888an8888, thank u for your answer. I see you take zoloft and zopiclone. doesnt that make you extemely tired too?

Meds can often cause fatigue, as can depression itself. It is such a balancing act, isn't it? Frustrating. I think the Wellbutrin could possibly trigger mania, so check with your prescriber about that part of it. I understand that sometimes starting with lower doses of medications can ease the fatigue and other side effects, and sometimes the body sort of adjusts to the medication over time. It may take several days/weeks to adjust, depending upon the person and the particular medication. Sometimes I think a prescriber will have a person take one medication to fix the side effect of another, if nothing else is effective as a substitute for the offending medication. Combining medications with other treatment modalities helps, like massage, etc. I really hope that there is some near-perfect therapy for you that you and your prescriber can find! It is awful to feel so fatigued!

I feel extreme fatigue, too. Every medicine seems to make it worse, even if it helps the depression. So far, anyway. ...I haven't found my near-perfect therapy. I don't want to give up yet.

Still I didnt take any sleeping meds. Just melatonine now and then. I sleep quite well and I have more energy. Still not a normal level but that could be the remains of my depression. But at least I dont have the constant drowsiness I had from the meds.

Pearlys, glad it seems you've found a bit of a solution and have more energy. Hope it keeps up for you! I usually sleep fine but my energy starts really declining slowly but surely starting around 5 p.m. I usually go in bed by 8 p.m. because I'm so tired - - even though I don't go to sleep until 9. It's very frustrating but I chalk it up to the depression.

After an incident last week my mood deteriorated, I am very emotional now with lots of crying spells. And my sleep is back to where I started. Fall asleep around 23:00, wake up between 3 and 4 am, can't sleep for an hour or more, fall asleep again, sleep for 2 hours, wake up again etc.

Sometimes I think I am lazy. But when I don't even have the energy to do things that I used to enjoy, like hobbies, then this isn't lazyness is it?

No it isn't laziness, cause you would get up and do things you liked if you felt better. I am very tired too, I blame my meds and depression. But at least I am not crying and staring at the walls.

I'm crying but not staring at the walls. But I feel like ****. Had a stressful day yesterday, took a seroquel, didnt take meds for a week or so. The seroquel knocked me out really fast and I slept all night long. Still feel miserable today

i also sometimes wonder if im just lazy, but then i remember im on 9 different meds, and that that is what is causing my tiredness and sleepiness.i don't cry much, but am sad inside, you're lucky if you can cry, i cant for some reason. then you can get your feelings out. i havnt cried in years.