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This Is What Depression Feels Like – In The Words of Sufferers

This Is What Depression Feels Like – In The Words of Sufferers

Depression is a really difficult condition to understand, which can make it hard for us to offer meaningful support if we have a friend or relative who’s facing it. Depression isn’t the same for everyone, so there’s no ‘one size fits all’ explanation. In order to help you better understand, I’ve explored some of the common themes and feelings experienced by people struggling with depression so that we can all be a better friend to people who are depressed.

1. Sometimes, you feel nothing at all

People who are struggling with depression will often talk about a complete lack of emotion and feeling:

“Nothing, that was what I felt. All day, every day, NOTHING.”

After a while they might even forget what it feels like to feel, leaving them unable to know how to respond to things that happen each day:

“I didn’t have the energy, empathy or motivation to feel happy for my friends. I vividly recall a friend telling me she’d got engaged and I felt nothing. I think I said ‘congratulations’ but in a dull, emotionless way that led her to believe I didn’t care. And I didn’t. But that wasn’t me talking, it was my depression. I really hurt her but I didn’t intend to, I’d just lost the ability to care for and be happy for her. You can see me in all of her wedding photos. The unsmiling bridesmaid. I wanted so much to be able to smile and feel happy for her but I just couldn’t remember how.” 

2. Nothing feels real

Often, people who are struggling with depression will talk about their life as if they are living in a kind of dream (or nightmare) state where everything feels somewhat meaningless and surreal:

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“When you’ve been devoid of feeling for a while, things take on a different meaning – well a lack of meaning really. Until you’ve lost all feeling, you don’t realise how important a part of the fabric of day to day life our thoughts, feelings and emotions are. I felt like I was kind of sleepwalking. Awake enough to interact with those around me, but never feeling fully present or real.”

Many people use analogies like being stuck under water or down a well to explain the feeling of distance from the rest of the world.

“Every minute of every day was lived as if I was almost at the point of drowning. The point after you’ve stopped struggling and you’re just lying there, watching the rest of the world as your lungs fill with water and the water envelopes you and you think ‘I don’t belong here anymore.’”

3. You can feel like an observer in your own life

It’s common for people to talk about feeling absent from their own lives. Depression can make you feel like an outsider looking in rather than an active participant:

“It was like watching a TV show of my life. I didn’t necessarily like all of the episodes but I felt incapable of changing them – like some producer had made the decisions, not me. It all just washed over me as I watched on.” 

4. The future can feel inconceivable

Both the short and the long term future can feel hard to grasp. This doesn’t necessarily mean feeling suicidal or not wanting to live, but rather just not being able to imagine it.

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“My Dad was talking to me about college choices and I just found myself thinking ‘college? is that even possible?’ – not in an ‘I’m stupid’ kinda way, more in a ‘that’s a thing people do, I’m not really ‘people’ I’m just this blob of….nothing…. how could college be for me?”

“My friend suggested that as I was managing a bit better now, perhaps we could get coffee next week. I said no. Not because I don’t like coffee, or didn’t want to be with my friend, but just because I couldn’t get my head around the idea of this afternoon, let alone next week”

5. Just occasionally, you have happy moments when it’s all okay

People who struggle with depression sometimes have minutes, hours, or days when things feel real again and they can see a glimpse of what it feels like not to be depressed.

“Every now and then the clouds would clear, and it was like I was alive again. It never lasted long. At first I would just feel so low knowing it would pass, but after a time I learned to grab these moments of respite and do all my living whilst they were with me.”

6. But you feel guilty if you feel okay

There’s a common misconception that if someone is depressed, they never feel okay and never smile. This can leave sufferers feeling confused and guilty during respite periods:

“I was signed off work for depression, but here I was walking through the park enjoying the sunshine and the bird song. I felt like a total shirker as I thought of my colleagues back at the office picking up my workload. The day before I had not left my bed and, as it turned out, that was also true of the day after too, but right then I felt okay – and I felt guilty for feeling okay.”

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7. And sometimes you put on a brave face and everyone thinks it’s okay

It can be pretty easy to fool everyone if you want to:

“Before I leave the house, I check I’ve got my wallet, my keys, and my fake smile. If I’ve got those three things, I’m set.”

“After a while, you teach yourself how to act normal. It stops people getting upset and worried. It means that all day, every day is a lie and it’s kind of tiring but it does stop people from worrying so much.”

8. People want you to be fine, so they believe you if you try to fool them

We can all be guilty of not looking past the ‘happy mask’:

“When people say ‘how are you?’ they never mean it. The thing is just to say ‘I’m fine’ and plaster on a fake smile. Hardly anyone sees past it.”

9. It really helps when people reach out, but you don’t know how to thank them

When we’re struggling with depression, sometimes we need the friend who sees past the happy mask more than we need air. But we don’t know how to tell them “thank you” or to acknowledge the fact that we need them. We may even ignore them. But it doesn’t mean we’re not grateful:

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“I had the most amazing friend. She stuck by me. Every day she would text or email. Every day I would ignore her but she continued. Just little messages that let me know in her kooky way that she cared. No one else persisted like she did. The rest all took my lack of response as a sign to stop. She, somehow, realised that I needed those messages. They were a lifeline, and the fact that they came without the expectation of a response made them all the more precious.”

10. It affects your friendships deeply–for better and worse

Depression is a tough illness to face. Many people who suffer from it will lose friends along the way. However, sometimes it’s also a time when someone really special steps forward, and we develop a lifelong friendship with them:

“It’s hard to be friends with someone who’s depressed. I get that. Most of my friends kind of drifted away.”

“Before I was depressed I had so many friends. Afterwards, I had just one true friend. But one true friend is worth more than a thousand friends who drop away when things get hard.”   

I hope this helps you understand – or explain – this difficult illness just a little better. You’re a good friend for caring enough to read this far. Good luck.

These quotes all come from people who are currently suffering from or have recovered from depression and who have shared their experiences with Dr Pooky Knightsmith. All people quoted have given their permission for their words to be shared anonymously.

Featured photo credit: Shi Xuanru 4 by Jonathan Kos-Read via imcreator.com

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Published on November 14, 2018

Why You Suffer from Constant Fatigue and How to Deal with It

Why You Suffer from Constant Fatigue and How to Deal with It

With our busy, always on lives, it seems that more and more of us are facing constant tiredness and fatigue on a regular basis.

For many people, they just take this in their stride as part of modern life, but for others the impact can be crippling and can have a serious effect on their sense of wellbeing, health and productivity.

In this article, I’ll share some of the most common causes of constant tiredness and fatigue and give you some guidance and action steps you can take to overcome some of the symptoms of fatigue.

Why Am I Feeling Fatigued?

Fatigue is extreme tiredness resulting from mental or physical exertion or illness.  It is a reduction in the efficiency of a muscle or organ after prolonged activity.[1]

It can affect anyone, and most adults will experience fatigue at some point in their life. 

For many people, fatigue is caused by a combination of lifestyle, social, psychological and general wellbeing issues rather than an underlying medical condition.

Although fatigue is sometimes described as tiredness, it is different to just feeling tired or sleepy. Everyone feels tired at some point, but this is usually resolved with a nap or a few nights of good sleep. Someone who is sleepy may also feel temporarily refreshed after exercising. If you are getting enough sleep, good nutrition and exercising regularly but still find it hard to perform, concentrate or be motivated at your normal levels, you may be experiencing a level of fatigue that needs further investigation. 

Symptoms of Fatigue

Fatigue can cause a vast range of physical, mental and emotional symptoms including:

  • chronic tiredness, exhaustion or sleepiness
  • mental blocks
  • lack of motivation
  • headache
  • dizziness
  • muscle weakness
  • slowed reflexes and responses
  • impaired decision-making and judgement
  • moodiness, such as irritability
  • impaired hand-to-eye coordination
  • reduced immune system function
  • blurry vision
  • short-term memory problems
  • poor concentration
  • reduced ability to pay attention to the situation at hand

Causes of Fatigue

The wide range of causes that can trigger fatigue include:

  • Medical causes: Constant exhaustion, tiredness and fatigue may be a sign of an underlying illness, such as a thyroid disorder, heart disease, anemia or diabetes.
  • Lifestyle-related causes: Being overweight and a lack of regular exercise can lead to feelings of fatigue.  Lack of sleep and overcommitting can also create feelings of excessive tiredness and fatigue.
  • Workplace-related causes: Workplace and financial stress in a variety of forms can lead to feelings of fatigue.
  • Emotional concerns and stress: Fatigue is a common symptom of mental health problems, such as depression and grief, and may be accompanied by other signs and symptoms, including irritability and lack of motivation.

Fatigue can also be caused by a number of factors working in combination.

Medical Causes of Fatigue

If you have made lifestyle changes to increase your energy and still feel exhausted and fatigued, it may be time to seek guidance from your doctor.

Here are a few examples of illnesses that can cause ongoing fatigue. Seek medical advice if you suspect you have a health problem:

Anemia

Anemia is a condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to the body’s tissues. It is a common cause of fatigue in women.

Having anemia may make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe.[2]

Chronic Fatigue Syndrome (CFS)

Chronic Fatigue Syndrome (CFS) is a condition that can cause persistent, unexplained fatigue that interferes with daily activities for more than six months.

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This is a chronic condition with no one-size-fits-all treatment, but lifestyle changes can often help ease some symptoms of fatigue.[3]

Diabetes

Diabetes can cause fatigue with either high or low blood sugars. When your sugars are high, they remain in the bloodstream instead of being used for energy, which makes you feel fatigued. Low blood sugar (glucose) means you may not have enough fuel for energy, also causing fatigue.[4]

Sleep Apnea

Sleep apnea is a serious sleep disorder where sufferers briefly stop breathing for short periods during sleep. Most people are not aware this is happening, but it can cause loud snoring, and daytime fatigue.

Being overweight, smoking, and drinking alcohol can all worsen the symptoms of sleep apnea.[5]

Thyroid disease

An underactive thyroid gland means you have too little thyroid hormone (thyroxine) in your body. This makes you feel tired and you could also put on weight and have aching muscles and dry skin.[6]

Common lifestyle factors that can cause fatigue include:

  • Lack of sleep
  • Too much sleep 
  • Alcohol and drugs 
  • Sleep disturbances 
  • Lack of regular exercise and sedentary behaviour 
  • Poor diet 

Common workplace issues that can cause fatigue include:

  • Shift work: Our body is designed to sleep during the night. A shift worker may confuse their circadian clock by working when their body is programmed to be asleep.
  • Poor workplace practices: This may include long work hours, hard physical labour, irregular working hours (such as rotating shifts), a stressful work environment, boredom or working alone. 
  • Workplace stress – This can be caused by a wide range of factors including job dissatisfaction, heavy workload, conflicts with bosses or colleagues, bullying, or threats to job security.
  • Burnout: This could be striving too hard on one area of your life while neglecting others, which leads to a life that feels out of balance.

Psychological Causes of Fatigue

Psychological factors are present in many cases of extreme tiredness and fatigue.  These may include:

  • Depression: Depression is characterised by severe and prolonged feelings of sadness, dejection and hopelessness. People who are depressed commonly experience chronic fatigue.
  • Anxiety and stress: Someone who is constantly anxious or stressed keeps their body in overdrive. The constant flooding of adrenaline exhausts the body, and fatigue sets in.
  • Grief: Losing a loved one causes a wide range of emotions including shock, guilt, depression, despair and loneliness.

How to Tackle Constant Fatigue

Here are 12 ways you can start tackling the causes of fatigue and start feeling more energetic.

1. Tell The Truth

Some people can numb themselves to the fact that they are overtired or fatigued all the time. In the long run, this won’t help you.

To give you the best chance to overcome or eliminate fatigue, you must diagnose and tell the truth about the things that are draining your energy, making you tired or causing constant fatigue.

Once you’re honest with yourself about the activities you’re doing in your life that you find irritating, energy-draining, and make you tired on a regular basis you can make a commitment to stop doing them.

The help that you need to overcome fatigue is available to you, but not until you tell the truth about it. The first person you have to sell on getting rid of the causes of fatigue is yourself.

One starting point is to diagnose the symptoms. When you start feeling stressed, overtired or just not operating at your normal energy levels make a note of:

  • How you feel
  • What time of day it is
  • What may have contributed to your fatigue
  • How your mind and body reacts

This analysis may help you identify, understand and then eliminate very specific causes.

2. Reduce Your Commitments

When we have too many things on our plate personally and professionally, we can feel overstretched, causing physical and mental fatigue.

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If you have committed to things you really don’t want to do, this causes irritability and low emotional engagement. Stack these up throughout your day and week, then your stress levels will rise.

When these commitments have deadlines associated with them, you may be trying to cram in far too much in a short period of time.  This creates more stress and can affect your decision making ability.

Start being realistic about how much you can get done. Either reduce the commitments you have or give yourself more time to complete them in.

3. Get Clear On Your Priorities

If working on your list of to-do’s or goals becomes too overwhelming, start reducing and prioritizing the things that matter most.

Start with prioritizing just 3 things every day. When you complete those 3 things, you’ll get a rush of energy and your confidence will grow.

If you’re trying to juggle too many things and are multi-tasking, your energy levels will drop and you’ll struggle to maintain focus.

Unfinished projects can make you self-critical and feel guilty which drops energy levels further, creating inaction.

Make a list of your 3 MIT (Most Important Tasks) for the next day before you go to bed. This will stop you overcommitting and get you excited about what the next day can bring.

4. Express More Gratitude

Gratitude and confidence are heavily linked. Just being thankful for what you have and what you’ve achieved increases confidence and makes you feel more optimistic.

It can help you improve your sense of wellbeing, which can bring on feelings of joy and enthusiasm.

Try starting a gratitude journal or just note down 3 things you’re grateful for every day.

5. Focus On Yourself

Exhaustion and fatigue can arrive by focusing solely on other people’s needs all the time, rather than worrying about and focusing on what you need (and want).

There are work commitments, family commitments, social commitments. You may start with the best intentions, to put in your best performance at work, to be an amazing parent and friend, to simply help others.

But sometimes, we extend ourselves too much and go beyond our personal limits to help others. That’s when constant exhaustion can creep up on us.  Which can make us more fatigued.

We all want to help and do our best for others, but there needs to be some balance. We also need to take some time out just for ourselves to recharge and rejuvenate.

6. Set Aside Rest and Recovery Time

Whether it’s a couple of hours, a day off, a mini-break or a proper holiday, time off is essential to help us recover, recharge and refocus.

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Recovery time helps fend off mental fatigue and allows us to simply kick back and relax.

The key here, though, is to remove ourselves from the daily challenges that bring on tiredness and fatigue. Here’s how.

Can you free yourself up completely from work and personal obligations to just rest and recover?

7. Take a Power Nap

When you’re feeling tired or fatigued and you have the ability to take a quick 20-minute nap, it could make a big difference to your performance for the rest of the day.

Napping can improve learning, memory and boost your energy levels quickly.

This article on the benefit of napping is a useful place to start if you want to learn more: How a 20-Minute Nap at Work Makes You Awake and Productive the Whole Day

8. Take More Exercise

The simple act of introducing some form of physical activity into your day can make a huge difference. It can boost energy levels, make you feel much better about yourself and can help you avoid fatigue.

Find something that fits into your life, be that walking, going to the gym, running or swimming. 

The key is to ensure the exercise is regular and that you are emotionally engaged and committed to stick with it.

You could also walk more which will help clear your head and shift your focus away from stressful thoughts.

9. Get More Quality Sleep

To avoid tiredness, exhaustion and fatigue, getting enough quality sleep matters. 

Your body needs sleep to recharge.  Getting the right amount of sleep every night can improve your health, reduce stress levels and help us improve our memory and learning skills.

My previous article on The Benefits of Sleep You Need to Know will give you some action steps to start improving your sleep. 

10. Improve Your Diet

Heavy or fatty meals can make you feel sluggish and tired, whilst some foods or eating strategies do just the opposite.

Our always on lives have us reaching for sweets or other sugary snacks to give us a burst of energy to keep going. Unfortunately, that boost fades quickly which can leave you feeling depleted and wanting more.

On the other hand, whole grains and healthy unsaturated fats supply the reserves you can draw on throughout the day.

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To keep energy up and steady, it’s a good idea to limit refined sugar and starches.

Eating small meals and healthy snacks every few hours throughout the day provides a steady supply of nutrients to body and brain. It’s also important not to skip breakfast.

Eating a balanced diet helps keep your blood sugar in a normal range and prevents that sluggish feeling when your blood sugar drops.

11. Manage Your Stress Levels

Stress is one of the leading causes of exhaustion and fatigue, and can seriously affect your health.

When you have increased levels of stress at work and at home, it’s easy to feel exhausted all the time. 

Identifying the causes of stress and then tackling the problems should be a priority. 

My article on How to Help Anxiety When Life is Stressing You Out shares 16 strategies you can use to overcome stress.

12. Get Hydrated

Sometimes we can be so busy that we forget to keep ourselves fully hydrated.

Water makes up about 60 percent of your body weight and is essential in maintaining our body’s basic functions.

If we don’t have enough water, it can adversely affect our mental and physical performance, which leads to tiredness and fatigue.

The recommended daily amount is around two litres a day, so to stay well hydrated keep a water bottle with you as much as possible.

The Bottom Line

These 12 tips can help you reduce your tiredness and feeling of fatigue.  Some will work better than others as we are all different, whilst others can be incorporated together in your daily life.

If you’ve tried to make positive changes to reduce fatigue and you still feel tired and exhausted, it may be time to consider making an appointment with your doctor to discuss your condition.

Featured photo credit: Annie Spratt via unsplash.com

Reference

[1]Oxford English Dictionary: Definition of fatigue
[2]NHS Choices: 10 Reasons for feeling tired
[3]Verywellhealth: What is chronic fatigue syndrome
[4]Everyday Health: Why does type 2 diabetes make you feel tired
[5]Mayo Clinic: Sleep apnea
[6]Harvard Health: The lowdown on thyroid slowdown

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