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Aug 25

Fatigue and Depression or Bipolar

Fatigue and DepressionFatigue is a common symptom in people with recurrent depression or bipolar.

And in fact a common symptom in the general population. It is estimated that up to 10% of otherwise healthy people suffer from fatigue. And it is a more common symptom in women than in men.

Sometimes fatigue may persist well beyond other symptoms of depression.

First, it is important to assess the type of fatigue you are dealing with –

Are we talking about trouble initiating any activity (generalized weakness), or trouble concentrating (mental fatigue) or a reduction in the capacity for sustained physical activity (easy fatiguability)? Some people have a mixture of these, but figuring out what type of fatigue is most prominent can be helpful in determining what the cause of the fatigue is.

It is probably useful to talk to your doctor and get an evaluation. Some people with depression and fatigue may also have another medical condition. Common ones include –

  • Medications (especially high blood pressure medicines, medicines for sleep, and some antidepressants and mood stabilizers)
  • Thyroid disease
  • Low cortisol (adrenal insufficiency)
  • Chronic kidney or liver failure
  • Heart or lung diseases (associated with shortness of breath)
  • Anemia
  • Cancer (if there is significant unexplained weight loss)
  • Infections (mononucleosis, CMV, hepatitis, HIV, parasites, especially if you have been traveling recently)
  • Sleep disturbances (obstructive sleep apnea, restless legs, severe allergies)
  • Chronic fatigue syndrome (a relatively rare condition with specific criteria)
  • Fibromyalgia (associated with tender points on the body)
  • Idiopathic (or “Other”)

Your doctor can help you assess for these. He should take a careful history of the onset of symptoms (gradual, sudden, associated with travel, etcetera) and how long the symptoms have been going on, as well as any physical symptoms that point to a particular cause.

For most people with fatigue and depression or bipolar, the symptoms of tiredness will gradually improve once they are no longer depressed.

Others, who have a specific cause, may need treatment for that cause.

A few will fall into that “other” category, or will have fatigue that seems to be caused by the very medications that they need in order to have stable moods.

For them a careful assessment of diet and exercise (very gradually increasing amounts of exercise is one of the best treatments for chronic fatigue) is in order. And perhaps other medications, although use of medications for fatigue are not without significant risks.

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