Why Does Depression Make You So Tired? The Science Behind the Exhaustion

If you're living with depression, you already know it's far more than feeling sad. One of the most debilitating—and least understood—symptoms is the bone-deep exhaustion that can make even getting out of bed feel like running a marathon. For many patients we see at Next Step Psychiatry, fatigue is actually the symptom that finally brings them through our door.

The Brain Chemistry Behind Depression Fatigue

Your brain relies on three key neurotransmitters to regulate energy and mood: serotonin, dopamine, and norepinephrine. In major depressive disorder, these chemical messengers fall out of balance. Dopamine drives motivation and reward; norepinephrine fuels alertness and concentration; serotonin stabilizes mood. When all three are disrupted, the result is pervasive fatigue that no amount of coffee can fix.

Other Reasons Depression Drains Your Energy

Sleep Disruption

Depression wreaks havoc on sleep. Some people develop insomnia and lie awake for hours. Others experience hypersomnia—sleeping 10, 12, or more hours and still waking up exhausted. Either pattern prevents the restorative deep sleep your body needs.

Poor Nutrition

Depression affects appetite in both directions. You may eat too little, depriving your body of essential fuel, or overeat comfort foods that spike blood sugar and leave you crashing. Either way, your energy suffers.

Chronic Stress

Depression and stress are deeply intertwined. Chronic stress elevates cortisol, which depletes energy reserves over time and contributes to inflammation that can worsen both depression and fatigue.

Medication Side Effects

Ironically, some antidepressants can cause drowsiness, especially in the first few weeks. If medication-related fatigue persists, your prescriber may adjust the dose, switch medications, or modify the timing of your doses.

Reduced Physical Activity

When you're exhausted, exercise feels impossible. But inactivity actually worsens fatigue by reducing cardiovascular fitness and depriving your brain of mood-boosting endorphins. Even a short walk along the Lilburn greenway can start to reverse this cycle.

How to Fight Depression Fatigue

• Prioritize sleep hygiene: Consistent bedtimes, limited screens before sleep, and a cool dark room.
• Move when you can: Start with 10-minute walks and build gradually.
• Eat regularly: Focus on protein, vegetables, and whole grains to maintain stable energy.
• Talk to your prescriber: Medication adjustments can significantly reduce fatigue.
• Consider advanced treatments: For treatment-resistant depression, options like Spravato (esketamine) can provide relief when traditional antidepressants haven't worked.

Depression Treatment in Lilburn, GA

Next Step Psychiatry offers comprehensive depression treatment, including medication management and Spravato therapy, for patients throughout the greater Atlanta area. Dr. Aneel Ursani and Fathima Chowdhury, PA-C work with each patient to find the right treatment approach—because you deserve more than just surviving each day.

4145 Lawrenceville Hwy STE 100, Lilburn, GA 30047 • 678-437-1659