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Why am I so tired all the time?

This time of year, I always seem to have trouble. Some nights I have difficulty falling asleep and can’t seem to shut off my mind. On weekends, I can’t get out of bed in the morning. I decline invitations to go do things after work, because everything feels like a huge effort. What is going on with me and what should I do?

There are many reasons why you may feel run down. But in our experience, one of the most common causes for feeling exhausted, especially this time of year, is depression.

Depression is one of the most common mental health concerns and a frequent reason for someone to visit a health care provider. Depression affects 7 percent of adults, and women experience depression two-to-one compared to men. Often, depression presents itself with other illnesses such as anxiety, eating disorders, substance abuse, diabetes, cancer and other medical conditions. It’s different from having a bad day. Depression symptoms last for weeks and interfere with daily life.

While depression is more common when someone experiences loss or stress from death, a breakup, abuse, job loss or a sudden change in finances, it can also occur for no obvious reason. Depression can occur with the change in seasons. Specifically, depression symptoms can worsen in the fall to early winter, and this is known as seasonal affective disorder. A family history of depression may mean you are more likely to also suffer with depression.

Drugs and alcohol change the chemical balance in the brain and can lead to depression. Some people use drugs and alcohol to numb the pain, but, in the long run, it just makes depression worse. Physical illness and hormone changes can lead to changes in the brain that contribute toward depression.

Common symptoms of depression include feeling sad, down and hopeless most days or no longer enjoying the things you used to do. In addition to these symptoms, if you are depressed, you may lose or gain weight, sleep too much or too little, feel tired and feel guilty or worthless. If you have depression, you may forget things or feel confused, feel restless, irritable, have slow movement or speech, have difficulty concentrating or making decisions, have poor memory or think about death or suicide. Depression affects your whole body and your brain chemicals, and you may experience headaches, stomachaches or other aches and pains.

Depression is real, and the most effective treatment may be a combination of interventions. Step one is to visit your health care provider. You and your health care provider will discuss a plan of care that is individualized for you. Your provider will also assess you for other illnesses that can appear like depression, such as thyroid disease, and screen for co-existing disorders like anxiety. To feel better, people with depression can improve their health, start a regular exercise routine, see a counselor, modify their diet, use light therapy or take medication that help relieve depression.

It’s up to you to get help and talk to your family and friends. Therapy can offer emotional support by helping you better understand your thoughts and feelings. A trained professional can assist you in working through issues in your life and relationships. Different settings exist for therapy, and this may be done in a group setting or a one-on-one setting. Therapy can take time before you notice how much it is helping. There are different methods for talk therapy, but they all involve giving insight about your emotions, new tools for dealing with your problems and emotional support for making progress.

Antidepressant medication can reduce suffering and improve your ability to function during the depressed period. It may take several weeks of taking an antidepressant before you feel a difference in mood improvement. If it doesn’t seem to be working, more time may be needed, the dose may be increased or the medication may be changed.

If you are feeling tired, restless and alone, talk to your health care provider today. Recovering from depression is a process and it takes time, but you are not alone. Help is just around the corner.

Michelle Napral is a nurse practitioner at the University of Minnesota Health Nurse Practitioners Clinic, 3rd Street & Chicago. Send questions to nursnews@umn.edu.