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Depression is acommon cause of fatigue, so you might be wondering whether your fatigue is a result of depression. But just because you’re tired all the time doesn’t necessarily mean that you’re depressed.
The fact is there are many underlying conditions that could be responsible forfeeling tired all the time. Frommood disordersto issues affecting your physical health likechronic fatigue syndrome, the following psychiatric and medical conditions are some of the most common ailments associated with fatigue.
But first, it’s important to note that many of these conditions share symptoms similar to depression, so we’ll start there. By understanding the distinctions between depression and other factors that cause fatigue, you can seek out the right treatment and start to feel like your energetic self again.
Depression Recovery: How to Know You’re Making Progress
Verywell / Nusha Ashjaee
Depression
Depression, which research suggests is associated with an imbalance ofneurotransmittersin the brain, is commonly linked with fatigue.The condition is also associated withdisturbed sleep, which can also significantly contribute totiredness. While some people may have difficulty falling asleep or staying asleep, others may oversleep. Both of these sleep disturbances can leave you feeling apathetic and sluggish.
Othersymptomsassociated with depression include:
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see ourNational Helpline Database.
If you think you may be experiencing depression, talk to your doctor. They can refer you to atherapistwho can help you manage your emotions or another mental health professional such as apsychiatristwho may also recommendantidepressants. Don’t let depression go untreated.
Discover the Treatment Options for Depression
Anxiety
Anxiety and anxiety disorders are often associated with fatigue as well as sleep disturbances.Sleep deprivationmay also contribute to feelings of anxiety, which perpetuates a cycle of both anxiety and sleeplessness. This, of course, can make it difficult to manage both conditions.
The following are common anxiety disorders that may be associated with sleep disruptions and fatigue:
Therapy for Anxiety Disorders
Stress
Stress can lead to sleepless nights. Stress can also wear you down and cause you to feel fatigued. We’ve all experienced the repercussions of stress at one time or another. If left unmanaged, stress can also wreak havoc on your mood. Stress can be a trigger for depression and anxiety disorders.
Like anxiety, stress can contribute to poor sleep and poor sleep cancreate stress. For instance, you know that you need to get a good night’s sleep so that you have energy the next day, but you might have trouble falling asleep because you are worried that you aren’t going to get enough sleep.
Fortunately, there are many ways to combat stress that don’t require sleep aids or medications. mind-body techniques such asyoga nidra, or “yogic sleep,” andmeditationcan help you manage stress and sleep better so you can wake up feeling refreshed with more energy.
Mindful MomentFeeling sluggish? Take this free3-minute meditation to boost your energy—or choose from ourguided meditation libraryto find another one that will help you feel your best.
Mindful Moment
Feeling sluggish? Take this free3-minute meditation to boost your energy—or choose from ourguided meditation libraryto find another one that will help you feel your best.
Why Am I So Tired After Work?
Bipolar Disorder
If you have bipolar disorder and are experiencing sleep disturbances, talk to your doctor about appropriate treatment for your disorder.
Attention-Deficit/Hyperactivity Disorder
Attention-deficit/hyperactivity disorder (ADHD)is a common psychiatric condition among both children and adults and is commonly associated with a variety of sleep disturbances that can contribute to daytime sleepiness. Many of the medications used to treat ADHD can also impact sleep.
Sleep patterns and habits are usually assessed when treating ADHD. In fact, research has shown that interventions to improve sleep hygiene can help reduce the severity of ADHD symptoms and increase the person’s overall quality of life.
How to Fall Asleep With ADHD
Often, physical health issues such as thyroid problems and chronic fatigue syndrome can result in fatigue symptoms resembling depression.It’s also possible that fibromyalgia, sleep apnea, or an autoimmune disorder such as rheumatoid arthritis or lupus could cause you to feel tired all the time.
Here are some physical factors that could be draining your energy and what you can do about it.
Underactive Thyroid
If you have an underactive thyroid (hypothyroidism) simple activities can leave you feeling wiped out. Your thyroid is a small gland in the front of your neck that produces hormones that regulate your metabolism. When it’s not producing enough of these hormones, your metabolism slows down. This can lead to fatigue, weight gain, and even depression.
Some research suggests that over 60% of people with thyroid disorders may experience symptoms of depression.
The traditional treatment for hypothyroidism involves medications that increase thyroid levels in your body. Symptoms of fatigue may get better or go away once the thyroid condition has been treated appropriately with medication. To confirm the diagnosis, your doctor will useblood teststo look at your levels of thyroid hormones including thyroxine and thyroid-stimulating hormone (TSH).
Chronic Fatigue Syndrome
Those with chronic fatigue still have an interest in activities but lack the energy and capacity to do them. Because CFS shares symptoms with other medical and psychiatric illnesses, it is not uncommon for it to be diagnosed as depression or another psychiatric condition. People may also experience both CFS and a psychiatric condition at the same time.
The underlying cause of chronic fatigue syndrome is not yet fully understood, and treatment may involve certain medications and lifestyle interventions.
Fibromyalgia
Estimates suggest that 40% of people with fibromyalgia also have a co-occurring major depressive disorder.
There is no specific test that can diagnose fibromyalgia. Instead, doctors must rely on an assessment of your health history and symptoms. Diagnosis typically requires the presence of widespread chronic pain, fatigue, and sleep disturbance. Treatment for fibromyalgia usually involves a combination of medication and lifestyle changes.
Autoimmune Disorders
Autoimmune disorders involve the immune system attacking the body. Rheumatoid arthritis,lupus, andceliac diseaseare examples of autoimmune disorders. Autoimmune processes have also been implicated in certain types of diabetes and multiple sclerosis (MS).
While these conditions aren’t as common as depression, they can present with similar symptoms. In fact, according to some research, depression-like symptoms are present in up to 50% of patients with autoimmune disorders.These symptoms typically emerge over the course of the disease and are associated with psychosocial factors,chronic pain, and long periods of disability.
Sleep Apnea
Sleep disorders, such as obstructive sleep apnea, can also cause many symptoms similar to those of depression. Obstructive sleep apnea is a condition where your breathing is interrupted during sleep for longer than 10 seconds. This can happen many times an hour.
These frequent interruptions interfere with your sleep quality, resulting in daytime fatigue, morning headaches, and poor concentration.It can also have a serious impact on your mood. One study found that approximately 46% of people with sleep apnea have symptoms of depression.
If you think you have a sleep disorder, speak with your doctor. In addition to reviewing your symptoms, your doctor will likely take your medical history, conduct a physical exam, and may recommend a sleep study. They may also order additional tests to rule out other medical conditions that may be causing your symptoms.
What Is Chronic Sleep Deprivation?
Iron-Deficiency Anemia
Your body uses iron to make hemoglobin, the part of the red blood cell that carries oxygen to all the parts of your body.
When you don’t have enough iron, your blood can’t carry enough oxygen to your body. This can leave you feeling sluggish, fatigued, and lightheaded. You may also have dull or pale skin and experience headaches, dizziness, and shortness of breath.
There are many potential causes that can lead to anemia aside from irondeficiency, so your doctor may ask you further questions about your diet and lifestyle and order more tests if needed.
Dehydration and Inadequate Nutrition
Staying hydrated and getting proper nutrition is important for keeping your energy levels up. Research shows that a lack of fluid intake is associated with sleep issues, fatigue, and alertness.
Not getting enough calories in your diet can also leave you feeling tired all the time, as can eating too many refined carbohydratesor not getting enough protein.Allergies to foods such as wheat or dairy may also contribute to tiredness.
Lifestyle Factors
If you don’t seem to have enough energy, it could be because you’re not getting enough physical activity. Research shows a sedentary lifestyle can lead to fatigue and difficulty sleeping.
Cigarettes and alcohol can also affect sleep quality and leave you feeling groggy the next day.
Sleep Problems Associated With Alcohol Misuse
Depending on the severity of your symptoms and whether you’ve been diagnosed with a psychiatric or medical condition, there are a few habits anyone can do to improve their quality of sleep and have more energy the next day.
A Word From Verywell
While depression remains one of the most common causes of symptoms like tiredness and fatigue, it’s not the only condition that produces depression-like symptoms. If you are experiencing persistent tiredness and fatigue, it is important to seek a proper diagnosis. It’s also possible to have more than one diagnosis (known ascomorbidity) contributing to your symptoms.
For example, there are people who have both clinical depression and hypothyroidism. If you’re tired all the time and low on energy, your best bet is to work with your healthcare provider to explore your symptoms and get a proper diagnosis and treatment plan.
The Military Sleep Method: Benefits and How It Works
31 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: Prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-zAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.Timpano KR, Carbonella JY, Bernert RA, Schmidt NB.Obsessive compulsive symptoms and sleep difficulties: Exploring the unique relationship between insomnia and obsessions.J Psychiatr Res. 2014;57:101-7. doi:10.1016/j.jpsychires.2014.06.021Koffel E, Khawaja IS, Germain A.Sleep disturbances in posttraumatic stress disorder: Updated review and implications for treatment.Psychiatr Ann. 2016;46(3):173-176. doi:10.3928/00485713-20160125-01Enns MW, Bernstein CN, Kroeker K, et al.The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases.PLoS One. 2018;13(6):e0198975. doi:10.1371/journal.pone.0198975Datta K, Tripathi M, Mallick HN.Yoga nidra: An innovative approach for management of chronic insomnia- A case report.Sleep Sci Pract.2017;1(7). doi:10.1186/s41606-017-0009-4Gold AK, Sylvia LG.The role of sleep in bipolar disorder.Nat Sci Sleep. 2016;8:207-214. doi:10.2147/NSS.S85754Peppers KH, Eisbach S, Atkins S, Poole JM, Derouin A.An intervention to promote sleep and reduce adhd symptoms.J Pediatr Health Care. 2016;30(6):e43-e48. doi:10.1016/j.pedhc.2016.07.008Vassend O, Røysamb E, Nielsen CS, Czajkowski NO.Fatigue symptoms in relation to neuroticism, anxiety-depression, and musculoskeletal pain. A longitudinal twin study.PLoS One. 2018;13(6):e0198594. doi:10.1371/journal.pone.0198594Gaitonde DY, Rowley KD, Sweeney LB.Hypothyroidism: An update.Am Fam Physician. 2012;86(3):244-251.Hage MP, Azar ST.The link between thyroid function and depression.J Thyroid Res. 2012;2012:590648. doi:10.1155/2012/590648Roberts D.Chronic fatigue syndrome and quality of life.Patient Relat Outcome Meas. 2018;9:253-262. doi:10.2147/PROM.S155642Yancey JR, Thomas SM.Chronic fatigue syndrome: Diagnosis and treatment.Am Fam Physician. 2012;86(8):741-746.Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment.Pain Res Treat. 2012;2012:426130. doi:10.1155/2012/426130Gracely, RH, Ceko, M, and Bushness, MC.Fibromyalgia and depression.Pain Res Treat.2012; 486590. doi:10.1155/2012/486590Kodner C.Common questions about the diagnosis and management of fibromyalgia.Am Fam Physician. 2015;91(7):472-478.Pryce CR, Fontana A.Depression in autoimmune diseases.Curr Top Behav Neurosci.2017;31:139-154. doi:10.1007/7854_2016_7Yanjun L, Tang X.Depressive syndromes in autoimmune disorders of the nervous system: Prevalence, etiology, and influence.Frontiers in Psychiatry.2018;9:451. doi:10.3389/fpsyt.2018.00451Benros ME, Waltoft BL, Nordentoft M, et al.Autoimmune diseases and severe infections as risk factors for mood disorders: A nationwide study.JAMA Psychiatry. 2013;70(8):812-820. doi:10.1001/jamapsychiatry.2013.1111Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD.Obstructive sleep apnea and depression: A review.Innov Clin Neurosci.2011;8(8):17-25.Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F.The correlation of anxiety and depression with obstructive sleep apnea syndrome.J Res Med Sci.2014;19(3):205-10.Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-360.Pross N, Demazières A, Girard N, et al.Influence of progressive fluid restriction on mood and physiological markers of dehydration in women.Br J Nutr. 2013;109(2):313-321. doi:10.1017/S0007114512001080Khong TK, Selvanayagam VS, Sidhu SK, Yusof A.Role of carbohydrate in central fatigue: A systematic review.Scand J Med Sci Sports. 2017;27(4):376-384. doi:10.1111/sms.12754Pezeshki A, Zapata RC, Singh A, Yee NJ, Chelikani PK.Low protein diets produce divergent effects on energy balance.Sci Rep. 2016;6:25145. doi:10.1038/srep25145Yu W, Freeland DMH, Nadeau KC.Food allergy: immune mechanisms, diagnosis and immunotherapy.Nat Rev Immunol. 2016;16(12):751-765. doi:10.1038/nri.2016.111Yang Y, Shin JC, Li D, An R.Sedentary behavior and sleep problems: A systematic review and meta-analysis.Int J Behav Med. 2017;24(4):481-492. doi:10.1007/s12529-016-9609-0Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH.The role of sleep hygiene in promoting public health: A review of empirical evidence.Sleep Med Rev. 2015;22:23-36. doi:10.1016/j.smrv.2014.10.001Harvard Health Publishing.Tips for beating anxiety to get a better night’s sleep.Herbert C, Meixner F, Wiebking C, Gilg V.Regular physical activity, short-term exercise, mental health, and well-being among university students: The results of an online and a laboratory study.Front Psychol. 2020;11:509. doi:10.3389/fpsyg.2020.00509Ogeil RP, Phillips JG.Commonly used stimulants: Sleep problems, dependence and psychological distress.Drug Alcohol Depend. 2015;153:145-151. doi:10.1016/j.drugalcdep.2015.05.036
31 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: Prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-zAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.Timpano KR, Carbonella JY, Bernert RA, Schmidt NB.Obsessive compulsive symptoms and sleep difficulties: Exploring the unique relationship between insomnia and obsessions.J Psychiatr Res. 2014;57:101-7. doi:10.1016/j.jpsychires.2014.06.021Koffel E, Khawaja IS, Germain A.Sleep disturbances in posttraumatic stress disorder: Updated review and implications for treatment.Psychiatr Ann. 2016;46(3):173-176. doi:10.3928/00485713-20160125-01Enns MW, Bernstein CN, Kroeker K, et al.The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases.PLoS One. 2018;13(6):e0198975. doi:10.1371/journal.pone.0198975Datta K, Tripathi M, Mallick HN.Yoga nidra: An innovative approach for management of chronic insomnia- A case report.Sleep Sci Pract.2017;1(7). doi:10.1186/s41606-017-0009-4Gold AK, Sylvia LG.The role of sleep in bipolar disorder.Nat Sci Sleep. 2016;8:207-214. doi:10.2147/NSS.S85754Peppers KH, Eisbach S, Atkins S, Poole JM, Derouin A.An intervention to promote sleep and reduce adhd symptoms.J Pediatr Health Care. 2016;30(6):e43-e48. doi:10.1016/j.pedhc.2016.07.008Vassend O, Røysamb E, Nielsen CS, Czajkowski NO.Fatigue symptoms in relation to neuroticism, anxiety-depression, and musculoskeletal pain. A longitudinal twin study.PLoS One. 2018;13(6):e0198594. doi:10.1371/journal.pone.0198594Gaitonde DY, Rowley KD, Sweeney LB.Hypothyroidism: An update.Am Fam Physician. 2012;86(3):244-251.Hage MP, Azar ST.The link between thyroid function and depression.J Thyroid Res. 2012;2012:590648. doi:10.1155/2012/590648Roberts D.Chronic fatigue syndrome and quality of life.Patient Relat Outcome Meas. 2018;9:253-262. doi:10.2147/PROM.S155642Yancey JR, Thomas SM.Chronic fatigue syndrome: Diagnosis and treatment.Am Fam Physician. 2012;86(8):741-746.Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment.Pain Res Treat. 2012;2012:426130. doi:10.1155/2012/426130Gracely, RH, Ceko, M, and Bushness, MC.Fibromyalgia and depression.Pain Res Treat.2012; 486590. doi:10.1155/2012/486590Kodner C.Common questions about the diagnosis and management of fibromyalgia.Am Fam Physician. 2015;91(7):472-478.Pryce CR, Fontana A.Depression in autoimmune diseases.Curr Top Behav Neurosci.2017;31:139-154. doi:10.1007/7854_2016_7Yanjun L, Tang X.Depressive syndromes in autoimmune disorders of the nervous system: Prevalence, etiology, and influence.Frontiers in Psychiatry.2018;9:451. doi:10.3389/fpsyt.2018.00451Benros ME, Waltoft BL, Nordentoft M, et al.Autoimmune diseases and severe infections as risk factors for mood disorders: A nationwide study.JAMA Psychiatry. 2013;70(8):812-820. doi:10.1001/jamapsychiatry.2013.1111Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD.Obstructive sleep apnea and depression: A review.Innov Clin Neurosci.2011;8(8):17-25.Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F.The correlation of anxiety and depression with obstructive sleep apnea syndrome.J Res Med Sci.2014;19(3):205-10.Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-360.Pross N, Demazières A, Girard N, et al.Influence of progressive fluid restriction on mood and physiological markers of dehydration in women.Br J Nutr. 2013;109(2):313-321. doi:10.1017/S0007114512001080Khong TK, Selvanayagam VS, Sidhu SK, Yusof A.Role of carbohydrate in central fatigue: A systematic review.Scand J Med Sci Sports. 2017;27(4):376-384. doi:10.1111/sms.12754Pezeshki A, Zapata RC, Singh A, Yee NJ, Chelikani PK.Low protein diets produce divergent effects on energy balance.Sci Rep. 2016;6:25145. doi:10.1038/srep25145Yu W, Freeland DMH, Nadeau KC.Food allergy: immune mechanisms, diagnosis and immunotherapy.Nat Rev Immunol. 2016;16(12):751-765. doi:10.1038/nri.2016.111Yang Y, Shin JC, Li D, An R.Sedentary behavior and sleep problems: A systematic review and meta-analysis.Int J Behav Med. 2017;24(4):481-492. doi:10.1007/s12529-016-9609-0Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH.The role of sleep hygiene in promoting public health: A review of empirical evidence.Sleep Med Rev. 2015;22:23-36. doi:10.1016/j.smrv.2014.10.001Harvard Health Publishing.Tips for beating anxiety to get a better night’s sleep.Herbert C, Meixner F, Wiebking C, Gilg V.Regular physical activity, short-term exercise, mental health, and well-being among university students: The results of an online and a laboratory study.Front Psychol. 2020;11:509. doi:10.3389/fpsyg.2020.00509Ogeil RP, Phillips JG.Commonly used stimulants: Sleep problems, dependence and psychological distress.Drug Alcohol Depend. 2015;153:145-151. doi:10.1016/j.drugalcdep.2015.05.036
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: Prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-zAmerican Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.Timpano KR, Carbonella JY, Bernert RA, Schmidt NB.Obsessive compulsive symptoms and sleep difficulties: Exploring the unique relationship between insomnia and obsessions.J Psychiatr Res. 2014;57:101-7. doi:10.1016/j.jpsychires.2014.06.021Koffel E, Khawaja IS, Germain A.Sleep disturbances in posttraumatic stress disorder: Updated review and implications for treatment.Psychiatr Ann. 2016;46(3):173-176. doi:10.3928/00485713-20160125-01Enns MW, Bernstein CN, Kroeker K, et al.The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases.PLoS One. 2018;13(6):e0198975. doi:10.1371/journal.pone.0198975Datta K, Tripathi M, Mallick HN.Yoga nidra: An innovative approach for management of chronic insomnia- A case report.Sleep Sci Pract.2017;1(7). doi:10.1186/s41606-017-0009-4Gold AK, Sylvia LG.The role of sleep in bipolar disorder.Nat Sci Sleep. 2016;8:207-214. doi:10.2147/NSS.S85754Peppers KH, Eisbach S, Atkins S, Poole JM, Derouin A.An intervention to promote sleep and reduce adhd symptoms.J Pediatr Health Care. 2016;30(6):e43-e48. doi:10.1016/j.pedhc.2016.07.008Vassend O, Røysamb E, Nielsen CS, Czajkowski NO.Fatigue symptoms in relation to neuroticism, anxiety-depression, and musculoskeletal pain. A longitudinal twin study.PLoS One. 2018;13(6):e0198594. doi:10.1371/journal.pone.0198594Gaitonde DY, Rowley KD, Sweeney LB.Hypothyroidism: An update.Am Fam Physician. 2012;86(3):244-251.Hage MP, Azar ST.The link between thyroid function and depression.J Thyroid Res. 2012;2012:590648. doi:10.1155/2012/590648Roberts D.Chronic fatigue syndrome and quality of life.Patient Relat Outcome Meas. 2018;9:253-262. doi:10.2147/PROM.S155642Yancey JR, Thomas SM.Chronic fatigue syndrome: Diagnosis and treatment.Am Fam Physician. 2012;86(8):741-746.Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment.Pain Res Treat. 2012;2012:426130. doi:10.1155/2012/426130Gracely, RH, Ceko, M, and Bushness, MC.Fibromyalgia and depression.Pain Res Treat.2012; 486590. doi:10.1155/2012/486590Kodner C.Common questions about the diagnosis and management of fibromyalgia.Am Fam Physician. 2015;91(7):472-478.Pryce CR, Fontana A.Depression in autoimmune diseases.Curr Top Behav Neurosci.2017;31:139-154. doi:10.1007/7854_2016_7Yanjun L, Tang X.Depressive syndromes in autoimmune disorders of the nervous system: Prevalence, etiology, and influence.Frontiers in Psychiatry.2018;9:451. doi:10.3389/fpsyt.2018.00451Benros ME, Waltoft BL, Nordentoft M, et al.Autoimmune diseases and severe infections as risk factors for mood disorders: A nationwide study.JAMA Psychiatry. 2013;70(8):812-820. doi:10.1001/jamapsychiatry.2013.1111Ejaz SM, Khawaja IS, Bhatia S, Hurwitz TD.Obstructive sleep apnea and depression: A review.Innov Clin Neurosci.2011;8(8):17-25.Rezaeitalab F, Moharrari F, Saberi S, Asadpour H, Rezaeetalab F.The correlation of anxiety and depression with obstructive sleep apnea syndrome.J Res Med Sci.2014;19(3):205-10.Semelka M, Wilson J, Floyd R.Diagnosis and treatment of obstructive sleep apnea in adults.Am Fam Physician. 2016;94(5):355-360.Pross N, Demazières A, Girard N, et al.Influence of progressive fluid restriction on mood and physiological markers of dehydration in women.Br J Nutr. 2013;109(2):313-321. doi:10.1017/S0007114512001080Khong TK, Selvanayagam VS, Sidhu SK, Yusof A.Role of carbohydrate in central fatigue: A systematic review.Scand J Med Sci Sports. 2017;27(4):376-384. doi:10.1111/sms.12754Pezeshki A, Zapata RC, Singh A, Yee NJ, Chelikani PK.Low protein diets produce divergent effects on energy balance.Sci Rep. 2016;6:25145. doi:10.1038/srep25145Yu W, Freeland DMH, Nadeau KC.Food allergy: immune mechanisms, diagnosis and immunotherapy.Nat Rev Immunol. 2016;16(12):751-765. doi:10.1038/nri.2016.111Yang Y, Shin JC, Li D, An R.Sedentary behavior and sleep problems: A systematic review and meta-analysis.Int J Behav Med. 2017;24(4):481-492. doi:10.1007/s12529-016-9609-0Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH.The role of sleep hygiene in promoting public health: A review of empirical evidence.Sleep Med Rev. 2015;22:23-36. doi:10.1016/j.smrv.2014.10.001Harvard Health Publishing.Tips for beating anxiety to get a better night’s sleep.Herbert C, Meixner F, Wiebking C, Gilg V.Regular physical activity, short-term exercise, mental health, and well-being among university students: The results of an online and a laboratory study.Front Psychol. 2020;11:509. doi:10.3389/fpsyg.2020.00509Ogeil RP, Phillips JG.Commonly used stimulants: Sleep problems, dependence and psychological distress.Drug Alcohol Depend. 2015;153:145-151. doi:10.1016/j.drugalcdep.2015.05.036
Ghanean H, Ceniti AK, Kennedy SH.Fatigue in patients with major depressive disorder: Prevalence, burden and pharmacological approaches to management.CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-z
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013.
Timpano KR, Carbonella JY, Bernert RA, Schmidt NB.Obsessive compulsive symptoms and sleep difficulties: Exploring the unique relationship between insomnia and obsessions.J Psychiatr Res. 2014;57:101-7. doi:10.1016/j.jpsychires.2014.06.021
Enns MW, Bernstein CN, Kroeker K, et al.The association of fatigue, pain, depression and anxiety with work and activity impairment in immune mediated inflammatory diseases.PLoS One. 2018;13(6):e0198975. doi:10.1371/journal.pone.0198975
Datta K, Tripathi M, Mallick HN.Yoga nidra: An innovative approach for management of chronic insomnia- A case report.Sleep Sci Pract.2017;1(7). doi:10.1186/s41606-017-0009-4
Gold AK, Sylvia LG.The role of sleep in bipolar disorder.Nat Sci Sleep. 2016;8:207-214. doi:10.2147/NSS.S85754
Peppers KH, Eisbach S, Atkins S, Poole JM, Derouin A.An intervention to promote sleep and reduce adhd symptoms.J Pediatr Health Care. 2016;30(6):e43-e48. doi:10.1016/j.pedhc.2016.07.008
Vassend O, Røysamb E, Nielsen CS, Czajkowski NO.Fatigue symptoms in relation to neuroticism, anxiety-depression, and musculoskeletal pain. A longitudinal twin study.PLoS One. 2018;13(6):e0198594. doi:10.1371/journal.pone.0198594
Gaitonde DY, Rowley KD, Sweeney LB.Hypothyroidism: An update.Am Fam Physician. 2012;86(3):244-251.
Hage MP, Azar ST.The link between thyroid function and depression.J Thyroid Res. 2012;2012:590648. doi:10.1155/2012/590648
Roberts D.Chronic fatigue syndrome and quality of life.Patient Relat Outcome Meas. 2018;9:253-262. doi:10.2147/PROM.S155642
Yancey JR, Thomas SM.Chronic fatigue syndrome: Diagnosis and treatment.Am Fam Physician. 2012;86(8):741-746.
Bellato E, Marini E, Castoldi F, et al.Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment.Pain Res Treat. 2012;2012:426130. doi:10.1155/2012/426130
Gracely, RH, Ceko, M, and Bushness, MC.Fibromyalgia and depression.Pain Res Treat.2012; 486590. doi:10.1155/2012/486590
Kodner C.Common questions about the diagnosis and management of fibromyalgia.Am Fam Physician. 2015;91(7):472-478.
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