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Hello, I am feeling very tired today! Friday June 14, 2013

Someone posted a comment about tiredness a while back, in fact two people did.

What they said struck a big chord with me. The essence of both their comments was that whilst they found it difficult to distinguish between the different causes of their tiredness, once they had sorted out the different causes, they were better able to deal with their fatigue.

Now... I feel tired when I don't get enough deep refreshing sleep and I have never ever thought that anything else causes me to feel tired, the sort of fatigue where everything feels a bit pointless and I am unenthusiastic about things. When I sleep well (once in a blue moon) I am on top of the world, confident, witty and guess what, not tired!

Once a medic said to me that I wasn't sleep deprived but depressed instead but I insisted NO! I am only depressed because I haven't slept properly.

Oh dear, it's such a conundrum, such a chicken and egg situation. I don't know where I am on this issue.

Does anyone out there have this problem? Does bad sleep tiredness feel different to fatigue caused by something else? How will I recognise a different type of fatigue and it's cause?

Does this dilemma happen with other forms of mental health problems? I think finding a cause for how we feel is nigh impossible most of the time!

Thoughts on the above? Please feel free to post a comment on our Blogspot:

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PWD Fri, Jun 14th 2013 @ 6:35am

Gosh reading this is uncanny it is as though I have just wrote it.This is my dilemma to a tee, Wed night awake from 3 yesterday awful day. Last night slept till 5am today a fair bit better. But which is it the tiredness or the depression. To sum up my thoughts yesterday I was putting my weetabix in the fridge instead of the microwave to warm it up now that is definitely tiredness. Thanks Julia for a great Blog


Exidia Fri, Jun 14th 2013 @ 6:54am

Yep - strikes a chord with me too, though I am bright-eyed and bushy tailed today because although last night was late I'd had a great evening (alcohol-free - which helps). Also I'm going to get my son from Uni today - another good thing.
On the other hand, when I'm depressed the tiredness seeps through me until I am bone weary, but I can feel that it's not physical, it's just that my brain is shutting my body down so it doesn't have to face up to the pain.
So I know the difference - but it doesn't help I'm afraid.

Anonymous Fri, Jun 14th 2013 @ 8:07am

I too have been confused over this issue in the past. Eventually I reached the point where I couldn't handle the lack of sleep anymore and I asked my doctor for sleeping pills. For me, it was definitely the right choice. I was able to catch up on sleep and be much more productive throughout the day, and it eased my depression, a little, too.

Anonymous Fri, Jun 14th 2013 @ 8:38am

Read the human givens theories on depression and anxiety and it explains completely the links between sleep and mood. They have very easy to read (read them in an afternoon) books on the subject. My anxiety has stopped completely since working with one of their counsellors and reading the book. And my depression is now well managed. Sleep is a healer and I love it, even when I don't get enough of it.

Nicola Fri, Jun 14th 2013 @ 8:51am

Isn't this a conundrum?! I tend to sleep 8-10 hours a night, and yet I regularly find myself so exhausted that I have to sleep in the afternoon. I find it difficult to distinguish the cause of my feelings in other ways too - for the past few days I've felt thoroughly fed up, and yet its always so hard to tell whether my feelings are because of a genuine issue that needs resolving or a symptom of the illness. Plus, even thinking about these issues means contributing more cognitive effort to thinking about depression, which can in turn make all those symptoms worse. What a pickle!

Anonymous Fri, Jun 14th 2013 @ 8:53am

Completely in agreement. I rarely sleep well to the point that I have been nodding off at my desk this week, and have correspondingly felt very low. Never quite sure which causes the other! At the point now where my bed is my favourite place to be, I just never seem to be there for long enough.

Mary Blackhurst Hill Hill Fri, Jun 14th 2013 @ 9:05am

Great Blog, Julia. Tiredness is a really good indicator for me as to where I am in my cycle. Right at the high point I only need 4 or five hours sleep a night and am full of energy (exhausting for everyone else around me) and when down I am like a cat and can sleep for 17 hours a day easily, although rarely straight through the night. It was this fatigue that took me to the doctor in the first place, where like many people, I argued "I'm not depressed; I'm just tired. Can't you give me a tonic or something?" I now try to regulate my sleep and am finding that following the 5:2 intermittent fasting programme is really helping me sleep well, and to feel more awake during the day (funny that).

Anonymous Fri, Jun 14th 2013 @ 9:43am

For what it's worth, I tend to distinguish between mental exhaustion and physical tiredness. Whilst the former tends to be linked to less sleep, it can happen to me even when I'm sleeping well, depending on what else is going on in my life. The later is entirely dependent upon the 6/7 hours sleep I need a night.

Caroline Ashcroft Fri, Jun 14th 2013 @ 9:45am

Hi there, I've just had an email from Julia who would like to thank you all for your comments. She'd love to reply and will do in due course, but she's currently in sunny Spain and can read the comments but isn't able to post any.

lizhill Fri, Jun 14th 2013 @ 9:51am

Interesting blog - as you can see by all the comments! Getting a good night's sleep certainly helps with mood - there aren't many (any?) people in the world who's mood is improved by lack of sleep. However, the quality of the sleep is important too. I'm tired today even though I had plenty of sleep last night, because I drank alcohol with dinner. It's worth working out what makes you tired - it might not just be lack of sleep. Perhaps keeping a journal (nothing onerous) just a line or two about how you are feeling and what you did during the day might show up some patterns. Some people make me tired - if all they do is talk and never listen. Some situations make me tired - if I have to concentrate hard to understand what is going on (this can be a good sort of tired, as long as you give yourself the chance to rest afterwards). Physical activity, paradoxically, can actually make you less tired as it can give a chance for proper rest afterwards. Listen to what your body is telling you about when you should rest, people and situations you should avoid, and when, where and how your body is best able to get the rest that it needs.

Anonymous Fri, Jun 14th 2013 @ 10:19am

Sleep, food and exercise are necessary for all humans - whether the 'glamorous bipolar' variety or just ordinary ones. Activity/energy drives mania and that is when it is important to recognise 'work. rest and play'. Sometimes physical activity is the way to dissipate mental over activity, sometimes a self hypnotic approach works as it simulates REM sleep. Although it's harder to exercise (motivationally) when depressed it appears, to me, to be the best way to 'earn' a good sleep that then enhances mood.

Taking care of oneself is what it's all about. Ask a helathy type one diabetic for example.

Anonymous Fri, Jun 14th 2013 @ 10:27am

I have found Paul Mckenna, I can make you sleep has quite literally changed my life, i now get into bed at 11 and sleep whole night through, i have been listening to this for just over a month ever night, given up caffeine and dont drink alcohol. I enjoy sleep !!!

Anonymous Fri, Jun 14th 2013 @ 10:30am

Great post! I seem to be feeling tired all the time at the moment which then leads to lack of energy and sitting around doing nothing all day when I have plenty I should be doing...When I try and get an early night I'll go to bed at 10:30 but then wake at 4:17am - yes, it really is that precise - for 5 days in a row last week I woke at that time! lol It would be good to find out why I feel this tired all the time, all bloods show nothing wrong so am at a loss really! Thanks for the post! x

Anonymous Fri, Jun 14th 2013 @ 11:05am

I have struggled with this dilemma for years as I have a number of medical problems which cause exhaustion namely fibromyalgia, HMJS, hypothyroidism and IBS. In the past I have been to the doc. about tiredness and been told I was depressed and they advised me to increase my anti-depressants and I've had to argue that I'm not down I feel physically ill. Over the years I got these diagnoses but the Drs and myself find it very difficult to separate cause and effect. There is no doubt that lack of sleep either through anxiety or just getting up for several nights in a row when someone is unwell is a major trigger for depression.
I would say say that its important to go for health check as physical illness can be a cause/trigger but in my case it took a long time to identify the fibro as blood tests etc. don't reveal anything. By the time I got referred affecting many body systems to a rheumatologist she said I had ALL of the 'classic' symptoms and she reckoned that I'd had it over 20 years. It is difficult for a dr to see past the depression label and I think that sometimes its good to see a different dr. from the practice who may look again.
Thanks for the blog and the Moodscape board, definitely a good tool for spotting trends and changing what I can.

Victoire Fri, Jun 14th 2013 @ 11:13am

Hi Julia, I have always found the same difficulty, in distinguishing between depressed mood tired and tired tired (so to speak). My doctor and family will often say when I report a run of bad nights - "are you worrying about anything?" or "you're probably feeling low". Yet often this doesn't ring true. I can definitely see the connection between anxiety and lack of sleep and can spend the wee hours worrying about something and not being able to drop off. But then last night, after a good day, I had yet again, a fitful night, falling finally into heavy doze at around 5, which then mean I'm bleary and foggy headed at 8. I have stopped catnapping in the day as I worry it'll only make things worse. But after a run of bad nights, I feel quite desperate to lie down and close my eyes... and I know I'm not thinking straight or clearly and certainly my anxiety goes up when i'm tired. So its a conundrum! Sorry, i''m not offering any words of wisdom here, merely echoing your post! Don't doctors talk of patients who are TATT? (Tired All the Time)? (not very helpful to the patient though I can understand the frustration). I'm sure I must fall into this bracket...

Sue Freeman Fri, Jun 14th 2013 @ 11:39am

There is definitely a 'chicken and egg' issue here. As a hypnotherapist I used to find clients coming to me with what they thought was depression - it had similar symptoms - but turned out to be the consequences of anxiety, leading to constant rumination, leading to the brain trying to REM sleep to process the overload and thus not being able to fit in the deep sleep which revives us. During deep sleep we boost our immune system and repair physical injury, set our melatonin levels to regulate our sleep,produce growth hormone (especially in teenagers)and probably most relevant top up serotonin levels. I only discovered quite recently when teaching about the baby brain that we have a minute store of serotonin at every nerve synapse to maintain the optimum connection. You can see how serotonin deficiency could not only make you feel low (brain connections sluggish), but physically tired (muscle connections sluggish).
I've been meditating with a mantra for 25 years and found it brilliant for preventing overload. I regularly found teaching clients a form of meditation improved their sleep and thus their mood. It's also good with any physical illness as it allows the body to recuperate where possible. I've just discovered 'Mindfulness' by Mark Williams and Danny Penman and am trying new ways of extending my meditation skills. I'm not saying that medication isn't needed, just that it's important to not to jump straight in with it before assessing the whole person.

Caroline Ashcroft Fri, Jun 14th 2013 @ 12:10pm

Hi Sue, thank you so much for this information. I'm sure it will be of help.

carly-sullivan Fri, Jun 14th 2013 @ 12:11pm

Perhaps this is not the best forum for me to make my first comment because I've been blessed with the ability to sleep even in the toughest times -- not always the best sleep, but still... But I would like to inject another thought. Poor sleep or lack of sleep will undermine mood, and mood shifts, of many types, will make us tired. But I'd like to suggest that there is such a thing as emotional fatigue. I don't know if a mental health professional would validate that, but I've spent the last year dealing with the end of my marriage, work stress, home responsibilities I didn't have when I had a partner, and the effects of Super Storm Sandy, and I'm tired. I'm not depressed. I've dealt with depression for nearly 50 years, and I know when I'm depressed. This (amazingly) is not it. And as I said, I sleep. But I'm tired. I'm tired of coping, tired of being strong, tired of doing what needs to be done, tired of thinking about whether I've done everything, tired of being tired. Self-care is helpful. Eating well, exercise, making time for a bit of pampering. Counseling is helpful. And ultimately, I think, time will help. But it's not "all in my head." The mind is tired, the heart is tired, and the body comes along.

Anonymous Fri, Jun 14th 2013 @ 12:37pm

Just before my depression was diagnosed I went on for almost a month with an average of 3 hour sleep nights. You can imagine the level of tiredness I reached. But I think that was the way my mind made me look for help. The first thing the doctor prescribed me were sleeping pills together with the depression medication. Without me getting proper rest the depression medication was going to be useless. Once the depression medication kicked off I was able to quit the sleeping pills.
Since then I did have had some though nights but have never reached the same level of severity. I fact I have not taken sleeping pills anymore. What I find now is the cause of sleeping difficulty is rumination. Whenever something a little out of the ordinary happen during the day (someone I care about did or said something to me I didn't quite like, I did or said something I feel I shouldn't have, I find myself with too much behind work at the office, I'm excited for a coming event, etc) I start ruminating at night. I found a good book works for me. It has to be good though. I force myself into reading, a little hard to do at first, but as the story starts getting me, my rumination starts to fade away, and with calmness comes sleepiness.
Another thing I realized is that there are two kinds of tiredness. One is the result of stress at work and daily stuff, and thefe is another one, a delightful tiredness, which is the result of doing something you like that requires energy. For me it is hiking among nature. I try to do it whenever I can. When I can't I do some exercise, or walk or jog around the neighborhood. Outside is the key for me. The delightful tiredness gives the best sleep.
All of this is what I know works for me, but I have to be honest, when I feel really down is very hard to get to do it. But I keep trying. Someday will come when I will be strong enogh that it is not going to be a big effort anymore.

Anonymous Fri, Jun 14th 2013 @ 1:16pm

For all those who feel tired during the day despite having slept at night check with your doctor whether you ahve sleep apnoa. I suffered from this for years without knowing thinking I was sleeping and yet falling asleep in the afternoon, life became very dpressing and tough. This is a manageable condition if diagnosed and for me at least was a life changer.

Anonymous Fri, Jun 14th 2013 @ 3:15pm

I definitely find days harder to cope with when I'm tired. Recently I've been using my IPhone to help me when I can't get to sleep. When I notice I've been awake for some time tossing and turning with my mind going round and round worrying about things I set my IPhone to play either soothing music from my library, or something soothing from Youtube, or play a podcast or an audio book. Then I set the Timer (in the Clock app) to turn the IPhone off after a certain number of minutes (when hopefully I'm sound asleep!) Very often I start listening to a short story or something but don't get very far as the voice lulls me to sleep within minutes (also I think that actively listening to something switches the head thoughts off). I quite often have to do this several times in one night, but at least I get off to sleep for a while each time. I'm sure other smartphones could do this too.

If you go onto and search for "sleep music" or "sleep relax" or something like tht you'll get all sorts of things that might help, or "sleep hypnosis" might be interesting. Otherwise go to and there are loads of books, short stories etc that you can listen to for free, also

Hope this is helpful.

Diana Fri, Jun 14th 2013 @ 5:00pm

Please, anon, I didn't understand what you mean by the 'humans givens theories'. Are they PAMPHLETS written by the
N.H.S. ? ( as they are good too - on anxiety, depression,
and sleep problems )

Diana Fri, Jun 14th 2013 @ 5:12pm

Try 'British Snoring & Sleep Apnoea Association' incase your G.P. doesn't take you too seriously at 1st. It is a
Charity, so will charge for any 'appliances' ( but they do not take any profit on the appliances !)

Elizabeth Fri, Jun 14th 2013 @ 9:49pm

Hello, I like your comment. I think there definitely is something like emotional tiredness. I have two related points from my experience:

- As to my therapist, depression-related tiredness may come from suppressed feelings. I don't understand it fully but I do know that crying of expressing myself in some other way sometimes helps lift the tiredness.
- When working with emotions, perhaps trying to explore my feelings, I must put in a lot of concentrated effort and as a result I can get really exhausted after an hours session

Good luck everyone dealing with tiredness.

Anonymous Sat, Jun 15th 2013 @ 12:19am

I once had the causes of fatigue (or TATT) outlined for me as: 1. physical illness 2. depression 3. stress/anxiety 4. exercising too much 5. sleeping too much or too little. Walking through these helps me focus on where the root cause might be and make small adjustments. Then over time I learnt how each one felt and got better at correcting it early. For me, stress induced tiredness has a draining feeling which goes away/lifts slightly if I do something fun, or just something nice for me but tiredness because of lack of sleep (due to something other than my brain going into overdrive) is more physically exhausting. Exercise helps stress-induced tiredness but not lack of sleep. If you're lacking sleep and when you wake your brain is going on one or more issues, the root cause is not lack of sleep.

Caroline Ashcroft Sat, Jun 15th 2013 @ 12:35am

I would just like to say how interesting this correspondence has been. Thank you to everyone who has contributed with their advice or experience. It's obviously a big problem and talking about it and sharing experiences can only help. Thank you all and thank you to Julia for writing this blog.

Sue Freeman Sat, Jun 15th 2013 @ 8:37am

Try this link to Human Givens. Joe Griffins work on sleep is fascinating.
Sue Freeman

Anonymous Sat, Jun 15th 2013 @ 7:25pm

I have phases of bad sleep and when I have been deprived of a good nights sleep for a couple of nights I find it extremely difficult to keep my mood up.
I think if you are a depressive and prone to negative thinking it is more difficult to keep those negative thoughts at bay when you are tired.
But then sometimes you don't sleep well when you are anxious and have worrying thoughts so it is a chicken or egg scenario.
All I know is that when I sleep well, I can be more positive about life.

Suzy Sat, Jun 15th 2013 @ 9:24pm

Wowsers! There is no shortage of comments and info to work your way through here Julia eh? I'm certain that there is nothing I can add that isn't already here or that you don't already know but doing daily battle with an illness called narcolepsy I can say that this is an issue I contemplate regularly, if not daily. Oftentimes I simply can't decipher what's the root cause of a low mood. Does a depression make the narcolepsy worse or does the narcolepsy make anxiety or a depression worse? I suspect it's perhaps a bit of both. I've come to learn that I'm more prone to poorly nerves or poor emotional health because of the ongoing sleep debt. I know it's been said oh so many times before but information really is power. So, I devour everything I can on good sleep hygiene, my particular illness-narcolepsy, depression, anxiety and all the daily "maintenance" stuff (Moodscope being just one such example) that can help all of these things. Feeding my soul and creating things (anything!) helps me oodles as has different kinds of counseling through the years too. I'm currently receiving CBT through the NHS, for which I'm hugely grateful. I could go on and on but maybe my waffling would actually only serve to overwhelm you further. :o( I suppose what I really wanted to say was: I feel for you! Treat yourself very gently. I also wish you a very restful, beauteous holiday. x P.S. I find my body struggles with gluten, dairy, sugar and sometimes meat too. It takes practice to listen to what our bodies are saying. But they are always, always telling us something. The art is, I suppose, learning to listen and really hear.

Silvia A Tue, Jan 28th 2014 @ 3:03am

I've been reading lot of articles about sleep deprivation. This is a good one:

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