February 11, 2015

Winter 2015 is synonymous with gray skies, gloomy drizzle, blue-funk heaveyheartedness, house-bound sameness and conversations on the topic of depression. Maybe it is not depression one may be feeling; maybe it is fatigue. How does one distinguish between depression and fatigue?

To answer that question, let’s distinguish between five things:

1. Fatigue: Fatigue occur when the human body simply runs out of power. It is rooted in the body struggling with a unrelenting problem. Perhaps it happens because of long-term burden, malnutrition, hormonal irregularities, and/or prolonged diseases like diabetes, arthritis, and/or obesity to name a few. Fatigue lasts all day and every day. Sufferers may be distracted for short periods of time, however, fatique remains constant.

2. Tiredness: Being tired lasts for two-three days following external forces such as disrupted sleep patterns (entertaining house guests), high levels of concern (mid-term exams), demanding physical tasks (moving an office or spring yard cleanup). Even a sudden increase in the numbers of people one is around socially may lead to feelings of being “out of juice” or expressions like “I am tired!”

3. Grief: The body slows down and is not willing to do as much as usual with the onset of the process of grief. With the loss of a person, pet, or employment, the brain needs time to adjust to the new reality. Unlike some cultures, Americans tend to undervalue the grieving process.

Nevertheless, grief is not depression. The breakup with a boyfriend, sweetheart, partner and/or spouse is not depression. It is grief. It is dealing with loss. As we recreate the story and make meaning of the loss, we may find that we have more zest for our life, Grief is a process that may occasion great renewal.

4. Seasonal Effective Disorder (SAD): This condition is more common during the fall and winter. When there are fewer hours of sunlight, less serotonin is produced in the brain. Serotonin, a hormone that affects mood, appetite and sleep, is also a neurotransmitter, a transmitter of messages between nerve cells. Low serotonin levels may cause the messages between nerve cells to be tranmitted ineffectively, leading to the symptoms of SAD, such as feeling blue and down.

It is really important for each of us to get outside for at least 20 minutes every single day–drizzling rain, blowing snow or not. When dealing with Seasonal Effective Disorder, I find the following helpful: time in nature; sun lamps; and 2,000 IU’s of a reliable source of Vitamin D (Carlson) each morning.

5. Depression One of the easiest ways to distinguish depression from fatigue is by listening—yes, listening to body and brain messaging. With instances of depression, the “inner critic” is particularly loud and brutal. Depression can be physically caused by not having enough nutrients for neurotransmitter synthesis and production; lack of exercise; inadequate sleep; and/or unprocessed historic emotional information and experiences. Depression and fatigue can happen at the same time, but they have different treatment needs.

When in doubt, what is called for is time with a primary care giver and a request for a laboratory work up for fatigue. If you say you are depressed, the care giver may only give you medications. I believe that it is important to first rule out the nutritional/physiological causes. So, a list of labs to be requested is on the Resources page at

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