Depression and Fatigue: A Vicious Cycle


About the article below:
This seems to confirm that I have depression.
One of the things that has been hard about having depression is that when I opened up about feeling depression, many people have said, “That doesn’t sound like depression. Maybe it’s….”

Segment below from “Depression and Fatigue: A Vicious Cycle, “written by Rachel Nall, RN, BSN, CCRN  and medically reviewed by Timothy J. Legg PhD, PMHNP-BC 

Part 1 of 6: Overview
How Are Depression and Fatigue Linked?
Depression and chronic fatigue syndrome are two conditions that can make someone feel extremely tired, even after a good night’s rest. It’s possible to have both conditions at the same time. It’s also easy to mistake feelings of fatigue for depression and vice-versa.

Depression occurs when a person feels sad, anxious, or hopeless for an extended period of time. People who are depressed often have sleep problems that involve sleeping too much or not sleeping at all.

Chronic fatigue syndrome is a condition that causes a person to experience continuous feelings of fatigue that don’t have any other underlying causes. According to an article published in The Primary Care Companion to the Journal of Clinical Psychiatry, doctors often misdiagnose chronic fatigue syndrome as depression.

Part 2 of 6: Depression vs. Fatigue
What Are the Differences Between Depression and Fatigue?
The main difference between these conditions is that chronic fatigue syndrome is primarily a physical disorder while depression is a mental health disorder. There can be some overlap between the two.

Symptoms of depression can include:

  • continuous feelings of sadness, anxiety, and/or emptiness
  • feelings of hopelessness, helplessness, or worthlessness
  • disinterest in hobbies you once enjoyed
  • eating too much or too little
  • trouble concentrating and making decisions

There are also some physical symptoms that can occur with depression. People may have frequent:

  • headaches
  • cramps
  • stomach upset
  • other pains

They may also have difficulty going to sleep or sleeping through the night, which can lead to exhaustion.

People with chronic fatigue syndrome often have physical symptoms that aren’t commonly associated with depression. These include:

  • headaches
  • joint pain
  • tender lymph nodes
  • muscle pain
  • sore throat

Depression and chronic fatigue syndrome also affect people differently when it comes to their daily activities. People with depression usually feel very tired and aren’t interested in doing any activity, regardless of the task or the required amount of effort. Meanwhile, those with chronic fatigue syndrome usually want to engage in activities but just feel too tired to do so.

To diagnose either condition, your doctor will try to rule out other disorders that can cause similar symptoms. If your doctor thinks you have depression, they may refer you to a mental health expert for evaluation.

Part 3 of 6: Fatigue and Depression
A Vicious Cycle

Unfortunately, people who have chronic fatigue syndrome may become depressed, and those who have depression can develop chronic fatigue syndrome. The two conditions often feed off each other in a cycle that’s difficult to break.

Many people with chronic fatigue syndrome experience sleep disorders, such as insomnia or sleep apnea. These conditions often make fatigue worse, because they prevent people from getting a good night’s rest. When people feel tired, they may not have the motivation or energy to perform their daily activities. Even walking to the mailbox can feel like a marathon. The lack of desire to do anything can put them at risk for developing depression.

Fatigue may also fuel depression. People with depression often feel very tired and don’t want to partake in any activities.

Part 4 of 6: Diagnosis
Diagnosing Depression and Fatigue
To make a depression diagnosis, your doctor will ask you about your medical history and give you a questionnaire that assesses depression. They may use other methods, such as blood tests or X-rays, to make sure another disorder isn’t causing your symptoms.

Before diagnosing you with chronic fatigue syndrome, your doctor will run several tests to rule out other conditions that cause similar symptoms. These may include restless leg syndrome, diabetes, or depression.

Part 5 of 6: Treatment
Treating Depression and Fatigue
Therapy or counseling can help someone with depression feel better. Depression can also be treated with certain medications. These include antidepressants, antipsychotics, and mood stabilizers.

Taking antidepressants can sometimes make symptoms of chronic fatigue syndrome worse. That’s why your doctor should screen you for depression and chronic fatigue syndrome before you take any medication.

Several therapeutic treatments can benefit people with chronic fatigue syndrome, depression, or both. These treatments include:

  • deep-breathing exercises
  • massage
  • stretching
  • tai chi (martial arts)
  • yoga

People with depression and chronic fatigue syndrome should also try to develop good sleeping habits. Taking the following steps can help you sleep longer and more deeply:

  • go to bed at the same time every night
  • create an environment that promotes sleep (such as a dark, silent, and/or cool room)
  • avoid taking long naps (limit them to 20 minutes)
  • avoid foods and drinks that can prevent you from sleeping well (such as caffeine, alcohol, and tobacco)
  • avoid exercising at least 4 hours before bedtime

Part 6 of 6: Seeking Help
When to See Your Doctor
Both chronic fatigue syndrome and depression cause changes that can negatively affect your personal and professional life. The good news is that both conditions can improve with the right treatment. Speak with your doctor if you’re struggling with prolonged fatigue or think you have depression. If you have thoughts of hurting yourself or committing suicide, call 911 immediately or have a loved one take you to the hospital. You can find additional resources for depression on the National Alliance on Mental Illness (NAMI) website.

Posted November 19, 2015

I’ve always felt like the lucky one


“Wow, you live in my neighborhood? A lady like you? I can’t believe someone like you lives in my neighborhood. I mean look at your blonde hair and pretty skirt.”

 The woman in her cut off jeans and sweatshirt stood next to my car, and extended her hand. “My name’s Valerie.”
“Hi Veronica, I’m Laura. Yep, I live here. I like living here. The neighbors are great. Plus this is what I can afford.”
She twisted her jaw to the side and sucked in her cheeks. My first impression when I drove up and saw her on her red bike talking to the older gentleman next door, was that she was an addict. She has that skin and bones nervous body language. But you never know what’s going on with people. As she twisted her jaw to the side, I felt my heart twist a bit too.
“I mean look at you. You look like a school teacher.” She said incredulously.
I smiled and said, “You are right. I am a teacher.”
She grinned back, “Yeah? Where?”
“At Pima.”
“Hey, can you look out for him? Check in on him once in a while.” She looked and nodded toward the neighbor. He was digging up weeds in his front yard.
“Yeah, I do. And his son lives with him and takes care of him. He’s a good guy.”
We chatted a bit more and ended up sitting on the cushioned chairs on my front porch. She told me about being raped by her brother at 7 years old, and how tough her life has been. How her dad is old and the house is a mess. And how she was messed up with the wrong people and did “bad things” when she was growing up. She kept saying, “What if I’d grown up with a nice family like you did?” or “I don’t want to make excuses, but what if I’d grown up like you did.”
At one point I tried to say, “Well… both my parents are alcoholics and things were kind of messed up.” But she had a vision of me and my perfect life. And somehow that seemed both comforting and provoking to her. It’s true, her hardships are huge compared to mine.
Finally, she said, “I was in prison for the last 9 years for killing a 17 year old boy in a DUI.” Her face looked raw and exposed, skin stretched tight. “My mom died a month ago. All that time I was in there and my mom was sick. I came home and she was all alone, in her own poop…. all alone.” She started to cry and I asked if she’d like a hug. She nodded and as we hugged, she rasped, “Sometimes I just want to blow my brains out. I feel sooo bad.” I just held her until she let go.
We sat down again, and I said, “Sometimes life is so ugly. So hard.”
She nodded. Then shook her head and said, “What would people think us sitting here like this. You look so elegant. And I look like a thug. I mean, what would they think.”
“You are not a thug.” I said.
“I know! I’m not.” She twisted her jaw and sucked in her cheeks, then her tone changed and she said, “Thanks for listening to all that shit. Hey, can we play dominoes some time?”
“Sure. I don’t know how to play, but sure.”
She grinned wide. “Great! I’ll kick your ass.”
I smiled back.
This was just a random incident, she doesn’t know I’m doing a project on depression. Perhaps by opening myself up to exploring depression, people will feel on some level that they can tell me their story. Then again, strangers have always told me their stories.
That was on Tuesday, and since then, I’ve been thinking of how familiar her story of incest and poverty is. This is the story of so many people I grew up with and know as an adult: poverty, incest, all forms of abuse. I felt lucky as a kid that though my parents were alcoholics, they were nice people. I knew about the beatings other kids suffered, if not the incest. Maybe that is why so often people look at me and assume I had a perfect life, with no struggles. There is something about me that says I have been untouched by hardship. I think it is the opposite, that no matter how bad it was, I always knew that others had it worse.
I’ve always felt like the lucky one.
-Laura Milkins 
Host of The Depression Session

Habits of People With Depression


I relate strongly to this…Anyone else?

The segment below is from Lexi Herrick of the Huffington Post; “11 Habits of People With Concealed Depression”

There will be two main types of people reading this: those finding themselves better equipped to understand some of the people they love and those who see their own reflections in these habits.

Depression often goes unseen, unrecognized, and undiagnosed. A person with concealed depression is someone who is conditioned to deal with their inner demons in a way that doesn’t make them clearly visible. They may or may not be diagnosed, and this may or may not be something they’ve shared with even their closest of companions. The problem is that the world becomes darkest when we all stop being able to understand each other. We tend to believe that hardship is worn openly upon one’s chest like a battle scar, but many of these wounds do not easily reveal themselves to those that do not take the time to look.

1. They may intentionally make efforts to appear OK and maybe even seem exponentially happy and upbeat.
The idea that those with depression all have one similarly dreary personality is false. Depression is more than just a mood. Those who live with depression have learned to alter their apparent moods, and may even be some of the most seemingly “happy” people that you know. Personalities can vary. Often those with depression try to stick with the positive and public parts of their demeanor regardless of what they’re going through on the inside. No one wants to bring others down, even if that means hiding how he or she is truly feeling.

2. They may have habitual remedies.
There are serious ways to treat depression, including therapy and medication. However, in addition to these remedies, there are lifestyle habits that those with depression use to treat their everyday state-of-mind. This can be in the form of music, exercise, driving, walks, or basically anything they know can get themselves out of a sinking set of emotions. Concealed depression has a lot to do with the ways people try to personally conquer their own demons.

3. They may have trouble with abandonment.
Anyone who has experienced depression understands the burden it can be. It can also be a burden for those closest to them. Sometimes when you let someone in enough to see the struggles you have, they walk the other way. Though it’s hard to blame these people for leaving, it creates a serious feeling of abandonment for those with depression. It forges a need for secrecy, out of fear of the recession of those they love. There is nothing more heartbreaking than finding out your ugliest layer of self is too ugly for someone you love to handle.

(there are 8 more)…

The most important habit and motivation of those with unseen depression to understand is that they search for love and acceptance. We all do. The only way to gain it is to spread it. Never turn away from a person who seems to be struggling. Love when it’s difficult. Cry when you need to. Reach out when someone closes the door. Open your heart, even if it feels terrifying to do so. If we keep forcing the bad to go unseen, the good will also go unseen.

To read the full article, please click:

Trying to get more sunlight


I’m trying to get more sunlight. 

     So… on Monday, I took a break at 4pm and went for a walk with a friend. We walked along the Santa Cruz River and talked about Thanksgiving preparations and my nerves about the first broadcast.
     The river is so pretty, I love the course sand and mesquite trees. The Santa Cruz comes down from Phoenix, breaking up into many washes and smaller rivers or rillitos all along the way. For anyone who doesn’t live here, you may be thinking about something with water running in it, but in our desert, the rivers run dry most of the year.
     We love our “River” and so much life thrives in those dry river beds: birds, coyotes, javelinas, bugs and bats. Hundreds of people walk and ride along their banks every day. And when the rain comes, all the city’s streets drain in rapid succession into the washes and the river rises 10 or 15 feet, dragging branches, shopping carts and small cars along with it. It’s a powerful thing to experience, and wonderful to see from the many foot bridges that cross the Santa Cruz.
     I remember when my mom first came to visit in Tucson seven years ago, we stood on the Mountain Ave. footbridge over the river after a hard rain. My mom, brother and I watched the coffee colored water rush by, churning and singing in its hurry to escape the city. I felt like the river matched the state of our lives at that time, churning and struggling, each trying to find our way to dry ground. Each of us had gone through a big change that year. I had just graduated from grad school and felt lonely and adrift. Standing on the bridge watching the sunset, our little family of three felt like a solid thing to cling to, as strong as the metal railing beneath my hands.
    That day, watching the rushing water felt cleansing and the setting sun nourishing. On my walk this day, it occurred to me that sun is probably too weak at 4pm to provide much vitamin D. However, with or without water the river has great healing power. As I walked and chatted with my friend, I felt some of my anxiety ease. From the river walk, you can see A mountain and Tumamoc, backed by mountains of the Saguaro National Park. So much beauty, so close to my house. I wished I went there every day. As we drove away, I felt light-hearted and cheered by the river and the mountains.
-Laura Milkins 
Host of The Depresison Session