Why does depression cause fatigue?

  • Why does anxiety cause tiredness?

    Depression can possibly cause fatigue through four systems. They are all interrelated, and are the effects that anxiety has on the body clock; the results that anxiety has on the free nerve system; the impacts that anxiety has on the HPA axis; and the relationship between tiredness serotonin and depression.

    The circadian rhythm is your body’s internal clock, and circadian irregularities prevail in anxiety( 1 ), with either insomnia( problems falling asleep), poor sleep quality, or hypersomonia( excessive sleep), being frequently seen in anxiety( 2 )( 3 )( 4 ). Circadian problems are a possible reason for the fatigue associated with depression.

    The second possible cause is dysregulation of the free nervous system( 5 )( 6 ). The free nerve system is the branch of the nervous system that manages organ functions, such as heart rate and the muscles associated with food digestion( 7 ). Dysregulation of this system can result in insufficient activation of the battle or flight action, which sets in motion the body for activity. It might also describe the sexual dysfunctions discovered in depression.

    The 3rd possible cause is dysregulation of the HPA axis( 8 )( 9 ). The HPA axis, or hypothalamic pituitary adrenal axis, is a method that your brain has for translating viewed tension into a bodily response. Increased stress lead to cortisol release, which is essential for moderating a variety of things. Hypocortisolism or hypercortisolism frequently presents itself as fatigue or despair( 1o), and is linked in other conditions associated with anxiety such as fibromyalgia(11).

    The last possible system is serotonergic dysregulation. The main theory of non-pathological fatigue is that increased muscle reuptake of branched chain amino acids, which share brain transporters with tryptophan the precursor to serotonin lead to increased serotonin in the brain and tiredness(12). No claims can be made about anxiety being caused by hyper or hyposerotonergic brain activity, and pathways can vary in their activity. It appears that in anxiety some areas, for instance the amygdala(13) have too much serotonergic activity, while others such as the prefrontal cortex have too little(14) The regions responsible for feeling fatigue might have too much serotonergic activity, leading to the tiredness related to anxiety.

    ( 1 )Kripke, Daniel F., Caroline Nievergelt M., Greg Tranah J., Sarah Murray S., Michael Mccarthy J., Katharine Rex M., Neeta Parimi, and John Kelsoe R. “Polymorphisms in Melatonin Synthesis Pathways: Possible Impacts on Depression.” J Circad Rhythms Journal of Circadian Rhythms 9.1 (2011): 8. Web. 27 Sept. 2016.

    ( 2 )Nutt, David, Sue Wilson, and Louise Paterson. “Sleep Disorders as Core Symptoms of Anxiety.” Discussions in Clinical Neuroscience. Les Laboratoires Servier, Sept.2008 Web. 27 Sept. 2016.

    ( 3 )Germain, Anne, and David Kupfer J. “CIRCADIAN RHYTHM DISTURBANCES IN ANXIETY.” Human Psychopharmacology. U.S. National Library of Medicine, Oct.2008 Web. 27 Sept. 2016.

    ( 4 )Turek, F. “C.1201 From Circadian Rhythms to Clock Genes in Depression.” European Neuropsychopharmacology 17 (2007): n. pag. Web. 27 Sept. 2016.

    ( 5 )Carney, Robert M., Kenneth Freedland E., and Richard Veith C. “Depression, the Autonomic Nervous System, and Coronary Heart Disease.” Psychosomatic Medication 67 (2005): n. pag. Web. 27 Sept. 2016.

    ( 6) Dauphinot, Virginie, Isabelle Rouch, Michel Kossovsky P., Vincent Pichot, Jean-Michel Dorey, Pierre Krolak-Salmon, Bernard Laurent, Frédéric Roche, and Jean-Claude Barthélémy. “Depressive Signs and Autonomic Nerve System Dysfunction in an Elderly Population-based Research Study: The EVIDENCE Study.” Journal of Affective Conditions 143.1 -3 (2012): 153-59 Web. 27 Sept. 2016.

    ( 7) Dorland, W. A. Newman. Dorland’s Illustrated Medical Dictionary. Philadelphia, PA: Saunders,2007 Print.

    ( 8 )Varghese, Femina P., and E. Brown Sherwood. “The Hypothalamic-Pituitary-Adrenal Axis in Major Depressive Condition: A Quick Primer for Medical Care Physicians.” Primary Care Buddy to The Journal of Scientific Psychiatry. Physicians Postgraduate Press, Inc.,2001 Web. 27 Sept. 2016.

    ( 9 )Molcrani, M. “HPA Axis Dysfunction in Anxiety: Correlation with Monoamine System Problems.” Psychoneuroendocrinology 22 (1997): n. pag. Web. 27 Sept. 2016.

    (10) Boon, Nicholas A., and Stanley Davidson. Davidson’s Principles & & Practice of Medicine. Edinburgh: Elsevier/Churchill Livingstone,2006 Print.

    (11) Tomas, Cara, Julia Newton, and Stuart Watson. “A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Fatigue Syndrome.” ISRN Neuroscience 2013 (2013): 1-8. Web. 27 Sept. 2016.

    (12) Meeusen, Romain, Philip Watson, Hiroshi Hasegawa, Bart Roelands, and Maria Piacentini F. “Central Tiredness.” Sports Medicine 36.10(2006): 881-909 Web. 27 Sept. 2016.

    (13) Wessa, Michèle, and Giannis Lois. “Brain Practical Results of Psychopharmacological Treatment in Major Anxiety: A Focus on Neural Circuitry of Affective Processing.” Present Neuropharmacology. Bentham Science Publishers, July2015 Web. 27 Sept. 2016.

    (14) Yang, Tony T., Alan Simmons N., Scott Matthews C., Susan Tapert F., Guido Frank K., Jeffrey Max E., Amanda Bischoff-Grethe, Amy Lansing E., Gregory Brown, Irina Strigo A., Jing Wu, and Martin Paulus P. “Teenagers With Major Depression Demonstrate Increased Amygdala Activation.” Journal of the American Academy of Kid & & Adolescent Psychiatry 49.1 (2010): 42-51 Web. 27 Sept. 2016.

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