My point of view about depression exhaustion, lack of motivation, and anhedonia is not a medical one. I am not a medical professional, so you won’t find a scientific explanation to what I describe, but rather my own experience of living with depression and how these different symptoms seem to interact with each other. Hopefully you’ll find some of the things I do to counteract them useful for you or a loved one.
What do I mean by "depression exhaustion," "lack of motivation," and "anhedonia"?
Depression Exhaustion: The chances are, if you’re reading this you have some idea (either through personal experience or a loved one) about the level of exhaustion depression can bring. I’m talking about the ‘just thinking about moving my arm to get the glass of water makes me so tired I have to close my eyes’ kind of exhaustion. It’s that feeling when you wake up that moving is not going to be possible for some time and just having that thought nearly sends you back to sleep. Once you are out of bed, it’s feeling like your limbs are weighed down by lead, it’s standing around having forgotten what you were doing repeatedly, it’s looking at your clothes and thinking how much effort it would take to put them on—let alone wash first—and putting a jumper on over your pyjamas instead.
Lack of Motivation: For me, lack of motivation manifests itself as ‘why bother fighting the tiredness?’ ‘What could I achieve anyway?’ ‘What’s the point?’ It’s that feeling that I just haven’t got anything to fight the exhaustion with or for, so I might as well just go back to sleep and the safety of oblivion. These are lies that my depression tells me, but when I feel so low on energy, it’s easy to believe them.
Anhedonia: I didn’t always know that this feeling had a name. This is when you can no longer enjoy or take pleasure in doing activities. It’s a feeling of always being along for the ride, being the observer but never quite taking part. It makes me lose interest in projects halfway through because, well, what’s the point if it’s no fun? Going through the motions becomes tedious. For example, reading books without feeling the emotions of the characters is a much poorer experience and it makes it difficult to concentrate on reading.
How do they feed each other?
In my mind it starts with the exhaustion. The more tired I get, the more I focus on what I can do rather than what I want to do. My willpower becomes eroded and with that my motivation falls into decline. I begin to exist on a different level, prioritising what has to be done and finding myself with little time for activities I usually enjoy. When I do have time to do them, I’m too tired to enjoy them properly so I opt for sleeping or resting instead.
My ‘reward’ for achieving more difficult tasks or extra jobs is feeling even more tired and recovery is slow. Therefore, my motivation to take part in life takes a nosedive as I try to preserve the tiny amount of energy I have for the purpose of existing. In this survival-state I start to lose the ability to feel emotions fully. The more tired I get, the less emotion I feel and the smaller the chance of me really enjoying an activity. By this time my brain thinks, ‘well hey, if it isn’t even going to be any fun and I’ll only be more tired, what’s the point in doing anything?’
The only motivation that remains is to be less exhausted. Luckily for me, this motivation was enough to get me to try a couple of things that seemed to help enough to give me the energy to try another couple, and so on.
What has helped break the cycle?
There hasn’t been just one thing that I’ve done that has helped; instead, it’s been the cumulative effect of lots of little things working together.
It’s a work in progress and by no means perfect. I keep adjusting things and trying new things here and there to see if I can make things any better; sometimes it helps, sometimes it doesn’t.
To combat the exhaustion, I try to have a sleep routine. If I’m really honest, this is what got the ball rolling. I try to go to bed roughly around the same time each night and get up at roughly the same time every morning (with assistance from multiple alarms). We don’t have a TV in the bedroom, my phone isn’t on display at night (hidden away under the bed as it’s my alarm), caffeine is limited to earlier in the day and in small quantities. I feel like you’ve heard all this before.
What I find also helps is letting myself sleep in a little if I’ve had a really bad night, i.e. awake regularly, didn’t get to sleep until the small hours, restless night, tense muscles all night, etc. I’ve found that in the long run, powering through doesn’t help. The tiredness just accumulates and I never catch up. There is no guarantee that I will get to sleep the evening following a bad night’s sleep, so if I can sleep in the morning, I do. My mood is so much better, I have that teeny bit more energy, and that feeds a spark of motivation.
Sometimes I have to accept that I need to stay in bed for a bit longer, sometimes I have to accept that my plans had to change, sometimes I have to accept that I can’t do what I thought I could. But there is always tomorrow to try again. Accepting that now is not the time but that there is the possibility for change helps me to feel another spark of motivation.
When I’m so tired that I don’t know what to do once I’ve pulled back the covers, a routine is essential, or I’ll just end up back under the duvet. This is just a few things that I do every day when I get up so that I don’t have to think and it has the added bonus of making me feel like I’ve achieved something.
For me, this is taking medication, making the bed, doing some stretches, doing yoga, putting any dry clothes away from the spare room, and getting dressed. Usually by the time I’ve done these things, my brain is functioning well enough to start thinking for itself. In the beginning, this routine was taking medication and getting dressed, so it evolved over time and as I had more energy.
This might seem to contradict what I said about routine, but hear me out… Taking a slightly different route on a walk, going shopping in a different place or going out for a meal in a different restaurant can make me focus less on how tired I am. If I’m less focussed on how tired I am, my curiosity has a chance to make an appearance. When I feel a little curious, I feel a little motivated and sometimes that spills over into feeling pleased about whatever activity I’ve been doing.
I’m not always keen to do the ‘different’ thing in the beginning (thinking about how much energy it will take) but every once in a while, it can really be worth it to feel a little motivated.
This is a very simple one. If I can take a bath or a shower, I always feel more motivated, as if I’ve cleaned myself up to do something. I can tap into this energy even if I have a sink wash, or even with a wet-wipe wash on the lowest energy days.
Spending twenty minutes writing down anything and everything that comes into my head feels liberating and energising. I love writing fiction and poetry, so an added bonus is that once I’ve got my pen going by journaling I feel motivated and energised to write something from one of these genres.
Exercise helps with exhaustion, motivation, and anhedonia. At first, I did yoga to relieve tension in my muscles so that I could sleep better. Then I started walking again and felt a tiny buzz of enjoyment from my heart pumping blood around my body and being outside in nature. I got back into cycling next. I didn’t quite have the motivation to run, but being half carried by a bike while getting my heart pumping even faster was appealing. I started to compare how long it took me to ride my usual routes. Finally, the day came when I went running again.
The more I exercise, the more energy I have and the better I sleep. The better I sleep the more motivated I feel and the more motivated I am to do something (be it a job or a fun activity) the more enjoyment I get out of doing it.
As I said in the beginning, I’m not a doctor. I’ve tried a few supplements along the way and there are a few I take now that seem to help. Perhaps it’s the placebo effect? I honestly couldn’t tell you. After trial and error, I seem to feel better when I’m taking Vitamin D3, Vitamin C, Cod Liver Oil, Magnesium, and a Probiotic. I can’t tell you whether they would work for you but maybe your doctor could help?
There is a way out of the cycle.
It feels like there will never be anything but tiredness, endless need for sleep, rest and recuperation. Endless thoughts about whether you will have enough energy to get what you need to do done. Just surviving, without wanting to do anything or enjoying anything you do do.
I still feel exhausted when I wake up every day but now I’ve built up a bank of tactics to help get me going or to make me think about slowing down when I need to. It’s a slow journey and I’m still on it. I can’t say that the same things will work for everybody but the most important lesson for me was to be patient and persistent enough try lots of things and hold on to the things that worked. I think sleep is a great place for everyone to start, for me this was the game changer.
Tomorrow is another day and a chance for you to find something that helps. Good luck.