Exploring the experiences of fatigue in adolescents with elevated symptoms of depression: A qualitative study

Rationale: Fatigue and depression are both common issues faced by adolescents and are associated with a range of negative outcomes, such as educational underachievement, interpersonal difficulties, and heightened risk of suicidal and self-harming behaviours. Fatigue can also be a symptom of depression, and in adults has been linked with greater functional impairment, increased economic burden, and reduced quality of life. Much less is known about fatigue within adolescent depression, but preliminary findings indicate that it is common, highly disabling, and often left unaddressed by treatments provided in routine mental health services. In order to effectively treat adolescent depression, it is important that we first understand the presentation of depression within this population, and identify which symptoms are most problematic. Qualitative methods have already been utilised in this field to explore symptoms such as anhedonia and sleep disturbances, and would be beneficial if applied to fatigue.

Objective: The current study aims to qualitatively explore adolescent’s experiences and understandings of fatigue in depression, in a mixed clinical and community sample.

Method: Currently, 17 adolescents (11 female, four male, two non-binary) with elevated symptoms of depression have taken part in individual semi-structured interviews, which were conducted online via videoconferencing or over the telephone. Participants are aged 15-18 years old (M = 16.29, SD = .92), with mean scores of 16.41 on the Short Mood and Feelings Questionnaire and 8.53 on the Chalder Fatigue Questionnaire. We expect to a further 4-8 interviews to take place. Data is being analysed using reflexive thematic analysis from an inductive, experiential perspective.

Results: We anticipate that generated themes will provide insight into how adolescents experience and understand fatigue as a symptom of depression. Themes may relate to how adolescents conceptualise fatigue, how they describe and recognise it in themselves and their peers, and how they communicate their fatigue to others. Themes may also encompass help-seeking, coping mechanisms, and the wider impact of fatigue on their lives. Findings will likely include considerations of how adolescents distinguish between fatigue and other symptoms of depression, such as low mood, anhedonia, and sleep disturbances, as well as transdiagnostic aspects and the interaction of comorbid conditions.

Conclusion: The conclusions of this research may hold important implications for future research and practice. Specifically, the findings of this study may provide useful insight into the relative importance of fatigue in the context of adolescent depression, indicating whether this is an area of research that requires further inquiry. Findings may also help clinicians to better identify fatigue within depression in practice, leading to earlier identification and treatment.