“People didn’t really understand why I was tired because I was just depressed”: Exploring adolescents’ lived experiences of fatigue in depression

Introduction: Adolescent depression is a prevalent and disabling condition, but current psychological treatments are only moderately effective. One way to improve outcomes is to further our understanding of adolescent depression and our capacity to target the most frequent and problematic symptoms. One such symptom is fatigue, with preliminary findings in adolescents suggesting it is common, highly disabling, and has the potential to interfere with adolescents’ engagement in psychological therapies for depression. Despite this, fatigue is poorly understood and often left unaddressed by treatments provided in routine mental health services. Therefore, the current study aimed to explore adolescents’ lived experiences of fatigue in depression, from the perspectives of a mixed clinical and community sample.
Methods: 19 UK-based adolescents aged 14-18 years old (M = 16.16, SD = 1.01) with elevated symptoms of depression took part in remote semi-structured interviews. Data was analysed using reflexive thematic analysis, which generated three themes.
Results: Theme 1, ‘fatigue is a complex concept’, explores adolescents’ understanding of fatigue as a dynamic, complex symptom, which has mental and physical components. Theme 2, ‘trapped in a cycle of fatigue’, considers the reciprocal relationship between fatigue and other depressive symptoms, and how a subsequent lack of energy affects adolescents’ engagement in everyday activities. Theme 3, ‘stigma as a barrier to help-seeking’, highlights adolescents’ reluctant to seek help for fatigue due to experience stigma, and the perception that fatigue is not serious enough to discuss with clinicians.
Discussions: Findings from this study highlight the complexity of fatigue within adolescent depression, and some of the challenges that might present in clinical practice. This presentation will consider implications regarding the conceptualisation, identification, and treatment of fatigue within adolescent depression, with a specific focus on how these implications may be implemented in practice.