You have the same sort of choice to make if you suffer from this fairly common combination. Obviously, working off a depression by really strenuous activity just isn’t on when you suffer from fatigue too. Leave that method to the people who have enough energy even though they are depressed. Many women say they feel too tired for anything. They can’t even summon up the energy to dress up and go out for a special occasion. And because they know that in normal circumstances it’s the sort of outing they would enjoy very much, they end up feeling more depressed than ever.

The trouble with depression is that it reduces everything — your hopes, your appetites, your sense of humour, as well as your energy. Even your ability to make choices is affected because you just haven’t the energy to make decisions and they don’t seem worth making anyway. One useful trick might be to make all your decisions in the weeks after your period, when you’re not depressed. Talk it over with your friends and relations if you can and let them help you. If they advise you to make an enormous effort to get out and enjoy yourself when you’re low, try and take their advice. Forget the muddle you’re in, or the housework you can’t face, or the problems you can’t look at and just go. I know it’s difficult but if it works, it could just give you the energy you need to get on with your life again.

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