Most people with depression have an unrealistic and negative evaluation of their worth or may be preoccupied with guilt from small mistakes.  

In fact, the guilt and shame these people experience is often misplaced. Meaning that they may blame themselves for their mental illness, believe that everything is their fault, and feel shame for struggling with depression symptoms.  

The fatigue people experience directly triggers their shame, as depressed people often stop living by their own values. For example, a person may strongly believe in productivity, but they may find it hard to stop procrastinating due to fatigue and may thus feel guilt and shame.  

When fatigue is prevalent, people may have several unfinished tasks – unpaid bills, unfinished work projects, a messy house, or an incomplete assignment.  

Due to the swamped number of tasks, people feel ashamed of not fulfilling their responsibilities. They stay under the radar about their unfinished tasks because when these tasks are revealed, so will their shame and judgement by others.  

Typically, people feel a sense of achievement after finishing a task. The ‘feel-good’ emotion occurs due to the release of a neurotransmitter called dopamine. 

However, the amount of dopamine released in people with depression may be insufficient. 

Hence, if the person cannot feel a sense of achievement when they get something done, then this lack of feeling usually impairs their motivation and pleasure.  

Ultimately, not wanting to finish a task may become a shameful secret. The shame, fatigue, and depressed mood act as a self-reinforcing loop. The loop looks like this: 

Low energy -> Unfinished tasks -> Low self-esteem -> Loss of accomplishment -> shame/guilt -> low energy.