Could there be a medical reason behind your gloomy mood and lack of energy? If you live with depression, anemia may be partly to blame.

A common depression symptom is the feeling that even the simplest tasks take more energy than you have. Anemia can also make you feel this way.

When you have anemia, your blood can’t transport as much oxygen as it should. This can impact many areas of your body, including your brain.

Not only does anemia reduce your energy levels, but it can also affect the way you think and feel. Anemia, particularly the iron deficiency kind, has been linked to mental health conditions like depression and anxiety.

Anemia is a condition that affects your blood cells and reduces their ability to transport oxygen.

The World Health Organization (WHO) estimates that nearly 25% (1.62 billion) of the population worldwide has some anemia. Most of these cases are due to an iron deficiency.

Depression is one of the mental health conditions that low iron can cause.

The area of your brain called the basal ganglia contains a higher amount of iron than other brain regions. Because of this, it responds readily to changing iron levels.

Researchers previously thought that the basal ganglia was mainly responsible for movement, but recent research suggests that this area also shapes the processing of emotional stimuli. So, if your iron isn’t at the right level, your brain might not process emotions properly.

A Japanese study from 2018 with 11,876 participants identified a link between self-reported depression and self-reported iron-deficiency anemia.

In a 2014 study, anxiety symptoms were linked to low iron. Neurotransmitter stability and energy metabolism influence emotions like anxiety, which are affected by iron levels.

This means that if your iron level is too low, changes to your energy and brain chemistry might make you feel anxious.

Hypoxia (reduced oxygen levels) from anemia affects multiple areas of your body, including your brain. It can cause physical, cognitive, and mental health symptoms, some of which include:

  • fatigue
  • weakness
  • irregular heart rate
  • dizziness
  • chest pains
  • cognitive impairment (trouble remembering, learning, concentrating, or making decisions)
  • mood changes

Anemia’s connection to mental health extends beyond long-term (chronic) blood oxygen deprivation. The most common form of this condition, iron deficiency anemia, has the added impact of insufficient iron.

Iron does more than help red blood cells carry oxygen. Along with preventing anemia, iron is involved in many essential cognition areas, including:

  • central nervous system (CNS) enzymes and proteins
  • CNS development
  • DNA replication and repair
  • white matter myelination (brain cell insulation)
  • development of neurotransmitter systems

A 2013 study revealed a link between iron deficiency and diagnoses like mood and developmental conditions.

It’s theorized that iron deficiency in childhood is linked to the abnormal myelination (covering) of neurons and altered neurotransmitters that contribute to child and adolescent-onset psychiatric conditions.

The cause of anemia depends on the type.

For example, iron-deficiency anemia results from inadequate amounts of iron in your body. You might not have enough iron in your diet, or you may not absorb it well. You can also lose iron through blood loss conditions such as menstruation, ulcers, or trauma.

Meanwhile, other types of anemia have causes such as genetics or autoimmunity.

There are several types of anemia, all of which can decrease the amount of oxygen transported in your blood.

Iron deficiency anemia

Iron deficiency anemia (IDA) occurs when you don’t have enough iron to make the blood hemoglobin you need to transport oxygen.

Pernicious anemia

This type of anemia is caused by a deficiency in vitamin B12, which is required to produce healthy red blood cells. People who have pernicious anemia sometimes lack intrinsic factor, which helps the body absorb B12. Other causes include diet, infections, medications, and surgery.


Thalassemia is a genetic condition that causes low hemoglobin levels. Reduced hemoglobin means your red blood cells can’t carry enough oxygen.

Sickle cell anemia

Sickle cell disease is also genetic but causes abnormalities in some red blood cells. These cells become abnormally shaped, rigid, sticky, and unable to carry oxygen.

Aplastic anemia

Aplastic anemia occurs when something interferes with the production of new blood cells, leading to a blood cell count that is too low. The most common cause is when your immune system attacks bone marrow cells.

Depression can significantly impact your life, but it’s manageable. If iron deficiency anemia is causing your depression, it may be easy to treat with a change to your diet or iron supplement.

Dietary change

Many doctors recommend improving your diet before taking an iron supplement unless a blood test shows that your iron is very low.

Dietary sources of iron include:

  • red meat
  • chicken
  • beans
  • peas
  • dark green leafy vegetables
  • fortified cereals

Foods containing vitamin C increase iron absorption. On the other hand, dairy products, tea, and coffee are examples of foods that interfere with iron. It helps to familiarize yourself with these interactions to maximize the effect of your dietary changes.

Iron supplementation

A 2020 study revealed that people with iron deficiency anemia have a higher chance of psychiatric disorders, but this decreases when they take an iron supplement.

It’s important to note that excess iron can accumulate in your body to unhealthy levels. It’s recommended that you have your iron level measured with a blood test before taking an iron supplement. Iron is a vital nutrient, but having too much can be as problematic as not having enough.

Sleep improvements

Proper sleep is a critical self-care goal. If you find it difficult to get an appropriate amount of restorative sleep, you might want to consider improving the consistency of your schedule. Sleep hygiene practices can also help, like mid-day caffeine cut-offs and a cooler bedroom temperature.

Light exercise

You can exercise with anemia but do so carefully and under a healthcare professional’s supervision. Regular movement increases circulation, improves sleep, and contributes to good health.

Anemia might cause fatigue or shortness of breath, so if you exercise, start slowly and keep your workouts short.

Sometimes a medical condition like anemia can contribute to a mental health condition such as depression. On the one hand, this may seem like you have more issues to manage. But understanding how different conditions influence each other can make them easier to treat.

Once you’ve talked with a healthcare professional about an anemia assessment, you can take steps to improve your physical health that will also help your mental health. This could mean learning more about anemia or reaching out to a nutritionist for guidance.

There are support groups available and therapists you can meet with to continue along your path of healing and self-discovery.