Fatigue and PTSD -- Why Am I So Tired?

I don't know how many times I have asked myself about fatigue and posttraumatic stress disorder (PTSD) since being diagnosed. There are times I feel extremely exhausted when I haven't done anything to cause it. Naps during the day have gone from being a luxury to being a necessity at times. Feeling this way isn't unusual for someone with PTSD; there are both psychological and physical factors that cause us to feel so tired. Fortunately, I have found some things that help me to deal with the PTSD and fatigue and still be productive.

Psychological Factors of PTSD that Make You Tired

There is no doubt that there is a mind and body connection in everyone; stress can make us sick, and conversely, a physical illness can cause us to be anxious or depressed. For people who have PTSD, it's no different. In fact, the mind and body connection is often more prominent in people with PTSD or other mental illnesses. Some of the psychological factors of PTSD that can cause us to be exhausted are:

• Stress--when anyone gets stressed it's likely to cause them to feel tired. When someone who has PTSD gets stressed, it can make him or her feel exhausted.
• Depression--one of the symptoms of PTSD is depression, and when you're feeling down it is likely to make you tired and want to sleep.
• Hypervigilance--feeling like you are constantly on alert, waiting for something bad to happen, takes a toll. That feeling of always being "on" is enough to make anyone with PTSD tired.
• Acting like everything is okay--often times, those of us with PTSD don't want to let others know that we are suffering. Acting as if everything is alright when it's not, is draining.
• Being triggered--when something triggers our PTSD symptoms to flare up, and fight, flight, or freeze kicks in, we can definitely feel worn out when the crisis is over.

Physical Factors of PTSD that Make You Fatigued

There are also some physical factors at play when PTSD causes fatigue. They may be brought on by psychological factors, or vice versa. There's that mind and body connection again (How to Cope With Body Memories in PTSD Recovery). Here is what may be happening physically that is exhausting:

• Hormones--the stress hormone cortisol is released during trauma. It desensitizes us so that we feel less pain, and it gives us a boost of energy. In people who have PTSD, cortisol is produced in higher levels and for a prolonged period of time, which can cause fatigue, as well as memory loss and decreased serotonin levels.
• Adrenal system--cortisol and other stress hormones are produced by the adrenal system. When there is an overload on the adrenal system, people with PTSD are likely to experience fatigue, exhaustion, and increased stress.

What to Do When PTSD Causes Fatigue

If you find that you are feeling exceptionally tired, try some of the following and see if they help. These are some of the things that work for me:

• Reduce stress--you can work on this proactively by using mindfulness, meditation, prayer, writing, talking about the things that are stressful to you, exercise, or anything that helps you keep your stress level down.
• Recognize limits--I admit this one is hard for me. I always think that I can do more than I can. Recognizing when you are reaching your limit of productivity, interaction, or stress, and then stopping to rest and reset, is very helpful in keeping fatigue and exhaustion at bay.
• Prioritize tasks--when you are getting close to reaching your stress limit, you need to prioritize what you have to do versus what you think you should do. For me that means that it's okay for laundry or dirty dishes to wait when I am tired.
• Schedule downtime--this is another proactive thing you can do to keep your stress level down and help you feel more active. Try to set aside time to relax or nap, just like you set aside time for an appointment or task.
• Talk to your doctor--if insomnia is a problem for you, it's important to talk to your doctor to see if there is an appropriate medication for you to help you get a good night's sleep.

Fatigue may always be a part of your PTSD symptoms, but it can be managed when you find the things that work for you. I would love to hear other ways to avoid fatigue and exhaustion in PTSD; please share your strategies in the comments below.

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