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PTSD and Fatigue: Is It Normal to Feel So Tired?

I received an email from a client last week; he was very upset. Usually, he’s the kind of guy who likes to travel on the drop of a dime but since PTSD began to control his life, he’s noticed that traveling takes an enormous toll on him.

After even the smallest trip, he wrote, “I have to sleep all the next day. Is this part of the PTSD profile?”

In a word: Yes.

Why PTSD Causes Fatigue

Let’s start with the mind/body connection. While modern medicine preaches the separation of your mind and body (I can’t tell you how many times my doctors said, “Your trauma that led to PTSD happened years ago, that can’t possibly be affecting you now!”), the truth is that your mind is capable of producing 50% more stress than your body can handle.

Think about that: If your mind is producing so much stress that your body can’t handle it, what will your body do? That’s right! Your body will let you know that your entire being is overly taxed. One way to do that is to feel enormously exhausted.

Then let’s add in depression. According to research, people who are depressed are more than four times as likely to experience inexplicable fatigue. Even without the research, I bet you know that from personal experience. You wake up in the morning feeling like the weight of the world is on your shoulders. Or as one client told me yesterday, “The thought of the day is just unbearable.” Carrying all of that load is exhausting! PTSD depression is particularly heavy. Often tied to issues that involve the past, present and future, plus topics that have to do with the very core of who you are, depression can weigh you down like cement boots in a swamp of quicksand. It won’t take long before you just feel ready to curl up and take a nap.

Now, let’s get more scientific about it all. Cortisol is the stress hormone you most need to understand. Useful during a trauma, cortisol helps desensitize us so we feel less pain, increases short-term memory function, and acts as a quick energy boost. All good things, right? But here’s the kicker:

When present in higher levels for a prolonged period of time cortisol can be responsible for memory loss, fatigue, and reduced serotonin levels. Typically high during and immediately after trauma, some studies have shown that cortisol levels actually decrease later in the presence of PTSD. (We’re all unique and different so the only way to know how cortisol might be affecting you is through the results of a quick blood test done at any lab as prescribed by your doctor.)

Scientifically speaking a little further: The adrenal system processes stress hormones, including cortisol. When there’s an overload on the adrenal system a survivor might experience a variety of symptoms such as fatigue, exhaustion and an overload of stress. While the medical community does not recognize adrenal fatigue as an accepted medical diagnosis, the symptoms can’t be denied. (Like cortisol, the effects of adrenal overload can be identified through a blood test.)

Whatever is going on with you – be it emotional, mental or physical in origin – the bottom line is that fatigue (and often inexplicable fatigue) very often accompanies symptoms of PSTD. If this is the case for you, be your own best friend.

Give yourself the rest your body calls for. Reduce the amount of running around and other over-stimulation you allow. Also, reach out to your personal and professional support system to help develop a schedule that both honors and respects the fatigue while also trying to reduce and even eliminate it through proper PTSD treatment.

Michele is the author of Your Life After Trauma: Powerful Practices to Reclaim Your Identity. Connect with her on Google+LinkedInFacebookTwitter and her website, HealMyPTSD.com.

47 thoughts on “PTSD and Fatigue: Is It Normal to Feel So Tired?”

  1. Thank you for writing about this! I never knew about it, and that is probably a huge contributor to my constant fatigue as I suffer from PTSD as well as a few other things. Is there any way you know of to help with this type of fatigue? It gets in the way of my studies, and that’s without the coping mechanism I have of falling asleep when I don’t understand a question on homework. Heh…
    But thank you – again! I really appreciate your work to help others. :]

    1. @Chelsea – I think the best way to deal with the fatigue is to deal with the source of it. Namely, PTSD. How are you approaching your PTSD recovery? On a coping level, I would say to deal with the fatigue by building in time for naps but even as I write that I know that allowing yourself to sleep won’t change the coping mechanism of wanting to when your brain gets overloaded, which it can quite easily when it’s already coping with so much. Which brings me back to my original question! How are you approaching your PTSD recovery? Relieving the exhaustion will come from relieving the stress that PTSD creates. There are many treatment options, a sampling listed here: http://www.healmyptsd.com/treatment If you’re in college they usually have counseling services that are free/low cost to students….

  2. I always thought the reason my partner was always in bed asleep was coz he was a lazy a** h*le. I do know he has PTSD but didnt know it was the tired factor aswell, now i know this i wont go on at him as much,wont stop me completly but a little.

    1. @Christine — From the outside PTSD can look lazy for sure! So much of what goes on during this Invisible Illness is not something others can see or understand. While as a partner it’s good to motivate and inspire someone to do the work of recovery and living, it’s also fair to recognize the limitations that PTSD coping puts in place. Sounds like you’re off to find a good balance!

  3. My 16 year young son james hung himself 2 years ago I am not the same woman ,I think of good memories they all end up with the same james hanging I found him I can’t cope no more I don’t want to socialize I don’t want to do anything I don’t leave the house everyday is a night mare I need help 🙁

    1. @Julie — Your situation would, indeed, be enormously tough to bear and you would just want to isolate and be alone. I’m so sorry for your pain and I wish there was something I could do to help. There are many terrific treatments for PTSD and trauma. One of my favorites (I used it in my own recovery) is neuro-linguistic programming. Some of the top names in NLP, Paul McKenna and John Grinder, are in London. I don’t know how far from there you are, but you might look into meeting with them or their colleagues for help.

      Until then, you can also try the Release Technique taught through The Sedona Method. You can read about it in a blog post I wrote: http://yourlifeaftertrauma.com/how-to-better-regulate-your-emotions/

      There are lots of ways to heal. Do reach out to get the help you need. You’re worth it.

      1. My son also hung himself when he was 15 yrs old that was 17 yrs ago and I have just been told I have PSTD…for I found him also.Myy heart goes out to u If u find a way to cope plz let me know.

        1. @Martha Joy — I’m so sorry for your loss and pain. Two ideas:

          1 – options for healing can be found on HealMyPTSD.com/treatment

          2 – join us in the free Heal My PTSD forum for support, connection and guidance: HealthUnlocked.com/HealMyPTSD

    2. Julie, I am so sorry to hear about your loss. I also wish there was anything I could do to help yo ease the pain. I have PTSD due to domestic violence and it is terrible but your case really touched me. I will pray for you. I hope you are feeling better.

    3. The same thing happened to me with my 20 year old daughter. I have survived and thrived. Meditation, mindfulness, and IADC (Google Induced After Death Communication). My sister and many others have also been greatly helped by these kinds of things. Bless you.

      1. @Mo — Thanks for sharing your experience. When we share our stories we really strengthen the PTSD community and everyone in it. I’m so delighted to hear that you’re feeling better. What a gift. Meditation was HUGE for me. I still practice it today because of it’s scientific and spiritual benefits. Here’s to your continued forward motion….

    4. julie..what have you done..this is 2 years old BUT it’s 2 years for me and i am the same way? this is not a life is it?

  4. I am a Hurricane Sandy Survivor.I live in Hard hit Long Beach, N.Y. less than a block away from the Ocean. and was at home, when the 17+ foot ocean surge came down my block and started to climb the stairs to my apartment. I didn’t know if I would live through the night. I was all alone, with no power. no phone or cell phone service. no running water. and did not know how long I would be trapped here.My car was destroyed by the Ocean Surge. so I could not leave.Eventually I was rescued and evacuated to friends.When I was finally able to return home , I retuned to a damaged home. and a City that was completely decimated. It was surreal. The streets were covered by so much sand that sanitation workers are STILL shoveling it off the streets 12 weeks later. The Curbs and sidewalks were filled with people’s possessions-including the WALLS of their homes. Our City is in ruins.Even the hospital was destroyed. My mind could hardly process that any of this had happened due to the scope of the damage.A number of homes burned down the night of the Hurricane. Many lost their entire homes, or their first floors. I have suffered great financial losses in terms of damages to home, vehicle etc etc.
    and am now dealing with mold issues. It has been very overwhelming.
    All things considered, I was functioning almost remarkably well-considering the magnitude of the trauma. both DURING and after the hurricane.for about a month or more. Suddenly , I was seized by such overwhelming exhaustion that I have been unable to even go to the supermarket to buy food. for a week or more at a time. As I also had respiratory symptoms,I thought I was ill, but I was too exhausted to go even go see a Dr. until today. when my Dr. suggested that my exhaustioni is “probably due to what you have been through.”
    How do I know if I am physically ill or if the trauma has caused the exhaustion.
    I am very glad to have found your article. The exhaustion is so crushing that I a nearly completely debilitated.Any advice as to how to proceed would be greatly appreciated. What kind of Dr. can I see to make sure that there is not a separte physical cause for my exhaustion?

    1. @Deborah — I’m so sorry for what you’ve been through. As a native NYer my heart is with you all the way. You pose a great question. Here’re my thoughts:

      1 – the mind is capable of producing 50% more stress than the body can handle; when the body overloads it does create physical symptoms (I experienced this to such a degree in my own PTSD journey that I was (erroneously) diagnosed with Celiac Disease, mercury poisoning and possible liver cancer, among other things.)

      2 – now would be a good time to have a full physical exam with your primary care physician. Make sure to include a full blood panel test so that you can rule out any physical causes.

      3 – in lieu of diagnosed physical ailments (and even with them, for example, chronic fatigue, fibromyalgia, etc.) now would be the best time to design your own individual trauma resolution program. There are many treatments for trauma and PTSD that are enormously effective. Take a look at the options here (by no means fully conclusive but some of my favorites) and get a sense of what’s available to you: http://www.healmyptsd.com/treatment

      4 – I just did a terrific interview on my radio show with a practitioner that is on Long Island. Take a listen and if it feels right I highly recommend reaching out to him: http://yourlifeaftertrauma.com/a-new-trauma-treatment-model/

      Please feel free to ask more questions, Deborah. The more you know and educate yourself the more quickly you will find relief. I’m here for you. 🙂

      1. At the age of 15 I was raped by a relative and I stuffed the memory away. At 23 I called a wedding off to a man who when I was hospitalized for depression the first time , my counselor had me read books on Ted Bundy to see their similarities. So yeah I had PTSD at an early age but through trauma resolution therapy, codependency education and DBT my trauma had taken a back seat. Then November 17, 2013 at 3:48 pm a tornado hit my house in Indiana. I was not home at the time but to this day I can remember the sights and sounds as we drove into the neighborhood. We were displaced for 3 weeks all the while my 15 year old Autistic daughter who we were adopting simply wanted to ride her bus to school. Our van was split in half by our neighbors tree so everyone coming through the neighborhood stopped in our drive to take pictures by it for their scrapbooks. But it was my van, by my house, disrupting my life! Once again PTSD from this and all the old stuff came back. But I worked in therapy and made it through. Jump to August 27, 2015 when the side wall of my bed broke around 2 am and I fell out of bed. Before I hit the floor I hit my eye on a piece of furniture and after emergency surgery with another that followed I have no sight in that eye. I am so very, very tired at this point. I wonder if my life will always have trauma. But my husband and I are foster/adoptive parents of teens many of who have PTSD. I often find myself holding my kids and telling them life will work out and it will get better. I cannot tell them this unless I really believe it but boy can life be a challenge and I never thought of my fatigue coming from my PTSD. Perhaps with this understanding I can be kinder to myself. Thank you so much for the new outlook!

        1. I think once you’ve experienced trauma and have developed PTSD, subsequent stresses or shocks fall into that same pattern. Some people who have not been traumatized don’t experience the same things you or I might as trauma. But since the old wound is there, it can get reopened.
          I did some energy work that really helped me, but I am still hypervigilant, and so get overwhelmed and exhausted quite often.

  5. Hi there,

    Thanks so much for your article! I recently went through quite a rough patch with my father being very ill, his wife not letting me know anything about his condition etc. Then my friend’s son hanged himself. Two days after that I was mugged by two men with a knife.

    This was about a month and a half ago. I am suffering from extreme nightmares and am constantly exhausted. It doesn’t matter how much I sleep I am always tired.

    The thing about the mugging is that it brought up a lot of past abuse I’ve been through and I want to know if “past PTSD” can affect “current PTSD” or does it have a “memory” that is stored somewhere in the brain?

    Once again, many thanks for a very informative article.

    Penny 🙂

    1. @Penny — First, let me just say that I admire your courage and resilience. That was an enormous amount of trauma to handle in any amount of time much less such a short period of time.

      What you’re describing is very common and the short answer is, yes. Past traumas and how they have or have not been resolved definitely affect current trauma and their effects. Long-term memory is stored both in the body and the mind so it makes perfect sense that, faced with a similarly experienced enormous feeling of fear or situation or sensation those earlier neural pathways holding past trauma could be activated in your present situation.

      The good news is there are many ways to reduce the effects of all trauma and find your way to healing. If you’re interested, take a look here for ideas about recovery: http://www.healmyptsd.com/treatment.

    2. Penny,

      Look into condition called, “complex PTSD”. It is still a bit of a controversy, but I am getting treatment through a psychiatrist and psychologist who practices “EMDR”. I know complex PTSD was the right diagnosis for me, specifically because of early, chronic trauma, then an incident of near death as an adult.


    3. Gosh, that was so much loss ans stress to suffer in such a short time. Yes, PTSD stores memories apart from your emotional awareness to help your survive. But those memories remain and can get triggered by other stresses and traumas. Only by facing them and allowing yourself to feel, bit by bit, the once terrifying emotions locked away with them, can you begin to heal. For me, the pain hasn’t gone away but at least I have learned to not repeat the patterns that cause me pain…. that repetition of patterns is the memory’s way of trying to purge itself of the trauma.

      My dad, too is sick — with bone marrow cancer. My dad and mom divorced when I was only a toddler, and when he remarried his new wife didn’t want anyone to know he’d been married before, and so they never told their children, my own half-siblings, that I existed. After not seeing my dad for over 30 years I had begun to visit them once a year —- but never got really close —- when my dad got sick my stepmother and half sister tried to prevent me from seeing him. And when I went to see him anyway my half sister never spoke to me again. Later, when I was posting on FB about how my PTSD stemmed from three childhood traumas: losing my dad, being molested (by a pediatrician) and developing a form of OCD, half brother’s wife thought I was accusing my dad of molesting me and forbade him from seeing her children. They patched things up but guess who they blame? Me. Now he won’t talk to me at all.
      Talk about the recurring pain of trauma. Through all of this I was finishing my PhD. It was the hardest time I’d ever gotten through.
      Now I am done trying to get a sense of family or belonging from my dad or any of his second family. It is so terribly sad, but I know I will feel better in the long run to not to chase after a sense of connection with them. Doubly sad because my mom is totally narcissistic and her idea of love is controlling people, including me, and if you don’t let her control you, she just gets mad.
      So somehow we have to survive, face the trauma & its associated emotions, and mourn the loss. We can get through it all. We need to honor ourselves and give ourselves plenty of time to heal and let the inner light that is the true you to shine through.

  6. Adrenal fatigue is a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems. The term often shows up in popular health books and on alternative medicine websites, but it isn’t an accepted medical diagnosis.

  7. Very helpful and informative site. 4 yrs ago I was involved in a tragic single car accident with my husband. He had to swerve to miss a moose that jump on the hwy without any warning. We rolled over 4 times. My husband died and I sustained injuries. I was forced to return to work on a gradual return to work 14 months after. This failed numerous times. Then the severe depression and now being slowly weaned off meds. I have been forced to work full time for almost a year and continuously battling everything including severe fatigue for 4 yrs now. This fatigue seems to be ignored by my professionals, and I can no longer deal with my daily work as I struggle to get up to go to work, struggle to find energy throughout the day and evening, weekends and even for my first time on vacation this summer since the accident. I struggled to do my work and to deal with my terrible loss with professionals. I now have a wonderful companion and am still having this terrible fatigue. I have a lot of natural vitamins and don’t feel like I am getting anywhere. I am exhausted of trying to fight this fatigue and trying to have a normal life. I don’t think I should be working in order to have a normal life, to permit me to use the little energy I have. I did have Wellbutrin and Effexor. Do you have any suggestions?

    1. @Carole — For added energy from a holistic source I really love ADAPTEN-ALL, from Ortho Molecular Products. It’s a natural adrenal supplement that helped me enormously. Check with your physician if you have any medical conditions or on medication to see if this would be an appropriate supplement for you.

  8. Hi Michele,
    Thank you so much for your information in this blog. I came across it on a google search and even though I’m Canadian and our system up here is a bit different I found your blog ever so helpful and your writing style is phenomenally engaging! It is so wonderful to know that I am not alone in my fatigue, that I’m not being lazy, and that there is a logical explanation for why I’m so tired. I was diagnosed with C-PTSD after a series of work place violent incidents, an abusive relationship with my former husband, and childhood physical abuse. I am a single mother of two wonderful girls and I have been struggling with my expectations for myself and the reality of what my body is allowing me to do. It has been a year since I was first diagnosed, along with bipolar disorder. I have healed a lot since then through the help of counselling, medical care and CBT and medication. Since I have returned to work part-time, I have been immensely tired, for days afterward. I feel like I shouldn’t be this tired. As I struggle with hypervigilance, I’m wondering if that would be a factor as well? I also seem to lose my keys, etc. often on workdays. Your blog was so compassionately written that i feel i can allow myself to heal physically without being angry or frustrated with myself for being so tired. It also gives me hope that as I heal my seemingly endlesss fatigue will improve. Thanks again for your awesome blog! It is wonderful to find this information.

    1. @Christie — I’m so glad you’re here! And very excited that the information on this blog has led you to some new insights about yourself. It sounds like not only did you discover that you’re experiencing something completely normal (including the lost keys on workdays, I hear that often!), buy it sounds like you’re already implementing a new level of self-kindness; that’s really important too. In fact, my next radio show is all about that. If you’d like more information about how to heal from experts in the field, tune into CHANGING DIRECTION, or listen to the archives any time for more new ideas and validation for what you’re experiencing: ChangeYouChoose.com/archives

      You have enormous healing potential; the goal is learning to access it. Onward toward freedom!

    1. G’day Jennifer

      Sadly it’s like asking will your broke leg ever go away , the short answer is no , it will repair over time but you can never have a unbroken bone again , sometime it’s stronger after it repairs and the mussels can be built up to make the leg stronger ,it is like this in your mind , you with get over this injury but need to work on strenghing the areas of your mind like you would mussels . also you need to learn the possible risks of a second injury and work out ways to minimize the risk . do may end up with a limp but at least you can walk , and may work so hard on strengthening the mussels you win gold in the Olympics for weight lifting its really up to us to get ourself back to as close to the old self as we can . sure we can also ways use a hand from anyone will to help us . hope that helps .

      1. It’s true.. the scars remain, like on the trunk of an old tree, but that doesn’t mean the tree will not blossom and bear fruit. It is part of our journey, and we have to face it and adapt the best we can. The important thing to remember is that you are incredibly strong to have survived in the first place… and even though it makes you feel isolated, you are not alone. There are so many of us carrying these burdens, and we can empathize and understand in ways that many others cannot.

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