PTSD Fatigue, PTSD Exhaustion, and Extreme Tiredness

PTSD Fatigue, PTSD Exhaustion, and Extreme Tiredness

I think PTSD exhaustion is one of the most common symptoms accompanying post-trauma; to be utterly exhausted, tired, fatigued, not having the will or the energy to do anything, and especially so after a triggering activation, when one’s story, accompanying emotions, and adrenaline get going. It saps the very life force and can take days to become fully renewed, only to be wasted yet again, in a heartbeat.

Suffering PTSD is cyclic: trigger sensitivity or dissociative behavior might increase, leading to more withdrawn periods of reclusiveness, making it harder to connect again to one’s self and others.  So it goes on and on, cyclically, until attended to.

PTSD Fatigue, PTSD Exhaustion as a Symptom of Trauma

It is not uncommon for people living with PTSD to develop ME or fatigue syndrome over time. It is one of the major symptoms accompanying PTSD, as are migraines, fibromyalgic pains, irritable bowel syndrome, depressed immune system, and inflammation.

PTSD fatigue, tiredness, lethargy, and exhaustion can manifest in different forms. It can vary from a flat-out draining attack related to what you are dealing with and suffering from, to a lingering, sullen, but persistently pervasive, exhausted state.

The cause of the draining attack is obvious; your flight/fight mechanism has kicked in through a triggering event, and after it has run its course, you will have to pick up the pieces and attempt to build yourself up again as best as you can.

Besides a triggering activation, there’s a lot of energy invested in keeping a traumatic state steadily static, and this is held mostly at an unconscious level.  It is this manifestation of PTSD that leads to the persistently exhausted state.

Rupture of Boundaries and the Nervous System Responses

Post-Traumatic Stress is a maladaptive pattern which was formed in response to an overwhelming experience or period in your life. It breaches your boundaries, healthy containment, and sense of self because you were unable to adjust and integrate the experience and feelings at the time that they occurred.

Feelings and sensations generally manifest through the body. When we judge a sensation or feeling as “good” or “bad” it becomes emotionally polarized and tends to become cyclic, unsteady, and pathological. This inevitably happens when you go through a traumatic experience or period in life.

Emotion residing in the body creates tension, and creates “knots” or concentric tension in body tissue. Emotions affect primarily the nervous and endocrine systems, and organs; from there, the effects travel to the muscular-skeletal system where pain first occurs due to the body’s enervation. These “knots” or “cysts” in the body are holding the emotion, as though frozen, and with deep traumas or early life trauma, they even store the memory of the original, pervasive event.

The Body as Container and the Price to be Paid

The body-mind keeps these emotional tensions–these energy cysts– in place to the best of its ability, at the cost of enormous energy. It might be preferable to choose pain, discomfort, or disease instead of coming to close to the sensation of the overwhelming helplessness in the face of the traumatic residue.

The remainder of your available energy has to compensate for keeping a traumatic state, with accompanying body tensions in place, which can result in lethargy, depression, tiredness, fatigue, ME and many other conditions and diseases.

» Dive deeper into this topic by reading The Trauma Essential Series →

How are you dealing with PTSD fatigue and exhaustion? Leave your comments below.

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  • Frank says:

    Doc at VA has giving me 4 different meds. I asked him if any meds. give you energy he said he would check? Just tired of being tired.

    • Cheryl says:

      B complex may help with energy. Also ask about magnesium supplements. Magnesium helps with anxiety and depression as well as muscle pain/cramps.

    • Roland says:

      The energy is locked up within the tiredness. The tiredness is the dissociation to not feel overwhelmed. Feeling into that rather than resisting will possibly open the underlying emotions that give rise to the tiredness. Make sure you do this with someone skillfully.

      • Michelle says:

        I have found this to be true. Insightful counsel.

      • Cheryl says:

        What are referring to for “feeling in to it” in this example? Feeling in to the tiredness? In to the overwhelmed? In to the original trauma? These few sentences fit me all too well. I’ve made good counseling progress, but nothing shakes the fatigue I’ve had for 30 years now! I force myself to minimally function through it and live life, but the fatigue itself is traumatic to have to struggle against day in and day out. I also have tried all sorts of nutritional regimens, some of which help a little, but again not enough to give actual relief. My newest technique to try is EMDR, which has promise but is getting dragged out with not much help in fatigue yet.

        • Anna says:

          Hi Cheryl, TRE (trauma release exercises) have been incredibly helpful for lifting my fatigue. 30 years is a hell of a long time to be suffering… I really hope it gets better x

        • Elise Hayden-Ferdman says:

          Hi, Cheryl!
          I have been doing EMDR for a few years, at first steadily for a year, and now just whenever something is coming up. With CPTSD over here, it felt like it took forever to plow through and experience any progress. I am so glad that I stuck with it. When I started I had chronic pain and fatigue from a whole slew of autoimmune disorders. I have so much more energy and far less pain now, as well as being more centered, empowered and resilient. Somatic focusing and EFT have similar effects, but I think EMDR with a well-trained therapist is better to start with. Anyhow, my suggestion is to not give up, keep going even if it is really hard and you aren’t sure it is helping. It takes time for some of us, but it is so worth it. Best of luck!

      • Elizabeth says:

        Look up adrenal fatigue related to hypervilance, this is often behind long term PTSD related fatigue

      • Brian says:

        This is pretty insightful and helpful to get more clear on my habitual tiredness as a compensatory strategy to avoid overwhelm. Seems simple but the impact is pretty huge, noticing a great deal of my coping strategies actually exhaust me and in the end, make me tired.

      • RC says:

        Feeling that right now. Narcissistic step father who hated me, a sibling who followed his lead (only realized that now, in my 50s).
        Not a surprise that I spent 20 years with a narcissistic husband, not knowing what was wrong with him in the end.
        I left 8 years ago, after much in the exact t health issues you spoke about. I have been incredibly exhausted nearly that entire time. I work and feel like I must have worked twice the number of hours-my heart is having a good deal of trouble again.
        I went back to school. I had so much trouble concentrating and so much physical pain and anxiety, but I did graduate with a 3.75. Studying was next to impossible, but I spent the extra time to get it done, forgoing sleep often. Crashed and became physically ill every single quarter.
        Market shift under a certain pressure and health care shift rendered my degree nearly useless, at least if I wanted to get ahead at all. Bankruptcy, failure..
        Finally, I was paying expenses (barely though), and a tornado dropped a tree through my roof. I wasn’t insured as I had sold nearly everything to get through school. Sibs continued to say how I wasn’t right, in many ways (I was my father’s favorite and never knew how jealous they were).
        Anyway, just exhausted and in pain, trying to hold everything together as I try once more to get life going.
        One of my sons and my daughter have been neglectful and abusive lately. They just don’t understand. THEY were my reason to go on. Now, I am sorting out how to learn to honor and respect and love myself, and have appropriate boundaries. We were never allowed to have boundaries, and I knew nothing about them.

        Thank you, for your work!

    • Jennifer says:

      Taking an active form of folic acid helps a little. It won’t give you all your energy back but it helps you have some days you can actually be productive. You can some good tasting chewables on Amazon.

    • Steve says:

      I have been entertaining the thought of low dose testosterone. It may get rid of the lethergy, give your circadian rhythm a reboot as well. I haven’t broached the subject with mmy doctor yet but, after 12+ years, I am ready to try something else.

    • Crystal says:

      Did he ever check and get back to you? Would love to know something that would help this overwhelming tiredness with the chronic depression.

    • Jerry says:

      ‘ Overwhelming helplessness in the face of the traumatic residue ‘ ……..So that is what is happening !!…..soo good to know….I just thought that i was
      no good …..thanx Roland ….this has really helped .

    • Kevin Newton says:

      Adderall that’s time released with 2 types of amphetamine. The VA has it but doesn’t like to start with it. You have to work up to it unless a doctor overrides. If you check the McGuire Veterans Hospital polytrauma transition center in Richmond, Virginia, they went through this with me last summer. The Polytrauma Transition Center is in its own bldg beside the main hospital. On the ptrip side is a nurse named Jim. Ask him about Col. Newton with the Kona coffee and he should remember me. He was familiar with my travails and should be able to guide you through getting the proper type of adderall. Good luck.

    • Julie says:

      Does this cycling of exhaustion, etc continue forever? I was diagnosed three years ago but this seems never-ending. About to go back into a Neuro-clinic for a few weeks. Too much exercise and I crash. Too much stress and I crash. Not even sure most of the time what the triggers are triggering. Trauma began from birth so memories are difficult.

    • Lynne says:

      I take kratom and Mucuna Pruriens. To restore energy and depleted dopamine … it’s extreemly helpful and a blessing!
      Also natural and has been used for centuries! Research these please! I’ve been taking for a few years now

  • Melissa says:

    Nodie – me too!!! Exactly!!! Can’t sleep, can’t get my brain to slow down and rest. So I take multiple sleep aids (alternate what I take to try to avoid dependence. Not sure it’s working but..). Then it’s like I’m drugged the next day! Lead in my bone marrow tired! If I’m able to nap, that really helps me to finally become functional. But whether I nap or not, I still can’t sleep at bedtime. :/

  • Chanda says:

    Diagnosed with Narcolepsy, hmm.

  • Mari says:

    What does “ME” stand for?

  • BB Graf says:

    As a massage therapist, I understand what this article is saying and the importance of doing soul healing work. Taking supplements is going to help you keep going in life but they will only help a bit and the resolve will not come until you ACTIVELY participate in the healing of the emotional wounds. Participating in Adult Children of Alcoholics meetings and workshops helps, (for people raised in families in any form of dysfunction) but working with a therapist is essential. The meetings are not meant to replace therapy. If you can find a therapist who work in the understanding of people being a triune being, body, soul and spirit you’ll find the best possible therapy because we are whole beings, not segments.

    • Joanne says:

      How to find a therapist that is affordable? At 61 should I even try?

      • Cheryl says:

        Yes it’s worth it! I am 51 and doing therapy with EMDR. The thing I’m discovering is I’m not entirely 51 years old… there are traumatized parts of me stuck at the original age and influencing my life accordingly. As I address the traumas, these parts of me can finally let go and integrate with my current self. I hope to be fully and completely 51 through and through, and to finally heal from my constant fatigue. So I say go for it and seek help for hurting child inside who doesn’t know anything about your age 🙂

      • ginger says:

        Of course you should try! You might have another 20 years of life left, why suffer anymore.

  • Moira says:

    I feel constantly depressed and tired and hidden repressed anger. Had one session of emdr and can feel things loosening up deep inside. I spent thousands on counselling and therapy. Wasted my money. Just could not go deep. All it did was keep the trauma alive I felt. This trauma specialist says it wouldn’t change me as I need to process the memories.

    • Roland says:

      Yes, unfortunately there are few who address the cognitive part and also work on processing the emotional charge related to trauma. Keep going!

  • Denise says:

    I am looking some sort of a healing retreat to go to. A retreat that possibly specializes in trauma and ptsd recovery. Is there one you recommend?
    Thankyou

  • […] Complex Trauma and PTSD Exhaustion, Fatigue and Tiredness […]

  • Sara says:

    This makes total sense, thank you.

  • Jordan says:

    Thank you for describing this in so much detail. My next question is: what do I do about it?

    Is there someone out there who can understand a traumatized body and knows how to help it?

    Thank you

    • Roland says:

      Hello Jordan. Understanding helps to create a framework. If you want to work deeper on a somatic/emotional level please get in touch by private message fro setting up an online counseling session. Regards

  • Anna says:

    Hi Nodie, TRE (trauma release exercises) have been really helpful for me. I was in a bad car crash (luckily not injured, but car was a total write off). That evening I went for a session with a TRE practitioner and happily drove a car the next day, no stress at all. Basically it is the body releasing trauma memory from the muscles, particularly the psoas muscles. Do some research on TRE – it’s amazing. Hope this helps 🙂

  • Dotsy Maher says:

    OMG…This article was VERY concisly helpful..BUT thank you to all commenters…
    WOW..intellectually I KNEW I was not alone…but it has been a bad week..
    AND..I reverted to physical pain and extreme..crippling fatigue..THANK YOU ALL for reminding my “shutting down self”…IT’S OK…IT’S JUST A LITTLE SET BACK ❤

  • Lewa says:

    It’s nice to see this put into words. I hope to start EMDR soon and am really hopeful. Thus far I have found a way to manage my fatigue, but I am so tired of being tired. I have changed my surroundings to reduce stressors and I have finally cut ties with my family, which was very helpful as they were a major trigger, but there is more, I want more healing beyond just finding a way to manage from one day to the next. It’s also very isolating to have so much fatigue because I feel like I let others down when I opt out or when I have to rest up. I think reading this article helps me feel less guilty because it is in fact real and not just in my head.

  • Albie says:

    The last six months trauma of the same keeps repeating. In the moment of repeat I feel calm and in control. Then about 2 day after that… I get a setback… crying, sleeping the whole day, it feels if I lost a day or three… at day 5 about I feel in control again and can go on like normal. What worries me is. For a day or 2 it feels like I have a total blank, cannot remember what I did or say. I’m getting worried about it. I dont feel depressed after a episode. Just angry…
    I dont take any medecine. Just Vitamines and folic acid.
    The Trauma is from some familymenber. My son went threw a bad teenage fase, family member keeps interfering. Like a Narsist! She infuance my husband. She interfierd in my marrage since I met my husban 29 years ago. Now she start with my children… She is stealing not just my life but also my husbands an now starting with my Children…it feels if she is busy killing me slowly…

  • Tracee says:

    I have trouble sleeping and get jolted easily and startled from surprise touches

  • karen says:

    The NHS does have trauma specialists, my NHS Trust has added this specialism – do try to campaign for greater awareness among GP’s and Mental Health Trusts of your somatic & PTSD symptoms. My belief is that this is under diagnosed & wrongly treated. As Roland said without containment & skilled psychological understanding, clients are left to flounder. I would also recommend a highly experienced massage body worker, to deal with long standing intense pain. Namaste.

  • Odette says:

    From early childhood right up until now, ive had endless trauma, emotional stress and sometimes severe depression. From an early age in adulthood i developed severe health issues. Complicated by raising children and living in an unhealthy unfufilled marriage ihave see various therapists over time whit not much success. My life has become so unbearable that i continuously pray that i can just sleep and not wake up.i have always had a strong spiritual belief system without which i don’t think i would have reached this age in my life.

  • Tricia says:

    I have been noticing for some time that I have cysts on my arms and could on my legs. I have chronic PTSD and I did associate when under tremendous stress at some point I as I call it go on auto pilot. Sometimes also I get extremely tired n can sleep for one day up to 5 days n not wake up. I really thought I was going crazy until I seemed therapy n started reading your articles. When I go on auto pilot I won’t remember anything about the incident until someone tells me how weird I was acting n people think I’m on drugs which I’m not cause I don’t use street drugs. This has been going on for a lot of years. I call them episodes and the can last up to four to five days. They can be very scary for me n my family. I don’t know a single person that this happens to which makes it hard for me to go out with friends cause I never know when an episode may accure.

  • geraldine says:

    Yes I have chronic depression. Had m.e in the past and fibromyalgia pain last 10 years. Am awaiting more in depth counselling. To incidents that happened when I was very young. Am so fatigued. Gets frustrating.

  • Jacqueline Cullis says:

    Thank you for your interesting articles. I experienced PTSD in 2013 after a traumatic a build up of 3 years of trauma events that happened. I was so fatigued that I struggled to get out of bed and stay awake during my day. I went to a breath worker who helped me to release my trauma. It took about 6 sessions of deep breath work which resulted in physical release from my body which was just the start. 5 years later through changing my thought patterns, eating a no sugar, gluten and diary free diet, swimming, meditation, drinking alot of water and green tea, spending quality time in the sunshine, doing gardening and taking care of myself, I am feeling 100% better. I have learnt humility and appreciate the fact that I am alive today. I also took anti-depressants for 6 months but stopped them cause it caused brain fog. I am on chronic meds…Vitamin D and have B12 injections when I go through a stressful period and take time out for me. I found that the most powerful tool that has helped me is to take charge of my thoughts and emotions and not allow my self to go into a negative place as soon I start feeling overwhelmed .

  • Alicia says:

    Complex trauma or C-PTSD. I have these episodes. Sometimes dissociative, sometimes suicidal actions, sometimes both. When I come out of them, I’m so exhausted. It seems like triggers are all over, but right now specifically; I’m in the middle of a civil case where the person I’m fighting was my therapist. There was grooming, gaslighting, pills and alcohol provided by him in sessions, until he brought me home from the hospital and sexually assaulted me. I had been given morphine for a kidney infection which had gone septic. Up until that point I always said no to his advances, but I felt guilty, like I was taking advantage of how much he ‘took care of me’. By this point he was in my life everyday, telling me what to believe and who my friends could be. Anyway, I even thought I loved him though I walked on eggshells most of the time. I had to tell him what he wanted to hear, or he would be upset and get into my head until I was triggered to the point I’d be in one of these blind states where suicide was the only out. I survived. I started telling him no. He sent me into these tailspins over the months after I said no. One day I realized he was harming me. I realized and tried to get him out of my life. He wouldn’t stop. He snuck onto my work property, left a scary card on my doorstep after the police told him to have no more contact with me. My state of mind was so threatened that I put my daughter in a house I thought she would be safe at, and I fled my home of 9 years, my job of 16, and moved from couch to couch and finally to a shelter. Two years have passed from the shelter, and I feel like my mind is never going to heal. One second I’m okay. The next, gone. When it passes, I’m so exhausted I can’t think or move. Society doesn’t understand. My own lawyer and mediator called it a relationship and an affair gone bad. Those statements put me in a bathtub with a knife. I don’t see a relationship or affair. I see a systematic abusive professional who destroyed my life. I’m in therapy. Trauma processing with EMDR. I don’t know if I’ll survive. I want my mind back. The one that wasn’t so damaged. I got here by looking up why I was so exhausted. Maybe the stuff here will help.

  • Aimee Hart says:

    What is being referred to as ME in this article?

  • Karen Bernhardt says:

    Watching others with PTSD is hard specially through fatigue when you know that rest and restoration can only come with time. Tanks once again Roland for touching on subjects and how to look at trauma. I am most impressed,

  • Satu says:

    I cannot recall ,when I realized the affect of trauma on my nervous system,but I describe is as “my nervous system has gone roque”.;it has a Life of its own. What I can do is not to harm&push it any further (the affect on ACH…) Resting;just quietly breathing “4 in 8 out”, doing tasks e.g.in half an hour intervals;then stopping for 5, going to bed early ,and even deliberately walking slower,if I feel myself rushing;These are some of the choices I have. I can feel “buzzy”,but bit by bit the Roque One joins in. Today I am safe&my physical actions can relay that message to my frayed nervous system.

  • Pat says:

    I have never had trauma counseling for historical sexual abuse. I’m experiencing all C-PTSD symptoms since remembering the trauma 15 yrs ago. Should I try to find a therapist for trauma therapy? I have had some therapy & then the therapist discharged me.
    Thanks
    Pat

  • Nadia says:

    Does anyone have any techniques, activities, ways of being that can help with PTSD related fatigue?

    • Jerry says:

      I write and write and write into it Nadia…..Hemingway once said that there
      was nothing to writing ….he just sits at his typewriter and bleeds !!
      I do the same with my pen and paper…
      hope that helps you as it does me .

    • Eleanor says:

      Sleep for over nine hours. Go to sleep every night at the same time. Only work part time at a safe, low stress job that brings personal satisfaction. Eat a no cane sugar, corn sugar, no chemical diet that is full of fresh fruit, vegetables and whole grains. Exercise at a gentle walk, do yoga, gardening, but nothing stressful, just enjoyable. Cut out all people that make you tired, stressed, or sad. Meditate and pray each morning before you get up. I turn on a YouTube guided meditation for healing and sit up in bed and meditate. Prayers can be as simple as saying five things you are grateful for. Get sun and fresh air. Constantly reassure your body that it’s safe. I do Neuro feedback therapy with EFT and talk therapy. Avoid therapists that drag you backward into the trauma session after session. Once you’ve spoken about what has happened it’s time to work on copping skills and strategies. All the above works for me until I overdue it and end up back in an exhausted state like I am now. I went six months being functional before this last set back. Now I’m working on moderation and learning to accept my limitations. Also, alcohol actually make everything so much worse. I love being tipsy but it takes my brain chemistry three days to recover and I’m a real pissy hellcat during those three days. Alcohol is just a demon in a fancy bottle for trauma survivors.
      Sending you love.
      E

  • Kay says:

    I have found over my adult life I am simply unable to work more than 30 hours without great difficulty. I have this tremendous fear of appearing lazy or incompetent because 40 hours is such a standard.

  • Rebecca says:

    Can you please recommend a therapist who can help me with dissociative amnesia, chronic fatigue, fibromyalgia, depression in Adelaide, South Australia please?

  • Glenna says:

    I’m always tired. I need 10 to 12 hours of sleep, per night (which, of course, I don’t get), in order to feel somewhat better. Less sleep, and I’m way more tired, and I can’t think straight. It affects my mood, leading to more depression. I have a C-Pap machine, that I love, but I still don’t feel rested…ever. 3 antidepressants, and thyroid meds, on top of that. Granted, I’m really doing the best I’ve ever done, but I’m too exhausted to do anything more than go to work, and go home and hide. I have bouts of random body pain/aches, as well as traveling, “voodoo-doll-like” stabbing pains. No answer from the doctors, and I can’t afford (with insurance) to push the issue to do more testing. Therapy takes forever. One ego state gets in the way of the other, and prevents complete processing. Now, sometimes, when I try to sleep, I am tortured by random, traveling itches. Scratch one, and another pops up. No rash, no allergies, no bugs…I know it’s just in my head. Wherever the itch is, when I scratch, it’s like saying “I’m not itchy, what are you doing?”.

  • Maria E says:

    Amazing

  • Eleanor says:

    I have complex trauma disorder. For 17 years I have been in counseling with various counselors, psychologists, and psychiatrists. I’m now doing Neuro feedback with EFT and talk therapy for one hour twice a week. This is the best therapy I have even found. My energy is up and I’m able to do more. My depression and anxiety is lower and I can sit with my back to a room and have even created an inner signal that tells me to redirect when negative thoughts or triggers try to take over my thoughts.

  • Kristin says:

    I’m afraid to try, but my core say do it. It’s an internal struggle I’m tired of fighting. I’m thoroughly convinced – having followed your blog and other readings- that I can’t become whole until I address the emotional residue. I believe I’m smart and highly capable of achieving so much more in life than I already have, but the negative self-talk went stop. I’m going to purchase the meditation series when I get paid. My inability to cope led to the trauma being passed down to my children, if you will. I need to become whole if I’m to help them become whole, too.

  • Leah says:

    So true! Fatigue is my primary issue! I use magnesium, B12 and prazosine an off label blood pressure drug used for lymbic activation. Lots of side effects and can only be taken at night but works amazing! Long term side effects and consequences not sure

  • Heather says:

    Physical activity beginning with walking and slowly working up to running, dance, or other activities help to release the energy trapped in the nervous system. At first it seems tiring, but if you approach slowly, over time then body will feel much better.

  • Sue says:

    It all makes sense to me, now!!!
    I have a diagnosis of EUPD. Before that, Bipolar.
    My psychologist used Mindfulness to rediagnose me. It was Hell. Opened my Pandora’s box & then discharged me, as it activated disocciative memories.
    (I have D.I.D)
    So all the anger,resentment,guilt,#shame came flooding back & the Alters. (The old me’s who got abused, I was to young to comprehend or deal with the things that happened, so I disocciated. )
    I use to be numb! But, the mindfulness opened up the black hole & I was left to relive the whole mess & feel all the emotions that I couldn’t express as a child, teenager. Reliving it, as though it was happening all over again. I have no support even my family avoid me.
    Yet I can’t disocciate, anymore. So constantly feel a sense of dread, besides the overwhelming emotions and feelings. Along with the insomnia & Alts, shame, guilt & exhaustion.
    Your posts are a lifeline.
    That I use to restore my hope & faith, to carry on
    Thank you.