Anxiety causes extreme tiredness or exhaustion. It is a fatigue that can almost completely immobilize us, and has been described as “a tiredness beyond tiredness”. It seems to weigh heavily on us, and we may feel like we’ve been drugged.
So why is this extreme tiredness or exhaustion so bewildering and persistent? Even if we get a good night’s sleep it doesn’t seem to lift. So what is happening?
Causes of the Tiredness
General fatigue results from our constant mental struggles to cope with the anxiety state symptoms, and to find a way out. We have been almost constantly fighting or avoiding anxiety for a long time, so it really is no wonder we feel incredibly tired.
“This hyped up metabolism combined with poor rest causes the extreme tiredness and exhaustion.”
The prolonged high levels of adrenaline that accompany the anxiety state cause an extreme tiredness and exhaustion that is physical in nature. The adrenaline triggered by our fight or flight reaction to the anxiety has our body burning energy at a level that would be associated with significant physical activity. So, even if we are doing very little, we become exhausted.
Our minds and bodies have been going a mile a minute with barely any rest, and our sleep may well have suffered too. This hyped up metabolism combined with poor rest causes the extreme tiredness and exhaustion.
Another factor is the despair that develops with prolonged anxiety. Nothing we try seems to make any difference, our feelings of joy and love seem to vanish, we lose interest in things we used to enjoy, and so our motivation to do anything evaporates. Inevitably we become lethargic and depressed.
We suffer both emotional and spiritual exhaustion, and with that comes its own form of tiredness – one born of despair.
How it Feels
Here are some examples of what sufferers say about their extreme tiredness or exhaustion:
“It feels as if I am dragging myself through the mud.
“I simply feel too tired to get interested in anything or do anything”
“I used to have endless amounts of energy before this; now my bones feel like lead.”
“I suddenly woke up a few days ago with terrible exhaustion. I feel like I didn’t sleep at all and it is now very difficult for me to even get out of bed.”
“It really is a tiredness beyond tiredness. I can sleep 13 hours straight and wake up exhausted and foggy headed.”
“It doesn’t seem to matter what I do. It is bewildering and, it would appear, never ending.
“I’ve been told by various doctors my exhaustion is really depression or low mood.”
Tiredness as a Symptom during Recovery
The tiredness is even more noticeable when we have been practicing facing and accepting our anxiety for a while and our adrenaline levels have dropped. While we may feel less anxious, we also can feel more tired.
I believe this is because we had become so used to functioning on high levels of adrenaline and other stress induced hormones and chemicals, that when they are reduced we feel depleted and exhausted. Consequently it takes a while for our body’s metabolism to adjust to these lower hormone levels, but, when it does, our fatigue lifts.
Tiredness as Avoidance
In some instances, tiredness can be a form of avoidance. Think of it as your anxiety gremlins trying to get you to stay in bed so that you can avoid life and avoid anxiety. It is a way for your brain to dissociate from the pain and suffering of anxiety.
This may get us some relief in the short term, but we pay the price in becoming less functional in life, and of course it doesn’t move us any closer to recovery. In this instance, we need to do things in spite of feeling tired, and give ourselves full credit for pushing through. This can feel like a monumental effort, but we can start with small things and progress from there.
It can sometimes be hard to distinguish whether the tiredness is an avoidance behavior, or whether it is genuine fatigue. The best thing to do is try to strike a balance between pushing through the tiredness to get things done and honoring our need for rest. Finding a healthy balance in areas like this is a large part of our recovery from anxiety.
The Four Fatigues
An alternative term for this extreme tiredness or exhaustion is ‘fatigue’. There are four areas of fatigue related to anxiety: physical fatigue, mental fatigue, emotional fatigue and spiritual fatigue. These four fatigues are explained in more detail in my book.
Spiritual fatigue is the one that is least understood. It is the loss of meaning in our lives. We feel like “What’s the point of anything”. Spiritual fatigue is a component of the depression that often accompanies anxiety. When it lifts, we begin to experience a return of interest in things that we used to enjoy before anxiety robbed us of all our joy and enthusiasm.
Fatigue lifts usually in the order listed above – with physical fatigue the first to respond, and spiritual fatigue the last to leave
How to Respond to the Tiredness
In most instances, extreme tiredness and exhaustion is a symptom we experience due to the natural progression of recovery. While we want to push through it in order to accomplish things, we also need to honor it and give ourselves sufficient opportunities to rest.
“Fatigue is a natural part of the recovery process”
This fatigue is just part of the recovery process, and, like all other feelings, it simply needs to be honored and accepted.
However, if you sense that you are using the fatigue as a reason to withdraw from life and close down, then you do need to push through it and get some things done. As stated, you can start with very simple, small things. The important piece is to break out of the malaise, and then keep going. Take the exhaustion and any other feelings and emotions with you – don’t wait for them to lift.
Perhaps all you can manage at first is getting out of bed, and then getting showered and dressed. Try following this up by checking for mail, responding to emails, visiting a friend, going to the local store etc. Find ways you can slowly get back into our life. After each activity give yourself credit for it.
Each small step is a success.
