Between managing eight Zoom calls a day and the trips at two in the morning to take your pandemic puppy out to do their thing, it’s no surprise that you’re feeling wiped out. But if your doc has given you a clean bill of health, you’re actually getting some solid sleep, and you’re still exhausted, it could be a sign your fatigue is actually due to anxiety.
If you have intense anxiety or panic attacks, this might not come as news. Since this type of anxiety can be draining and overwhelming, it makes perfect sense why it might zap all your energy. But chronic tiredness can crop up in milder forms of anxiety, too.
“Anxiety drives our sympathetic nervous system into overdrive,” says clinical psychologist Joshua Klapow, Ph.D. “It raises our heart rate, blood pressure, increases muscle tension, and releases toxins into our system that can cause inflammation.” All these things are exhausting for your body. “We can feel fatigue and malaise strictly from being anxious.”
If you and your doc agree that you’re not physically ill, but you still feel exhausted all the time, your physical symptoms might be from anxiety. Read on for some ways to tell the difference between normal tiredness and anxiety-induced fatigue.
1. Coffee Doesn't Seem To Be Helping
If you were dealing with run-of-the-mill sleepiness, you would likely feel a jolt of wakefulness after drinking a cup of coffee or two. But this trick doesn't always take the edge off for people with anxiety — and in some cases can even make it worse. "If your daily cup of coffee or some midday chocolate isn't perking you up, you may be dealing with more than being tired,” says psychotherapist Kimberly Hershenson, L.C.S.W.
2. You Still Feel Tired After A Good Night's Sleep
"If you are sleeping at least seven hours a night and still feel tired, it is likely something else is going on," Hershenson tells Bustle. Give yourself a few nights of seven to eight hours of sleep, and if you don't feel better, it’s time to check in with a doctor.
3. You're Suddenly Tired Before A Social Event
If you’ve been fine all day but get a bout of sleepiness right before that big get-together, take note. "For those who experience social anxiety, being around a large group ... will [leave you feeling] drained, sometimes both physically and mentally before, during, or after," says Aimee Noel, L.C.S.W., the clinical director at Sober College. "Those without social anxiety could feel energized interacting with a lot of people. If your tiredness correlates with these events, it may be a sign of anxiety."
4. Your Stomach's Been Bothering You
Again, anxiety often goes hand in hand with physical symptoms, so don't ignore any weird issues you might be experiencing. As Hershenson says, if you're struggling with anxiety, "you likely will experience other symptoms such as stomach pain, migraines, shortness of breath, and heart palpitations." So if your tiredness comes with a heaping helping of bellyaches, it might be your anxiety acting up.
5. You're Always A Little Too Tired
Feeling sleepy after a long day is one thing. But if you're totally and positively drained all the time, it could be due to the fact you're on "high alert" and feeling anxious all the time. "That creates intense cortisol levels rushing through your body," says clinical psychologist Gladys Frankel, Ph.D. It's like your body is constantly asking, "Where is the danger?" And that can be exhausting.
6. You Don't Have Much Of An Appetite
Anxiety can really mess with your appetite, which can then create a vicious cycle that increases fatigue you might have already been experiencing. “You may skip meals, not have an appetite, and thus not have adequate nutrition to keep your energy levels up,” Klapow explains. “Anxiety can also dehydrate you, playing into feelings of fatigue and malaise.”
7. You Would Describe Yourself As "Burnt Out"
There's definitely a connection between anxiety, tiredness, and your busy life. "The problem with today's stressors are that they are low grade (like our phones ringing, 24-hour social media, etc.) but continuous, which means the fight-or-flight pathway never turns off or has a chance to rebuild," says chiropractor Steven Zodkoy, author of Misdiagnosed: The Adrenal Fatigue Link. And that can definitely lead to feeling burnt out.
8. You're Crying All The Time
It's normal to feel a bit weepy when you're overly tired. But if your fatigue is due to anxiety, it could reveal itself as an outpouring of emotion that doesn't go away, even if you've had a good night's sleep. It's normal to be overly-emotional when you're anxious, Zodkoy says, as well as a bit depressed.
9. You Have Brain Fog
If you feel "out of it" on top of everything else, take note. "The number one symptom revealing that you are experiencing anxiety is lack of clarity," says mental health counselor Holly Davis, M.A. "This is the plaguing mind chatter that includes second-guessing yourself (and everyone else), being forgetful, and the overall lackluster of life that weighs down your body and mind."
10. You Have A Hard Time Getting To Sleep
When you're tired, often all it takes to feel better is the simple act of climbing into bed, and sleeping soundly 'til morning. But this can feel impossible for people with anxiety. Anxious people often have a difficult time falling asleep, Zodkoy says, as a result of all those circling thoughts and worries.
11. You Have Muscle And Joint Pain
Do your shoulders hurt all the time? “Oftentimes those with anxiety tense their muscles unknowingly and have a hard time relaxing their bodies,” Noel tells Bustle. “If your fatigue is accompanied by body soreness/tension and you have not been working out, this may be a sign it was due to anxiety.”
12. You Wake Up A Lot During The Night
Waking up a lot during the night will obviously contribute to feelings of fatigue. But have you ever wondered why you keep waking up? "Perseverating on triggers like finances or relationships [can make] it challenging for the person to turn their head off," Noel says. "This can cause a restless night’s sleep and tiredness and fatigue in the morning."
13. You're Having Trouble Getting Out Of Bed
It can be nice to stay in when you're feeling tired, or like you need a night alone. But if this becomes your MO, take note. "When isolation seems like a good idea, perhaps the symptoms are not just from a long week, or year, but perhaps even years of the drain that stress has taken," Davis says. If that sounds like you, consider checking in with your therapist to give yourself a mental health tune-up.
Joshua Klapow, Ph.D., clinical psychologist
Kimberly Hershenson, L.C.S.W., psychotherapist
Aimee Noel, L.C.S.W., clinical director, Sober College
Gladys Frankel, Ph.D., clinical psychologist
Steven Zodkoy, chiropractor, author, Misdiagnosed: The Adrenal Fatigue Link
Holly Davis, M.A., mental health counselor
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