How PTSD Can Leave Us Feeling Unremittingly Exhausted.

How PTSD Can Leave Us Feeling Unremittingly Exhausted. 1

Many sufferers of PTSD feel constantly exhausted and, in this article, I want to examine the reasons why:

Causes of exhaustion in the PTSD sufferer:

1) Disrupted sleep.

At my most ill, I was having to retire to bed at 3pm and would not re-emerge until about 15 hours later (ie 6am the next day).The sleep itself was very low quality, extremely broken and unrefreshing; I would wake up literally dozens of times and the sleep I did get was full of hideous, terrifying nightmares.

Indeed, badly disrupted sleep is very common in individuals who suffer from PTSD. The person may have frequent and intense nightmares, suffer broken sleep, take a long time to fall asleep and wake up undesirably early in the morning, unable to get back to sleep despite feeling exhausted (indeed, this is also one of the hallmarks of major depression).


PTSD sufferers who experience such symptoms of insomnia wake up feeling both mentally and physically unrefreshed and, as a consequence, find both their physical and mental abilities are impaired.

Also, as a result of not sleeping properly, they often find their ability to cope with everyday life is greatly diminished and their vulnerability to the adverse effects of stress are greatly increased.

2) Psychological strain.

People with PTSD are constantly tormented by, and attempting to fight, extremely painful memories and distressing intrusive thoughts. This, too, is exhausting.

3) Effort of ‘putting up a front’/hiding behind a false self.

Many sufferers of PTSD do not want others  (such as acquaintances and work associates) to know about their illness so feel they need to ‘wear a social mask’ and pretend that ‘everything’s fine’. Keeping up such a pretence is mentally taxing and extremely tiring.

4) Effects on diet.

People with PTSD may lose their appetites and consequently under-eat, leading to malnutrition and deprivation of important minerals and vitamins which may cause increased fatigue.

5) Workaholism.

Woody Allen, who has written, directed and, often, acted in one film a year for many decades says he works so much to distract himself from pessimistic thoughts and existential angst. In a similar way, one way some PTSD sufferers try to cope with their disturbing thoughts and feelings is to immerse themselves in work in order to divert their minds, working each day for excessive hours ( up to 20 hours a day, in the most extreme cases).

Consequences of extreme tiredness/exhaustion in the PTSD sufferer:

The consequences of the great fatigue the PTSD sufferer may experience include:

1) Lacking in mental and physical energy

2) Poor concentration

3) Poor decision making / poor judgment

4) Irritable mood

5) Extreme tiredness can lead to the development of depression (on the other hand, depression can also lead to constant tiredness)

6) Reduced ability to cope with everyday life

7) Impaired work performance / leads to more days absent from work

8) Impaired social life

9) Increased risk to physical health



We have seen from other articles that I have published on this site that significant and protracted childhood trauma can physically damage the developing brain and, in particular, the development of a brain region known as the AMYGDALA.


One of the functions of the amygdala is to regulate our emotions, including fear and anxiety, and, as a result of this damage, it can become dysfunctional.

This dysfunction may result in the amygdala becoming ‘stuck in overdrive’ leading us to feel constantly highly anxious and fearful – in other words, locked into a perpetual state of ‘fight or flight’.

When we are in a state of ‘fight or flight’, our bodies undergo certain physical effects; these include :

– increased heart rate

– increased blood pressure

– rapid breathing

– an increase in the production of the stress hormone known as cortisol

– an increase in the stress hormone known as adrenalin

According to Adrenal Fatigue theory, when we are subjected to chronic, intense stress, such as that described above, the adrenal gland becomes dysfunctional resulting in symptoms such as those listed below:

– constant, extreme tiredness

– an impaired ability to concentrate

– difficulty in getting out of bed in the morning

However, it is important to note that, at the time of writing, there exists insufficient evidence to establish Adrenal Fatigue Syndrome as a formally recognized disorder in the world of mainstream medicine.


If  ‘adrenalin fatigue syndrome’ is not, in fact, a real condition, being diagnosed with it by an alternative therapist might detract from the real issue which could be, for example, depressionchronic fatigue syndrome, heart failure, diabetes, poor diet, poor quality sleep or anemia, all of which conditions may produce symptoms of extreme and chronic fatigue.



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David Hosier BSc Hons; MSc; PGDE(FAHE).

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About David Hosier MSc

Holder of MSc and post graduate teaching diploma in psychology. Highly experienced in education. Founder of Survivor of severe childhood trauma.

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