One Fact a Day – PTSD Awareness Month

Fact 22

PTSD and Exhaustion


Tired, out of energy, shot, spent, wasted, worn out. Bleary, bone weary, dog tired, ready to drop.

People with PTSD experience all these feelings of exhaustion no matter where they are in recovery, from early trauma response to later stages of healing. I’m in that latter group, and the exhaustion is still with me.

The tiredness isn’t a bid for pity or a trick to get out of work. People with PTSD have real reasons they need extra rest:

  • Interrupted sleep at night. PTSD sufferers rarely get a whole night’s sleep. Their anxiety or invasive nightmares rout them out of bed in the middle of the night and wake them up early in the morning, often by 3 or 4 a.m. No wonder they’re tired.
  • High cortisol levels. Cortisol is the body’s stress hormone. It puts all systems on alert when danger is near. Cortisol is intended for a sprint, not a marathon. But when trauma-induced anxiety persists, chronically high cortisol levels can cause fatigue, memory loss, and depression.
  • Trying to be two people at once. PTSD sufferers who venture out into the world must maintain an outer image that is socially acceptable while controlling the fear, panic, and inappropriate behavior that’s ready to expose them as imposters at any moment. Going grocery shopping, talking with friends, and going to school or work often require an immediate rest when these anxious people return home.
  • On alert. Hypervigilance is a common symptom of PTSD. It produces a keen sensitivity to surroundings and a quick startle response, both of which are exhausting. For example, when I greeted a new dog at my local dog park the other day, the dog surprised me by barking and snapping at me. Suddenly, unreasonable fear overtook me. As I continued to walk in the familiar park, I startled at twigs snapping and birds singing. I became hot and sweaty and had difficulty breathing. I thought I had hypervigilance under control, but it’s always lurking under the radar, prepared to defend me against any trauma, real or imagined.

One day I asked my psychiatrist why I was always so tired. His response was oddly comforting. He said, “Your brain is healing. It needs the rest to get better.” It’s good to know that taking naps is actually positive  self-care for those who are wrestling with PTSD the rest of the day and even during the night.

What are your experiences with exhaustion?