Ask Amanda: Why Do I Feel So Tired All the Time?

Q: “I am so ridiculously tired all the time. I was with an abuser for four years—physical, emotional and verbal abuse—and we just separated so I’m wondering if it’s something to do with the trauma I experienced. Or maybe it’s something else? I sleep 10 hours a night, but can’t make it through the day without a nap but then I’m still practically falling asleep into my soup at the dinner table. Should I see a doctor?” – Exhausted

Dear Exhausted,

I’m sorry to hear you are almost falling asleep in your soup. You do not want to do this. It would likely be very hot, not to mention messy. 

In all seriousness, exhaustion is no joke. Feeling tired all the time can make life genuinely difficult, impeding your ability to concentrate, get things done and generally feel like a functioning human. The reasons for being tired can vary a lot, though, and we’ll talk about some of the possible causes below. 

But first: how do you know if you’re just plain old tired or if you’re suffering from fatigue? The main indicator is that normal tiredness can be fixed with a good night’s sleep or a long nap. Fatigue will be persistent—lasting days or weeks and is usually also accompanied by other symptoms, such as:

• Headache
• Dizziness
• “Brain fog” that impedes your decision-making ability
• Lack of concentration
• No motivation
• Muscle soreness or weakness
• Loss of appetite
• Moodiness
• Blurry vision

For survivors currently living through domestic violence, imagine how an abuser can take advantage of these symptoms when defenses are down, increasing their risk of being gaslighted that the abuse is all in their head. And for survivors like yourself, Exhausted, who’ve managed to separate from an abuser, constant fatigue can make getting back to your old self feel almost impossible.

Since I’m not a doctor, I spoke with one—Lina Velikova, MD, sleep expert and contributor to disturbmenot.co. She says stress and trauma, including abuse, can absolutely be the cause of feeling constantly worn out.

“If you think about it, the reason why we feel so tired after experiencing stressful events is quite simple. When we’re experiencing trauma, we are in ‘fight or flight mode’ and our body is in the state of alertness. However, when the danger passes, we relax and our stress falls on us in its full weight.”

When an abuser is present—even if they’re not physically present, but still infiltrating your life somehow, say through threatening text messages, stalking or even flashbacks—you may feel hyper-alert. Your body is tense; you’re ready for a possible attack. When the threat passes and you’re safe again, you may feel like you could sleep for days, exhausted by the adrenaline rush that you just experienced.

There’s something called the “let-down effect” that can happen after periods of high stress. When you’re in the midst of stress or trauma, stress hormones like adrenaline and cortisol protect you from feeling pain and keep you alert. When the stress is over, your systems return to normal and you may experience a panic attack, illness or a flare-up of pain or another ailment, like arthritis. It can also, of course, make you feel exhausted. 

Let’s talk about some other possible reasons for exhaustion:

• Burnout. “There’s a lot of stigma surrounding burnout. We’re still afraid to talk about it as if this is some kind of made up condition we’re using to express our dissatisfaction with work. However, burnout is classified as a psychological disorder and it’s very much real and serious psychological state,” says Velikova. Burnout—often seen in domestic violence advocates who help survivors day in and day out—can make you feel exhausted, ineffective and anxious. To prevent it, says the doctor, make sure you have a healthy work-life balance, that you're taking regular vacations and sleep at least for eight hours a day.
• Anemia. Iron-deficiency anemia can make you feel fatigued, tired, experience shortness of breath and chest pain, says Velikova. If you feel constantly tired, consult your doctor as soon as possible and ask for a blood test.
• Depression. People with depression are more likely to feel unexplainably tired. You may literally feel like you’re carrying the weight of the world on your shoulders. This can cause you to sleep too much or have trouble sleeping. If you’re also experiencing unrelenting feelings of sadness, hopelessness or worthlessness, and have lost interest in activities you normally enjoyed, talk to your doctor.
• Chronic Fatigue Syndrome. People who experienced childhood domestic abuse or were with an abusive partner are more prone to suffering from chronic fatigue syndrome (CFS), says Velikova. People with CFS are constantly tired, but can’t sleep, so this might not be you, Exhausted. However, if you start experiencing other symptoms of CFS, such as foggy thinking, sore throat, enlarged lymph nodes or unexplained headaches, you may want to talk to your doctor about it.

The only way to know for sure what’s causing your exhaustion, Exhausted, is to consult with a doctor and possibly run tests for some of the possible culprits above. If a diagnosable illness is ruled out, then you may be able to attribute your exhaustion to stress and trauma, in which case, talking to a counselor or therapist who specializes in domestic violence survivors might be the next best route. Working through the trauma, coming up with an emotional safety plan in case the abuser is still present in your life and prioritizing self-care could help you eventually get the bounce back in your step.

Have a question for Ask Amanda? Message us on Facebook, Twitter or email AskAmanda@DomesticShelters.org. 

Ask Amanda is meant to offer helpful resources and information about domestic violence. If in crisis, please reach out to your nearest domestic violence shelter for the guidance of a trained advocate.