Medically reviewed by Angela Sheddan, FNP
Written by Our Editorial Team
Last updated 5/31/2022
Anxiety is a weird condition when you really think about it. Consider the symptoms: anxiety can sometimes feel like a big, triple-shot espresso drink is coursing through our veins. It can keep us up at night, make us more alert — panicked, even — and energize us in the right situations.
And yet, anxiety can make us incredibly, exhaustedly, hyperbolically fatigued.
Fatigue and anxiety aren’t a combination we consider often, but it’s one we should consider more. Those exhausted days after sleepless nights might be a bigger problem than you realize.
Anxiety can cause a variety of problems beyond fatigue, too. To understand why, you need to understand what anxiety actually is.
When people think of anxiety, they typically think about panic symptoms — anxiety attacks. They imagine rigid, intense, hyper-aware and fearful individuals engaged in a fight or flight response to some real or perceived threat.
In reality, generalized anxiety disorder is a more complicated medical condition with a variety of other symptoms.
What we’re getting at is that anxiety doesn’t look one way or another.
The American Psychological Association says that anxiety is actually quite common, especially in a pandemic or post-pandemic world. Fatigue can manifest as restlessness, muscle tension, worry, irritability, insomnia (and other sleep problems) and even stomach issues.
There is a difference between anxiety and stress. Stress is not inherently evil. In fact, there are survival and performance benefits to being stressed: your senses are quicker, your focus narrows and when your stress is under control, it can help you perform at a higher level of function.
But there are negative sides of stress and, left unmanaged, they can rear their heads just as prominently.
Fatigue is a condition of physical or emotional tiredness, lack of motivation and more, but there are far more symptoms of fatigue than what we commonly discuss. A fatigued person may experience headaches, muscle pain, poor sleep and more.
In many ways, fatigue mirrors the physical symptoms of anxiety, which, beyond stress and insomnia, may include:
Bodily aches and pains
Chest pains and a racing heart
Increased blood pressure and blood pressure complications
Trouble sleeping and insomnia
Sexual dysfunction trouble with sexual performance
A weakened immune system
Digestive issues and stomach problems
Tension headaches, muscle tension and jaw clenching
Dizziness and other motor impairments
In other words, fatigue symptoms closely mirror and parallel anxiety symptoms. It would be possible to cover many of the symptoms of anxiety simply by saying “fatigue.”
Why do we discuss fatigue separately, then? One explanation is that fatigue and anxiety, while similar, are not always related. It’s possible to be fatigued without anxiety, and it’s possible to be anxious without fatigue.
When both conditions exist, however, there are some clear and not-so-clear links that need to be acknowledged.
Anxiety most certainly causes fatigue — mental and physical fatigue and related symptoms make up the majority of symptoms for generalized anxiety, according to the National Institute of Mental Health.
The question of how anxiety causes fatigue is a little more complicated to unpack.
A 2018 study explored the relationship of fatigue to risk factors like anxiety, depression and other mental health conditions, and found a strong link between these conditions and fatigue symptoms, but stopped short of elaborating on a specific cause.
Conditions like chronic fatigue syndrome are frequently associated with mental health issues. Chronic fatigue is defined as an impairing fatigue lasting at least six months, which can include symptoms and side effects like physical pain, weakness and feeling tired.
None of the expert resources or papers currently available seemed to point at a specific relationship or answer to the “chicken and egg” question.
In other words, we don’t know that anxiety causes fatigue for any certain reasons, nor do we know if fatigue can necessarily cause anxiety — or how.
The correlation between the two would appear to point to a close-knit relationship, but while there are early signals of a genetic connection, we’re likely still a few years away from being able to make predictions about who will see problems later in life.
And quality of life is important, regardless of your age.
In short, increased risk factors do not mean a certain problem later on, and there’s a bigger picture we don’t understand yet.
Fatigue isn’t a disorder or a disease, and in most cases, it’s a common symptom of something else that’s going on. You may be able to address fatigue symptoms by sleeping or resting, but in reality, your best option for treatment is to address the source of the fatigue you’re experiencing.
If the source is chronic anxiety, it means getting treatment for the anxious thoughts and feelings and making a plan to address the source of the chronic stress and uncertainty causing it.
Anxiety treatment may take one of many forms, and if you’re considering medication, the go-to solution most healthcare providers choose today is antidepressants.
Selective serotonin reuptake inhibitors, or SSRIs, offer numerous benefits to anxious individuals because they help the brain regulate mood imbalances, and whether that’s anxiety or sadness, they’ve been proven effective for treatment of many disorders.
Therapy may also be a beneficial option for you to consider with your healthcare provider. If you’re curious about therapy generally, check out our guide What Is Psychotherapy & How Does It Work?.
One type of treatment we’ll point you toward is cognitive behavioral therapy (CBT). CBT is essentially a therapy designed to help you retrain your brain to avoid those anxious thoughts and behaviors and replace them with healthier ways of thinking (and eliminate symptoms like fatigue in the process).
A mental health professional may also recommend certain lifestyle changes — eating a healthier diet, exercising more, getting daily physical activity and dropping certain bad habits like unhealthy eating, smoking, drinking, drug use and poor resting habits.
Your sleep quality is just one of the many things that can increase your risk for anxiety, so avoiding sleep disturbances and getting enough hours of sleep may be a major turning point in your anxiety fight.
If you're dealing with chronically disturbed sleep, extreme fatigue or reduced energy levels, you should speak to a health care provider about it soon.
While these are not necessarily signals of anxiety, they are signs of a problem. And whether that's a mood disorder or a health issue, it's something a professional should address.
If you're seeing a lack of sleep or fatigue as a result of ongoing anxiety issues, speaking with someone or seeking therapy will help you deal with the problem before it leads to more serious issues down the road.
The good news is that, regardless of how tired or worried you are, talking to someone has never been easier. Services like online therapy make it easy to speak to someone now and address the problem.
It's okay to be tired. It's okay to be stressed. But it's not okay to let this problem go unresolved.