Understanding The Cycle Of Anxiety and Fatigue

Medically reviewed by Andrea Brant, LMHC and Corey Pitts, MA, LCMHC, LCAS, CCS
Updated October 9, 2024by BetterHelp Editorial Team

Anxiety is a normal human emotion that virtually everyone will experience from time to time. However, when it’s experienced chronically due to an anxiety disorder, it can have a variety of negative impacts on daily functioning and both physical and mental health. One of these potential effects is fatigue and issues related to sleep. Here, we’ll take a closer look at the relationship between fatigue and anxiety and cover some strategies that may help.

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Is anxiety keeping you up at night?

Defining anxiety and its symptoms

The American Psychological Association defines anxiety as “an emotion characterized by apprehension and somatic symptoms of tension in which an individual anticipates impending danger, catastrophe, or misfortune.” It’s a natural human emotion that helped our early human ancestors respond to threats in their environment. Today, it can still be useful in keeping us safe, but it also has the potential to activate when not needed and cause distress and health problems as a result, including fatigue and anxiety-related symptoms.

Anxiety may qualify as a diagnosable disorder when it’s excessive, out of proportion to the situation, and persistent. Symptoms of an anxiety disorder can significantly affect daily functioning, work or school performance, relationships, and overall well-being. There are various types of anxiety disorders, each with its own set of symptoms. That said, the list of symptoms of generalized anxiety disorder—the most common mental illness in this category—illustrates how disruptive this type of condition can be, often leading to fatigue and anxiety.

Common symptoms of generalized anxiety disorder include:

  • Persistent worry that’s hard to control
  • A sense of restlessness
  • Unexplained pains like headaches
  • Body aches due to muscle tension
  • Digestive problems
  • Irritability
  • Brain fog and trouble concentrating
  • Trouble sleeping
  • Fatigue and feeling tired during the day
  • Anxiety attacks, or spikes in anxious feelings
  • Trouble with immune system functioning

Chronic stress or chronic anxiety and fatigue: What’s the connection?

Fatigue, or excessive tiredness, is correlated with anxiety disorders as a common symptom. The fatigue-anxiety relationship can be explained this way: Fatigue often increases as anxiety does, and vice versa. Increasing fatigue can make daily functioning difficult and may significantly impact a person's ability to manage their symptoms, exacerbating fatigue and anxiety.

One reason for this relationship is that anxiety consumes both physical and mental energy because it engages the fight-or-flight response. This response prepares the body to face a threat, so it triggers physiological changes like an increased heart rate and tense muscles. For example, imagine you’re taking a hike and encounter a bear. Upon noticing the bear, your heart rate, blood pressure, and muscle tension automatically increase as your body and mind are on high alert. This is your system’s way of preparing you to either engage the bear in combat to defend yourself (fight) or run away as fast as you can (flight). This constant activation can lead to significant fatigue and anxiety. 

The fight-or-flight system

The fight-or-flight system can be highly useful when encountering a wild animal. However, it’s also activated in a person experiencing day-to-day anxiety—albeit at a lower intensity than it would be in a bear encounter—even when there is no direct threat. Having this system frequently or constantly activated uses a lot of energy, which is one reason anxiety can cause fatigue and leave an individual feeling exhausted. Managing both fatigue and anxiety requires a comprehensive approach.
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Sleep and the fight-or-flight response

Persistent activation of the fight-or-flight system not only depletes your energy levels, but it can interfere with sleep as well. In fact, it’s designed to prevent sleep. The response is meant to enable you to respond to immediate threats, and inhibiting sleep or allowing you to wake someone quickly is an integral part of its function. This cycle of poor sleep and heightened anxiety can further contribute to fatigue and anxiety. 

In this way, anxiety can make it hard to get a good night’s sleep, and sleep deprivation can increase symptoms of anxiety. For instance, consider research that suggests that anxiety increases when sleep needs are not met. This is where the relationship between fatigue and anxiety can become cyclical: An increase in anxiety lowers sleep quality, and lower sleep quality increases anxiety, which then lowers sleep quality further, and the cycle repeats. Understanding and addressing both fatigue and anxiety is crucial for improving overall well-being. 

Tips for managing or breaking the anxiety-fatigue cycle

Anxiety and sleep quality influence each other significantly, and taking measures to improve both is typically the best opportunity for relief. Improving sleep quality usually begins with addressing your sleep hygiene, and it can help to use relaxation techniques to manage symptoms of anxiety in addition to seeking professional support. Addressing both fatigue and anxiety with comprehensive strategies can lead to better outcomes.

Maintaining sleep hygiene to fight tiredness from feeling fatigued

"Sleep hygiene" refers to engaging in healthy sleep habits that promote quality rest. The behaviors you engage in during the day can impact the length and quality of your sleep, especially those that occur within an hour or so of your bedtime. Sleep hygiene isn't a treatment for when you feel anxious—for which seeking professional treatment is recommended—but it’s often a key part of breaking the anxiety-fatigue cycle. 

Some sleep hygiene practices that may help you get enough good-quality sleep include:

  • Go to sleep and wake up at the same times each day
  • Avoid using screens (TVs, smartphones, tablets, computers) before bed
  • Ensure your sleeping space is cool, dark, and quiet
  • Try not to eat large meals shortly before bedtime
  • Avoid caffeine in the afternoon and evening 
  • Avoid consuming alcohol before bedtime
  • Create a relaxing nighttime routine to wind down before bed

Practicing relaxation techniques to relieve overwhelming and exhausting symptoms

Relaxation techniques are strategies designed to help reduce symptoms of anxiety and stress by deactivating the fight-or-flight response. Some examples include:

  • Deep belly breathing. Focus your breathing so it comes from your abdomen.  Slowly inhale for three seconds, hold your breath for a second or two, and exhale for about five seconds. Repeat three or four times.
  • Progressive muscle relaxation. Lay down and close your eyes. Going from head to toe, briefly tense and then relax each group of muscles one by one to promote relaxation.
  • Guided imagery. Close your eyes and visualize a scene that you find pleasant and soothing. Imagine the sights, sounds, smells, and feelings of this place in vivid detail to help you feel as calm as you might if you were really there.
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Is anxiety keeping you up at night?

Practicing mindfulness meditation when anxiety can be draining

Meditation comes from ancient cultural and spiritual practices of India, and it may be one of the oldest and most effective methods for helping reduce anxiety. To meditate, simply find a comfortable place to sit or lie down, focus on your breathing, and bring your attention to the present moment: how your body feels, your thoughts, the sounds of your environment. When your mind wanders, gently bring it back to this calm awareness of the present. Research suggests that just 10–20 minutes of mindfulness meditation per day may be enough to produce noticeable improvements, helping to manage fatigue and anxiety.

Engaging in physical exercise to release endorphins

Getting regular physical activity may provide a host of potential health benefits, including decreasing anxiety and improving sleep. Exercise releases endorphins, which may improve mood, decrease stress and anxiety, and allow for relaxation and better sleep. Adopting a regular exercise routine could be a valuable addition to professional treatment for fatigue and anxiety.

Engaging in therapy to address anxiety symptoms

If you’re experiencing symptoms of an anxiety disorder, it’s typically recommended that you consult with a therapist or other mental health professional. Symptoms of a diagnosable disorder typically won’t go away without treatment, which usually consists of talk therapy and coping strategies—sometimes in combination with medication. A therapist can suggest treatments that might help you reduce or manage anxious thoughts, which may help reduce fatigue as well. It may also be worth meeting with a physician to rule out any potential medical causes of your feeling drained. Addressing both fatigue and anxiety through therapy can lead to significant improvements in overall well-being.

Exploring online therapy

If you’re living with frequent fatigue, the thought of traveling to and from in-person therapy appointments regularly could seem overwhelming or even impossible. In cases like these, online therapy could be worth exploring as an alternative. It allows you to meet with a licensed therapist virtually from home instead of commuting to an office for treatment. Online therapy generally involves the same evidence-based techniques used in office settings, which research suggests may be just as effective when administered remotely. 

Takeaway

Anxiety activates the body's fight-or-flight system, which is designed to respond to immediate threats. Persistent activation of this system can lead to a reduction in both sleep duration and quality, resulting in fatigue. Relaxation techniques, regular exercise, and meditation may all help reduce anxiety and improve sleep. If you’re experiencing signs of an anxiety disorder or are looking for support in breaking the cycle of fatigue and anxiety, it’s also recommended that you seek professional treatment advice.

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