This article was written by the Grand Rising Behavioral Health clinical team and reviewed by licensed mental health professionals trained in anxiety disorders, CBT, DBT, and trauma-informed care. Reviewers follow APA and DSM-5-TR guidelines, ensuring evidence-based, up-to-date content on anxiety, fatigue, and mental health.

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Anxiety is common and can sap your energy, leaving you feeling worn out even when nothing seems wrong.

If you’ve wondered, “Can anxiety make me tired all the time?” the short answer is yes. Anxiety can cause ongoing tiredness through both physiological and psychological pathways. Understanding this connection is key to managing fatigue, improving sleep, and restoring overall well-being.

This article explores:

• Why anxiety causes persistent tiredness
• Signs of anxiety-induced fatigue
• Physiological and mental mechanisms involved
• Evidence-based treatments and lifestyle strategies
• FAQs and practical recovery tips

Key Takeaways

• Anxiety can trigger persistent tiredness by keeping the body in a constant state of alert (fight-or-flight response).
• Chronic activation of stress hormones, such as cortisol and adrenaline, disrupts sleep, metabolism, and energy regulation.
• Fatigue from anxiety often coexists with mental fog, emotional exhaustion, muscle tension, and sleep disturbances.
• Evidence-based therapies such as CBT, DBT, and mindfulness reduce anxiety symptoms and restore energy.
• Medication may complement therapy when sleep or anxiety is severe, but treatment is personalized.
• Lifestyle adjustments such as mindful movement, balanced nutrition, sleep hygiene, and stress management improve stamina and daily functioning.

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Why Anxiety Related Fatigue Is Often Misunderstood

Fatigue and Anxiety Don’t Always Look the Way People Expect

Anxiety-related fatigue is common, yet it is frequently overlooked or misinterpreted by both patients and clinicians. One reason is that fatigue does not always resemble simple sleepiness, and anxiety does not always present as overt nervousness. Instead, the two often overlap in subtle ways that are easy to miss.

Emerging research shows that anxiety, perceived stress, sleep disruption, and fatigue are interconnected rather than separate experiences. A 2025 study found that anxiety and fatigue can act as mediators between stress and sleep disturbance, illustrating how these symptoms can reinforce one another in daily life rather than occurring independently.[1]

Mental and Emotional Strain Can Be Deeply Exhausting

Another reason anxiety-related fatigue is misunderstood is how it is perceived. Fatigue is often dismissed as a lack of motivation or attributed solely to lifestyle factors, when in reality it reflects complex psychological and physiological processes.

Constant worry, hypervigilance, and emotional processing require sustained mental effort. Over time, this continuous internal strain drains energy in a way that feels fundamentally different from physical tiredness after exertion.

Many people feel exhausted without understanding why rest alone doesn’t fully restore their energy.

The Limits of a Single-Cause Medical Approach

Fatigue related to anxiety is also missed when care focuses too narrowly on either physical or mental explanations. Without a biopsychosocial perspective, clinicians may overlook how emotional stress, thought patterns, and bodily responses interact to maintain ongoing exhaustion.

Research emphasizes the importance of integrated assessment, as anxiety-linked fatigue often exists at the intersection of psychological distress and physiological stress responses rather than as a standalone symptom.[2]

Sleep Disruption Blurs the Picture

Sleep disturbance plays a major role in perpetuating anxiety-related fatigue. Anxiety can interfere with falling asleep, staying asleep, or achieving restorative sleep stages. Poor sleep then worsens fatigue and heightens anxiety, making it difficult to determine whether tiredness is driven primarily by anxiety, sleep loss, or both.

This overlap frequently leads to frustration and mislabeling, especially since routine medical evaluations may not fully capture the nuanced relationship between anxiety, sleep, and fatigue without intentional screening and clinical context.[3]

Understanding these dynamics helps reframe anxiety-related fatigue as a real and multifaceted experience, not a personal failing or vague complaint. 

How Anxiety Causes Persistent Tiredness and Physical Exhaustion

Anxiety keeps the body in a constant state of alert. This ongoing fight-or-flight response alters heart rate, stress hormones, and muscle tension.

While helpful in short bursts, chronic activation drains physical and mental energy, making true rest difficult. Fatigue then becomes a persistent symptom instead of a temporary side effect.

The Fight-or-Flight Connection and Physiological Link

Anxiety keeps the body in a constant state of alert by activating the sympathetic nervous system, which triggers changes in heart rate, muscle tension, and stress hormones like cortisol and adrenaline.

When this response is frequent or prolonged, the nervous and endocrine systems remain engaged far longer than intended. 

This near-constant activation disrupts normal recovery, drains both physical and mental energy, and causes ongoing fatigue that cannot be relieved by sleep alone.

How Cortisol and Adrenaline Affect Energy Levels

Cortisol and adrenaline support short-term survival by mobilizing energy and sharpening focus. Adrenaline gives quick energy bursts, while cortisol regulates metabolism and daily rhythms. When anxiety keeps these hormones elevated or unbalanced, their effects reverse.

Persistent cortisol disruption interferes with sleep quality, immune function, and appetite, all of which compound exhaustion and make fatigue harder to overcome.

Related Conditions Commonly Associated With Anxiety Fatigue

• Generalized Anxiety Disorder (GAD)
• Panic Disorder
• Major Depressive Disorder
• Insomnia and circadian rhythm disruption
• Stress-related somatic symptoms

A professional evaluation helps differentiate anxiety-related fatigue from other medical or sleep-related conditions.

Symptoms of Anxiety-Induced Exhaustion

Anxiety-related exhaustion appears in many ways. It can be mental fog that makes concentration difficult, constant tiredness, or physical aches from muscle tension. 

Symptoms of Anxiety-Induced Exhaustion

Spotting the pattern when fatigue coincides with anxiety symptoms helps point toward the right treatment.

Sleep Disturbances

Sleep problems are a major driver of daytime fatigue. Anxiety can make it hard to fall asleep, stay asleep, or reach restorative sleep stages. Poor sleep then worsens anxiety, creating a loop that reinforces tiredness. 

Practical sleep hygiene, like regular bedtimes, a calm pre-sleep routine, and limiting screens, can break that cycle and improve daytime energy.’

How to Effectively Treat Chronic Anxiety Fatigue

Treating anxiety-related fatigue usually requires a combined approach: therapies that change unhelpful thinking and behavior, and, when appropriate, medication to stabilize mood and sleep. Addressing both anxiety and its physical effects gives the best results for restoring energy and function.

Evidence-Based Therapies for Addressing Anxiety and Its Fatigue Symptoms

Treating anxiety-related fatigue requires interventions that address both the psychological drivers of anxiety and the physiological patterns that maintain exhaustion.

Cognitive Behavioral Therapy (CBT) and Related Psychotherapies

Cognitive Behavioral Therapy is the most validated psychological treatment for anxiety disorders and related symptoms, including fatigue.

CBT delivered individually, in groups, or through guided self-help reduces anxiety severity, improves coping skills, and supports lasting functional gains.

Clinical evidence suggests that structured CBT protocols reduce core anxiety symptoms and physiological hyperarousal that contribute to ongoing fatigue.[4]

CBT helps individuals identify and challenge distorted thinking, reduce avoidance behaviors, and build coping skills.

Research published in 2025 highlights that third-wave CBT protocols, such as acceptance-based and mindfulness-enhanced CBT, may offer additional benefit by fostering psychological flexibility and emotional regulation, both of which can reduce the mental drain associated with chronic worry.[5]

Dialectical Behavior Therapy (DBT) and Skills-Based Approaches

Although less often the sole first-line therapy for primary anxiety disorders compared with CBT, Dialectical Behavior Therapy, and other skills-based modalities, such as mindfulness-based stress reduction, are valuable for addressing emotional reactivity and distress tolerance.

These approaches teach emotion-regulation techniques, distress-tolerance skills, and mindfulness practices that can reduce physiological arousal and muscle tension, improving sleep quality and energy levels.

Clinicians often integrate such tools into CBT frameworks to strengthen overall resilience and reduce the intensity of anxiety-related exhaustion.

Medication Management

When anxiety symptoms are severe, persistent, or impair function, medication management can be a valuable component of treatment.

Medications may help stabilize baseline anxiety and improve sleep quality, which can indirectly reduce fatigue over time. 

Short-term use of anxiolytics or sleep aids may be appropriate in select cases under clinical supervision, especially when acute sleep disruption or distress interferes with daily functioning.

Medication decisions are personalized. At Grand Rising Behavioral Health, we tailor plans that pair therapy with medication management when it makes sense for recovery and energy restoration.

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Combining these options to fit your needs often leads to the greatest gains. Knowing the range of treatments helps you choose a plan that supports recovery and lasting energy.

Self-Help and Coping Strategies to Overcome Anxiety Fatigue

Alongside professional care, daily routines and lifestyle choices make a difference. Small, consistent changes in movement, breathing, and nutrition reduce symptoms and rebuild stamina.

Think of these strategies as practical tools that support therapy and medication in restoring balance.

Holistic Approaches

Mind-body practices like yoga, tai chi, and guided meditation reduce physical tension and increase mental calm. Regular meals, balanced nutrients, and hydration stabilize blood sugar and mood.

Restorative activities that feel manageable, such as short walks or gentle stretching, often lead to steady improvements in energy.

Mindfulness, Nutrition, and Exercise

Mindfulness exercises such as deep breathing, body scans, and brief grounding practices lower arousal and improve focus. Regular, moderate exercise releases endorphins and improves sleep quality, which combats fatigue.

Nutritious meals with protein, whole grains, and healthy fats give your body reliable fuel and better resilience against anxiety-driven tiredness.

Anxiety can leave you feeling tired, but recognizing the signs and taking targeted steps can reverse that pattern. If anxiety and fatigue are interfering with your days, reach out to a mental health professional for a personalized plan and steady support.

Grand Rising Behavioral Health: Expert Care for Anxiety and Fatigue

At Grand Rising Behavioral Health in Norwood, MA, we provide compassionate mental health treatment in Massachusetts and evidence-based care for anxiety, fatigue, and related mental health concerns. Our programs meet your needs at every stage of recovery:

• Partial Hospitalization Program (PHP),
• Intensive Outpatient Program (IOP), and
• Outpatient Program (OP)
• Telehealth services for flexible, remote support

Healing is not just about managing symptoms. It is about restoring energy, improving relationships, and reclaiming purpose. At Grand Rising, we create personalized care plans that combine therapy, lifestyle strategies, and, when appropriate, medication to help you feel your best every day. Contact us today to find lasting wellness.

Frequently Asked Questions

Can anxiety lead to physical health issues beyond fatigue?

Yes. Chronic anxiety can cause physical problems like increased blood pressure, digestive upset, and a lowered immune response.

Prolonged stress can increase inflammation and strain cardiovascular health. Addressing anxiety early is important for mental and physical wellness.

What lifestyle changes can help reduce anxiety and fatigue?

Helpful changes include regular, moderate exercise, consistent sleep and wake times, a balanced diet with whole foods, staying hydrated, and limiting stimulants like excess caffeine.

Adding short daily relaxation practices, such as breathing exercises or a brief walk, also supports energy and reduces anxiety.

How long does it typically take to see improvements in anxiety-related fatigue?

Improvement timelines vary. Some people notice relief within a few weeks after starting therapy or improving sleep habits. For others, meaningful change can take several months, especially if anxiety has been long-standing. Consistency with treatment and self-care is the most reliable way to see sustained improvement.

Are there specific foods that can help alleviate anxiety symptoms?

Certain foods support brain and mood health. Omega-3 rich fish, nuts, seeds, leafy greens, berries high in antioxidants, and whole grains help stabilize blood sugar.

Adequate protein and healthy fats at meals can prevent energy dips that worsen anxiety. No single food cures anxiety, but a balanced, nutrient-rich diet helps reduce symptoms.

What role does social support play in managing anxiety and fatigue?

Social support is vital. Connecting with friends, family, or peer groups can reduce isolation, provide practical help, and offer emotional perspective when anxiety feels overwhelming. Supportive relationships protect both mood and energy.

Can mindfulness practices be effective for everyone dealing with anxiety?

Mindfulness helps many people, but it is not a universal fix. Some find immediate benefits from meditation or breathing work. Others may prefer movement-based practices or therapy.

Trying different approaches and combining mindfulness with other treatments increases your chance of finding what works.

Resources

1. Wang, L., Zhou, Sj., Gao, L. et al. The chain mediating effect of fatigue, anxiety symptoms on the relationship between perceived stress and insomnia in Chinese researchers. BMC Public Health 25, 3695 (2025). https://doi.org/10.1186/s12889-025-24800-y
2. Toussaint, A., Weigel, A., & Löwe, B. (2024). The overlooked burden of persistent physical symptoms: A call for action in European healthcare. The Lancet Regional Health - Europe, 48, 101140. https://doi.org/10.1016/j.lanepe.2024.101140
3. Scheer, V., Valero, D., Valero, E., Weiss, K., Rosemann, T., & Knechtle, B. (2025). Identifying anxiety and sleep problems, associated factors, and sex differences in endurance and ultra-endurance runners. Frontiers in Psychology, 16, 1619220. https://doi.org/10.3389/fpsyg.2025.1619220
4. Papola, D., Miguel, C., Mazzaglia, M., Franco, P., Tedeschi, F., Romero, S. A., Patel, A. R., Ostuzzi, G., Gastaldon, C., Karyotaki, E., Harrer, M., Purgato, M., Sijbrandij, M., Patel, V., Furukawa, T. A., Cuijpers, P., & Barbui, C. (2024). Psychotherapies for generalized anxiety disorder in adults: A systematic review and network meta-analysis of randomized clinical trials. JAMA Psychiatry, 81(3), 250–259. https://doi.org/10.1001/jamapsychiatry.2023.3971 JAMA Network
5. Dai, X., Zhang, Z., Sun, L., Zhu, S., Wu, Y., Lian, J., & Deng, X. (2025). (Third-wave) cognitive behavioral therapy for generalized anxiety disorder in adults: A systematic review and Bayesian network meta-analysis. Journal of Psychiatric Research, 187, 134-143. https://doi.org/10.1016/j.jpsychires.2025.05.010

Disclaimer

This content is for informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always seek guidance from a qualified healthcare provider about anxiety, chronic fatigue, or any other medical or mental health condition. 

Never disregard professional advice or delay seeking treatment because of information in this article.

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