Living with ADHD and Chronic Fatigue: A Guide

Woman in her bedroom waking up with fatigue.

By Maria Romaszkan

I’ve been living with chronic fatigue for years now. I can’t remember the feeling of being well-rested and clear-headed. There’s only being more or less exhausted.

I was diagnosed with ADHD late, when I was 26, so I spent most of my life not understanding why I struggle with focus, memorizing and learning. I believed I was the problem. I would push myself further and further. My ADHD symptoms worsened, my brain fog got stronger and my body weaker. If you also have ADHD and chronic fatigue, this article is for you.

ADHD and Chronic Fatigue

Let’s be honest: Living with ADHD can be exhausting, especially without support or understanding. Research shows that people with ADHD may be more prone to chronic fatigue.

“Lots of neurodivergent people deal with chronic fatigue due to having to navigate a world designed for neurotypicals,” says Bex Harper, a coach specializing in neurodivergence and chronic illness. Neurodivergent refers to people whose brains work a bit differently from what is considered typical — including people with ADHD.

Harper adds: “There is also still quite a bit of stigma around ADHD. This lack of understanding and empathy can be exhausting to navigate on top of the extra struggles of being neurodivergent.”

Why else can ADHD leave you chronically exhausted?

• Anxiety

Mental health issues that often also affect people with ADHD are anxiety and depression, which can completely drain your energy.

What’s more, you often must work harder than your peers to stay on top of your work or school assignments, contributing to anxiety and cognitive load, which uses up a lot of your energy.

“Those with ADHD can become anxious about all the tasks they need to do and get caught in spiraling thoughts, which can further perpetuate stress levels,” says Maria Daves, an integrative psychologist and ADHD coach based in London.

• Sensory Processing Issues

People with ADHD are often more sensitive to external stimuli, such as sounds or touch, which impacts how they interact with the world.

Constantly processing these enormous amounts of information from the environment takes a lot of energy and makes people with ADHD prone to overstimulation.

• Hyperfocus

It feels fantastic to tackle your work efficiently, but when the energy spike fades, it can leave you utterly spent. What’s more, when combined with hyperfocus, it makes it easy to neglect your needs — such as hunger or the need to rest.

• Sleep Issues

If you have ADHD, it’s very likely you also have trouble getting proper rest at night. ADHD is associated with several sleep disorders and other sleep issues, like difficulty falling asleep and waking up.

Tips on Managing Chronic Fatigue When You Have ADHD

Recovery from chronic fatigue is possible, though it’s a very slow and delicate process. Most days, it’s about managing your symptoms one step at a time.

“I believe you can learn to manage symptoms, and there may be flare-ups at times, but you can learn to navigate fatigue by understanding how to pace and recover from activities,” says Harper.

Here are some tips that work for me. But remember, each case is different. You need to test and see what works best for you.

• Get a Check-up

Consider getting a complete health check-up to see if your chronic exhaustion might be connected to a serious medical condition. Dealing with doctors and tests and needing to advocate for yourself may feel overwhelming and make you even more exhausted — but it’s better to be safe than sorry.

• Take Care of Sleep and Diet

I can’t stress enough how important sleep is. Waking up rested has been a foreign feeling for years, but I can definitely feel a difference between sleeping for four and seven hours. When it comes to diet, I tend to avoid sugar, as it makes my brain fog worse and my energy levels uneven. The same goes for coffee; it can give you a short energy spike, but the following crash is rarely worth it. Consult a doctor or dietician before changing your diet.

• Pace Yourself

“Pacing yourself” might be easier said than done, especially if you have a job to keep or children to take care of. But whenever possible, try to pace yourself. From my experience, it’s better to stop and rest a bit when you feel like you can still keep going but are starting to get fatigued. That’s the sweet spot.

You can use a journal to track your activities and your condition, to understand how they impact your energy levels.

Don’t be afraid to lean on your family and friends — they’re here to support you.

• Be Compassionate Towards Your Current Limits

Just because I’m exhausted doesn’t mean my ADHD brain isn’t bursting with ideas, and I don’t want to start a dozen creative projects. But I can’t. My energy is precious. I need to ration it carefully. That often means days or months when I need to make difficult decisions about how to spend these few crumbs of energy. Not to mention that my ADHD already makes managing my day draining.

Respect your current limits. What your body needs now is rest and time.

• Listen to Your Body

One part of managing chronic fatigue is changing the relationship with your body. Instead of ignoring its signals and muscling through — listen to it. Do you feel sleepy? Are you tense? Avoid judgment in these observations; try to be curious and self-compassionate.

• Move a Bit

There are days when my body is stiff and heavy, and dizziness hits whenever I move too fast.

However, if I can move and it’s not too painful, I try to exercise, as it makes me feel slightly lighter and stronger.

Light stretching, yoga or a short walk are great ways to move your body but avoid overexertion.

There is even a particular type of yoga called isometric yoga dedicated to people with such conditions as chronic fatigue and pain.

• Get Medication

If you have physical symptoms, such as chronic pain or nausea, your doctor can recommend medication to manage them.

What’s more, if your stimulant medication makes you anxious, putting more stress on your body, your doctor may need to find a non-stimulant alternative.

• Try Bodywork

Constant overwhelm and stress makes the nervous system react like we’re in unceasing danger. That can significantly contribute to chronic fatigue. Bodywork can help with that.

I started working with a somatic experiencing practitioner to reconnect with my body and learn how to self-regulate and stay calmer. Somatic experiencing is a body-focused therapeutic method that helps resolve symptoms of stress, shock and trauma. I’m still exhausted, but am getting better at listening to my body. So I no longer push my limits as often.

Some people also try massages or physical therapy to release tension and manage chronic pain, which often accompanies chronic fatigue. Consult your doctor first to discuss which options are worth trying.

• Consider Therapy

Working with a therapist or ADHD coach can help you identify sources of stress or behaviors that contribute to your chronic fatigue. It certainly helped me see patterns that left me utterly spent.

“Stress often triggers chronic fatigue, so reducing the triggers would be an optimal starting point,” Daves says. “Identify the triggers, learn how to manage them, and change how you respond to them. Regular supportive psychological input (from a therapist or coach) can help someone identify their stressors, break them down and learn alternative ways to manage them.”

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Live support will be unavailable while we’re closed but you can always submit a request or leave a voice message. We’ll get back to you when we return on Tuesday, June 20th.

Each of our clinicians sets their own holiday hours. Check with your doctor for availability.

Looking to take our Assessment? That’s available all day, every day, whenever and wherever is best for you!