ADHD & Fatigue: Understanding the Connection

Does ADHD Cause Fatigue?

While individuals with ADHD may experience periods of hyperactivity and restlessness, they also frequently struggle with mental exhaustion, physical fatigue, and ADHD burnout. Several aspects of the neurodivergent ADHD brain can contribute to fatigue. One key factor is that the ADHD brain often has lower dopamine levels, which causes difficulties with motivation, emotional regulation, executive functioning, and circadian rhythm.¹ These challenges can lead to increased mental and physical fatigue, as the person may overcompensate to stay engaged and attentive.²

Additionally, the ADHD brain processes sensory input differently, which may result in individuals with ADHD feeling overstimulated, which can cause fatigue and a need to take a moment to ‘recharge.’³ ADHD also tends to co-occur with conditions like anxiety and depression, whose symptoms can cause fatigue.^4,5 These co-occurring conditions also lead to challenges that can further drain a person’s energy and compromise their quality of life.

Here are some ways that ADHD can cause fatigue:

Executive Dysfunction

One of the key symptoms of ADHD is executive dysfunction, which can cause issues with emotional regulation, working memory, and impulse control. ADHD executive dysfunction makes maintaining focus, managing distractions, and keeping thoughts organized require an immense mental effort. This continuous exertion can be mentally draining, leading to cognitive fatigue.

Hyperactivity

ADHD hyperactivity is characterized by excessive movement and a constant need for stimulation. It is a common ADHD myth that hyperactivity will only increase a person’s energy. In reality, hyperactivity prevents someone from properly winding down and adhering to a regular sleep schedule, it can result in sleep deprivation and overall fatigue.

Hyperfixation

ADHD hyperfixation is characterized by an intense focus on an activity, object, or people. This hyperfocus can consume a person’s attention and make it difficult to transition into other activities, leading to heightened mental and physical arousal. As a result, individuals with ADHD may lose track of time and stay up late, impacting their sleep quality.

Dopamine Deficiency

Research shows that ADHD brains produce lower dopamine levels, a neurotransmitter crucial in regulating sleep. Dopamine helps regulate the sleep-wake cycle by promoting wakefulness during the day and initiating sleep at night. When dopamine levels are lower, this delicate balance is disrupted, impacting overall sleep quality and one’s ability to fall and stay asleep throughout the night.^1,2

Sensory Overload

In addition to difficulties with executive functioning, individuals with ADHD may also experience sensory overload. This means they may be more sensitive to certain sensory stimuli, such as loud noises, bright lights, or strong smells. These sensory inputs can easily overwhelm their already overactive minds, resulting in exhaustion and difficulty focusing on tasks or engaging in social interactions.

Sleep Problems

ADHD and sleep problems often go hand in hand. Individuals with ADHD may struggle with sleep due to difficulties regulating their internal clock, winding down and losing track of time. The hyperactive and impulsive symptoms of ADHD can make it challenging to relax before bedtime, resulting in difficulties falling or staying asleep throughout the night. Common sleep issues among individuals with ADHD include insomnia, restless leg syndrome, and sleep apnea.²

Anxiety

ADHD and anxiety is another common co-occurring condition that significantly increases fatigue levels. The constant worry, racing thoughts, and heightened arousal associated with anxiety make it difficult for individuals to achieve a restful state. This can lead to disrupted sleep patterns, poor appetite, muscle tension, and increased heart rate, further exacerbating tiredness.

Overcompensating & Over-Committing

Time blindness and organizational challenges may lead individuals with ADHD to constantly try to catch up and feel overwhelmed. External and inner pressure may result in individuals overcompensating or pushing themselves to meet expectations and make up for ‘perceived shortcomings.’ Many individuals with ADHD feel the need to mask their symptoms in order to avoid the stigma surrounding ADHD, such as being called lazy. This constant pressure and overcommitment can quickly drain energy levels and contribute to feelings of fatigue.

Depression

The co-occurrence of ADHD and depression can significantly contribute to feelings of fatigue as it overwhelms individuals’ nervous systems. The persistent sadness, hopelessness, and lack of motivation associated with depression can make even simple tasks exhausting. Disrupted sleep patterns and changes in appetite and weight can further drain energy levels.

Can ADHD Medications Cause Fatigue?

While ADHD medications may not directly cause fatigue, they can contribute indirectly. One potential reason is that ADHD medication side effects can suppress appetite and disrupt sleep patterns, reducing energy levels during the day. Some individuals with ADHD may also be taking antidepressants for co-occurring conditions such as depression or anxiety, which can have side effects, including fatigue.

To assess whether a person’s ADHD medication is causing fatigue, their healthcare professionals will consider all the medications an individual takes and the potential interactions. They will also closely monitor and adjust medication dosage to mitigate side effects and enhance overall well-being.

How to Cope With ADHD Fatigue

While addressing ADHD fatigue can be challenging, there are healthy ways to cope. Certain lifestyle changes, such as maintaining a regular sleep schedule, engaging in regular exercise, and practicing stress management techniques, can greatly improve a person’s symptoms of ADHD fatigue. Additionally, incorporating a balanced diet, reducing caffeine intake, and creating a structured daily routine can help increase energy levels.

Here are ten tips for coping with ADHD fatigue:

1. Eat a healthy diet: Consuming a balanced ADHD-friendly diet rich in fruits, vegetables, whole grains, and lean proteins can provide the necessary nutrients and energy to combat fatigue.
2. Stay hydrated: Drinking plenty of water throughout the day helps maintain proper hydration levels, which can help alleviate fatigue symptoms.
3. Prioritize sleep: Establishing good sleep hygiene habits with a consistent sleep schedule and ensuring adequate sleep each night can significantly reduce fatigue.
4. Limit screen time: Excessive use of electronic devices can lead to mental fatigue and a lack of focus. Setting limits on screen time, especially before bedtime, can promote better rest and reduce ADHD-related fatigue.
5. Exercise regularly: Engaging in physical activity can reduce ADHD symptoms, boost energy levels, and improve focus.
6. Manage stress: Stress management techniques, such as deep breathing exercises and meditation for ADHD, can help reduce the impact of stress on ADHD symptoms and improve overall energy levels.
7. Take advantage of your calendar: Use your calendar to set reminders and time for tasks and self-care. It helps to stay on track and feel accomplished. Apps such as Motion can help you to stay on top of calendar management.
8. Break tasks into smaller chunks: Breaking down tasks into manageable segments can help prevent overwhelm, ADHD paralysis and mental fatigue.
9. Take self-care breaks: Incorporate short breaks throughout the day to recharge and prevent mental exhaustion. There are many different types of self-care, so it is important to find what works for you.
10. Seeking support: Connecting with support groups and finding a neurodivergent-affirming therapist can provide valuable guidance and encouragement in managing ADHD symptoms and fatigue.

Free ADHD Focus Plan Worksheet

A focus plan can help someone with ADHD estimate the time it will take to complete a task and plan out small steps to accomplish the larger goal.

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When to Seek Professional Support

When symptoms of ADHD start interfering with individuals’ daily functioning, energy levels, and quality of life, it is important to seek professional help. Generally, comprehensive treatment for adult ADHD fatigue involves a combination of medication management, psychoeducation, skills training, and psychological counseling.

When seeking professional help, a local therapist directory is a tool for finding therapists who specialize in ADHD and take your insurance. Alternatively, there are many online ADHD treatment services that can connect you with therapists and psychiatrists who have extensive experience diagnosing and treating ADHD.