Signs That Your Anxiety Could be Making You Tired and Weak

Author: Ari Whitten
Medical Reviewer: Evan Hirsch, M.D.


Normal Tiredness vs. Anxiety-Induced Fatigue

The American Psychological Association (APA) defines anxiety as “an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure.”

Anxiety generally revolves around work, health, finances, and other issues that demand a person’s attention. Small amounts of stress can be beneficial, such as being worried about being hit by a car, which means that a person will instinctively look both ways before crossing the street, thus ensuring their safety. But sometimes the duration or severity of an anxious feeling can be out of proportion to the original trigger, or stressor. This results in symptoms that include restlessness and feelings of being “on-edge,” uncontrollable worry, increased irritability, concentration difficulties, and sleep problems, such as problems falling or staying asleep or, overall, getting enough sleep.[efn_note]Medical News Today “What to Know About Anxiety.” October 2018[/efn_note] All these contribute to feelings of anxiety and extreme fatigue.

Stress-Induced Anxiety Side-Effects

 Stress and anxiety share many common symptoms, and chronic stress causes tension. There are about 16 mechanisms by which stress can affect your energy levels, and understanding these are vital in finding a solution to your extreme fatigue.

Stress Depletes The Endocannabinoid System

This is a system in your brain, which is responsible for shutting down the body’s stress response and re-establishing homeostasis. [efn_note]Neuropsychopharmacology (2016). Neurobiological Interactions Between Stress and the Endocannabinoid System.[/efn_note] When the Endocannabinoid System is depleted, we can no longer ward off fear and anxiety and stress becomes chronic, which allows fatigue to set in.

Throws Off Neurotransmitters In The Brain

Stress results in imbalances of serotonin, dopamine, and acetylcholine. [efn_note]European Journal of Neuroscience (2000). Chronic psychosocial stress reduces the density of dopamine transporters.[/efn_note] [efn_note]Obesity Research (1995). Brain serotonin, carbohydrate-craving, obesity and depression.[/efn_note] Low levels contribute to depression, anxiety, binge eating, addiction, lethargy, apathy and anhedonia (inability to take pleasure in life). Chronic stress can also cause GABA resistance. [efn_note]Joëls M et al. (2003). Hippocampal and hypothalamic function after chronic stress.[/efn_note] GABA is an inhibitory neurotransmitter that promotes relaxation and rejuvenation. When the brain’s sensitivity to this neurotransmitter is reduced it impacts your mental health and you have racing thoughts, fears, anxiety disorders, tension, and poor sleep. This again, contributes to lack of energy.

Decreases Thyroid Hormones

A proper functioning thyroid is essential in energy production, cognitive function, and muscle function.

HPA Axis Dysfunction 

This is the interaction between the hypothalamus-pituitary and adrenal glands. When you are chronically stressed (and the endocannabinoid system is depleted), the HPA Axis becomes chronically activated and starts to dysfunction. It becomes resistant to the negative feedback loops that try to calm the system and is associated with numerous medical conditions including CFS, Fibromyalgia, IBS, Depression, Bipolar Disorder, ADHD, PTSD, SAD, and even Alzheimer’s and Diabetes. [efn_note]Journal of Psychosomatic Research (2002). Hypothalamic–pituitary–adrenal axis, neuroendocrine factors and stress.[/efn_note] [efn_note]Cara Tomas, Julia Newton, and Stuart Watson, “A Review of Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Fatigue Syndrome,” ISRN Neuroscience, vol. 2013, Article ID 784520, 8 pages, 2013.[/efn_note] [efn_note]James P. Herman, “Neural control of chronic stress adaptation,” Front. Behav. Neurosci., 08 August 2013.[/efn_note]

Lowers Your Intelligence 

Stress can shut down centers in the Prefrontal Cortex, which are responsible for higher thought processes. This, in turn, results in poor self-control and lifestyle choices.

Makes You Hungry And Increases Sugar Cravings

When you eat a diet consisting of high glycemic processed food, lower in protein, and fiber results in inflammation, which directly suppresses the neurotransmitter Orexin (which is crucial in regulating wakefulness and energy levels). [efn_note]Anne Venner et al. “Orexin neurons as conditional glucosensors: paradoxical regulation of sugar sensing by intracellular fuels,” The Journal of Physiology, October 2011.[/efn_note][efn_note]Zhan S et al (2011). “Tumor necrosis factor-alpha regulates Hypocretin system via mRNA degradation and ubiquitination.”[/efn_note] Ironically, energy drinks especially sap your energy levels and may induce symptoms of anxiety such as increased heart rate and muscle tension.

Chronic Inflammation 

Inflammation is partly regulated by the stress hormone cortisol. But over time, chronic stress reduces the effectiveness of cortisol, and inflammation gets out of control. [efn_note]Zhan S et al (2011). “Tumor necrosis factor-alpha regulates Hypocretin system via mRNA degradation and ubiquitination.”[/efn_note] Chronic inflammation is linked to almost every disease from heart disease and cancer to depression and Alzheimer’s. It also has a direct impact on energy levels by shutting down Orexin.

Suppresses The Immune System 

A poor functioning immune system makes us more susceptible to infections. [efn_note]Carnegie Mellon University. “How stress influences disease: Study reveals inflammation as the culprit.” Science Daily, 2 April 2012.[/efn_note] 

Disrupts Your Circadian Rhythm And Sleep

The key cause of fatigue for most people is not getting a good night’s sleep. When the quality and hours of sleep are affected, it leads to chronic sleep deprivation and may result in other issues such as depression, symptoms of anxiety, weight gain, daytime sleepiness, and fatigue as well as increased rates of dozens of diseases. [efn_note]Steinach M., Gunga HC. (2012) Circadian Rhythm and Stress. In: Chouker A. (eds) Stress Challenges and Immunity in Space. Springer, Berlin, Heidelberg.[/efn_note] [efn_note]Survjit Cheeta et al, “Changes in sleep architecture following chronic mild stress.” Biological Psychiatry, February 1997.[/efn_note]

Increases Depression

Depression Concept

 Mood and energy are very much intertwined. Better moods facilitate better energy and vice versa. Chronic stress also causes energy regulating areas of your brain to atrophy. [efn_note]Conrad, Cheryl D. “Chronic stress-induced hippocampal vulnerability: the glucocorticoid vulnerability hypothesis.” Reviews in the neurosciences vol. 19,6 (2008): 395-411.[/efn_note]

Causes Chronic Physical Pain 

By changing the structure and function of your brain in profound ways, making it more and more sensitive to sensations of pain. The pain itself then causes more stress resulting in a vicious cycle of pain, stress, and chronic fatigue syndrome. [efn_note]Marwan N. Baliki et al, “Chronic Pain and the Emotional Brain: Specific Brain Activity Associated with Spontaneous Fluctuations of Intensity of Chronic Back Pain.” J Neurosci. 2006 Nov 22.[/efn_note] [efn_note]Chapman CR1, Tuckett RP, Song CW, “Pain and stress in a systems perspective: reciprocal neural, endocrine, and immune interactions.” J Pain. 2008 Feb 9.[/efn_note].

Lowers Beneficial Hormones 

Including pregnenolone, which is a precursor to both stress and sex hormones. When stress is chronic, your adrenals “steal” pregnenolone away from the production of sex hormones. [efn_note]Gao L1 et al, “Regulation of estradiol and progesterone production by CRH-R1 and -R2 is through divergent signaling pathways in cultured human placental trophoblasts.” Endocrinology, 2012 Oct.[/efn_note] This results in inflammation, poor mood, higher stress and anxiety, and lower energy levels.

Damages Your Mitochondria 

By causing oxidative damage when Mitochondria are damaged, it directly lowers our cell’s capacity to produce energy. [efn_note]Vicario, M et al. “Chronic psychosocial stress induces reversible mitochondrial damage and corticotropin-releasing factor receptor type-1 up-regulation in the rat intestine and IBS-like gut dysfunction.” Psychoneuroendocrinology, 2012.[/efn_note]

Leaky Brain Barrier 

By causing immune cells to release histamine and various inflammatory compounds. These chemicals increase the permeability of the blood-brain barrier allowing substances that do not typically enter the brain to enter. [efn_note]Theorides TC et al. “Corticotropin-releasing hormone and the blood-brain-barrier.” Front Biosci. 2007.[/efn_note]

Flushes Out Beneficial Minerals From The Kidneys 

This included potassium and magnesium, which most of us are already deficient in. Potassium and magnesium are essential for hundreds of metabolic processes in the body, and depleting these minerals can result in numerous problems, including fatigue, muscle breakdown, heart palpitations, and poor detoxification.

Induces A Leaky Gut

Also known as increased gut permeability, [efn_note]Vanuytsel T et al. “Psychological stress and corticotropin-releasing hormone increase intestinal permeability in humans by a mast cell-dependent mechanism.” Gut, 2014 Aug.[/efn_note] this increases the amount of bacterial toxin (endotoxin) entering the bloodstream and causing inflammation, which, as you now know, directly shuts down Orexin and decreases your energy levels. Leaky gut can also cause food sensitivities and intolerances, IBS, SIBO (small intestinal bacterial overgrowth), and gut pain [efn_note]Fukudo S, Nomura T, Hongo M Impact of corticotropin-releasing hormone on gastrointestinal motility and adrenocorticotropic hormone in normal controls and patients with irritable bowel syndrome Gut 1998;42:845-849.[/efn_note] [efn_note]Fukudo S. “Role of corticotropin-releasing hormone in irritable bowel syndrome and intestinal inflammation.” Journal of Gastroenterology, 2007.[/efn_note].

What You Can Do to Stop Tiredness

Now that you understand how living with anxiety causes fatigue, it is important to learn what lifestyle changes you can do to overcome stress and get your energy back. Six powerful stress management strategies are outlined below:

Minimize Or Eliminate Stimulants Such As Caffeine And Nicotine 

It has been scientifically proven that stimulants such as caffeine have numerous health and disease prevention benefits. However, chronic use can be counterproductive. If you are already stressed, caffeine will further stimulate the stress response system resulting in neurotransmitter resistance. 

Caffeine works to increase energy by blocking the neurotransmitter Adenosine, which normally calms the brain and relaxes you, thus causing an energizing effect. When you drink caffeine every day, the brain feels overstimulated and produces negative feedback adaptations to counter this and calm you back down. Over time, this lowers your baseline level of mood, performance, and energy. If you are currently addicted to caffeine, start weaning yourself off slowly and gradually (so as to avoid withdrawal symptoms). 

Despite initially feeling a little tired, this will be worth your efforts and is the first step in overcoming stress and anxiety.

Lower Your Sensory Load 

In the modern world, we are constantly bombarded by flickering lights, rapidly changing sights and sounds, social media, phones, TV, music, background noise, movies, games, etc. All these things are foreign to our biology and tax our brain in a way that has never been taxed before.

To cope and try and calm itself down, the brain increases the inhibitory neurotransmitters, Serotonin, and GABA, but overtaxing these systems results in burn out and neurotransmitter imbalances. 

If you are always on the go, listen to loud, aggressive music while driving or exercising, stare at a computer monitor (which though you may not realize it, constantly flickers) or TV screen for most of your workday or if you are indoors under artificial light for most of the day then you need to lower the stimuli to your sensory organs.

First of all, do not watch the news or fast-paced or violent movies within 1 hour of bedtime. Make sure you take small 5 minute breaks throughout your day, doing something you enjoy. Finally, get outside, preferably into nature for at least 30 minutes a day.

Optimize Your Circadian Rhythm And Sleep 

As blue light entering your eye after sunset decreases your production of Melatonin (an important hormone responsible for regulating your sleep/wake cycle and also a master antioxidant) and in turn disrupts your Circadian Rhythm, it is important to expose yourself to sunlight during the day and minimize your exposure to blue light at night. Firstly, wear blue light blocking glasses for at least 1hour (but preferably 2-3 hours) before bedtime. One of the best brands of blue light blocking glasses is SafetyBlue Sleep Saviour, which can be found on Amazon.

Make sure you also wear your glasses when watching TV after sunset. Secondly, download f.lux or Twilight apps on your computer, tablet, and/or smartphone. These free apps automatically lower the blue light emissions from your device after sunset. Thirdly, get incandescent, red, or amber colored light bulbs for a few lights in your house, in areas you spend time in at night, and also for your bedroom and bathroom. After sunset, make sure you only use these lights.

Incorporate Re-Charge Rituals Into Your Daily Life

These are predetermined periods of the day where you engage in consciously cultivating the kinds of brain performance habits you want (ones that build energy, focus, laughter, play, and gratitude). There are three types of rituals you should implement: a morning ritual, a nighttime ritual, and brief rituals interspersed throughout the day (ideally for about 1-5 minutes every hour). How you start and end your day teach your brain how to behave and reinforce the right neural circuits that help you focus, relax, and enjoy love and happiness. 

Some powerful re-charge rituals include mindfulness, meditation, prayer, deep breathing, laughter, positive social relationships, resistance breathing and breathing exercises, cold exposure, singing or chanting, dancing, music and sound therapy, yoga, exercise, massage, tai chi, acupuncture, spending time in nature, napping, power postures, sunbathing and hobbies. It’s important to identify which of these work for you personally and start building a daily practice. These rituals are incredibly powerful when practiced daily.



 Meditation is a must-do when it comes to overcoming stress. The benefits of meditation are well documented and backed by a mountain of evidence. It is, by far, one of the most powerful medicines available to humans and can help reduce mental health symptoms. 

Meditation can decrease stress [efn_note]Speca, Michael PsyD et al “A Randomized, Wait-List Controlled Clinical Trial: The Effect of a Mindfulness Meditation-Based Stress Reduction Program on Mood and Symptoms of Stress in Cancer Outpatients.” Journal of Biobehavioural Medicine, Sept/Oct 2000.[/efn_note], decrease anxiety [efn_note]Arias J.A et al. “Systematic Review of the Efficacy of Meditation Techniques as Treatments for Medical Illness.” The Journal of Alternative and Complementary Medicine. October 2006.[/efn_note], decrease feelings of loneliness [efn_note]Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5), 1045-1062.[/efn_note], improves your ability to regulate mood and emotions [efn_note]Jazaieri, H. et al. (2013). A randomized controlled trial of compassion cultivation training: Effects on mindfulness, affect, and emotion regulation. Motivation and Emotion, 38, 23-35.[/efn_note], decrease anxiety symptoms and make you happier [efn_note]Ramel1, W., Goldin, P.R., Carmona, P.E. et al. Cognitive Therapy and Research (2004)[/efn_note] [efn_note]Davidson, Richard J. PhD et al “Alterations in Brain and Immune Function Produced by Mindfulness Meditation.” Journal of Psychosomatic Medicine: July 2003.[/efn_note] [efn_note]Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5), 1045-1062.[/efn_note] decrease pain [efn_note]Zeidan, Fadel et al. “Brain mechanisms supporting the modulation of pain by mindfulness meditation.” The Journal of neuroscience : the official journal of the Society for Neuroscience vol. 31,14 (2011)[/efn_note], decrease inflammation [efn_note]Rosenkranz, M et al  “A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation.” Science Direct Brain, Behavior, and Immunity. January 2013.[/efn_note], increase your sense of connection to others [efn_note]Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5) [/efn_note], improve cognitive performance [efn_note]Jha, A.P., Krompinger, J. & Baime, M.J. “Mindfulness training modifies subsystems of attention.” Cognitive, Affective, & Behavioral Neuroscience (2007) 7: 109.[/efn_note] [efn_note]Levy, D. et al “a study of the effects of meditation on multitasking performance” ACM DL, 2011[/efn_note] and literally re-shapes your brain in beneficial ways [efn_note]Luders, E et al. “The underlying anatomical correlates of long-term meditation: Larger hippocampal and frontal volumes of gray matter.” NeuroImage. April 2009 [/efn_note] [efn_note]Davidson, Richard J. PhD et al. “Alterations in Brain and Immune Function Produced by Mindfulness Meditation.” Journal of Psychosomatic Medicine: July 2003[/efn_note] [efn_note]Lazar, Sara W et al. “Meditation experience is associated with increased cortical thickness.” Neuroreport vol. 16,17 (2005)[/efn_note]. 

Though there are various methods of meditation zivaONLINE is highly recommended. To learn more, listen to the podcast with Emily Fletcher, founder of zivaONLINE.

Rebuild And Balance Your Endocannabinoid System 

This is important to get your body to calm down and enter rest and relaxation mode.

First and foremost, you need to de-stress by following the recommendations above.

Second, optimize your intake of Omega 3 fatty acids, which are linked to the endocannabinoid system and protect your brain cells from damage and inflammation.[efn_note]Simonetto M. “A Novel Anti-Inflammatory Role of Omega-3 PUFAs in Prevention and Treatment of Atherosclerosis and Vascular Cognitive Impairment and Dementia.” Nutrients. 2019.[/efn_note] If you supplement with Omega 3’s, take Krill oil with high-dose astaxanthin (which is in itself a powerful neuroprotective and anti-inflammatory compound).

Third, double or triple the amounts of dark green leafy veggies you eat each day. In fact, you should aim to have greens with every meal. Greens are a great source of beta-caryophyllene, which is a phytocannabinoid that has a powerful effect on the endocannabinoid system.

Fourth, cut down on alcohol, as alcohol can throw the endocannabinoid system out of balance.

Fifth, use massage, acupressure mats (or acupuncture), and self-myofascial release. These also help balance the endocannabinoid system.

Lastly, use CBD (Cannabidiol), which is a powerful endocannabinoid signaller found in marijuana and hemp plants (note, this is legal and does not contain any psychoactive compounds). Hundreds of studies have shown that CBD can benefit human physiology. If you suffer from chronic stress, CBD is one of the most beneficial compounds in existence, as it is a powerful anti-anxiety and anti-stress cannabinoid signaling compound. Oral intake of CBD is best, and Bluebird Botanicals is a highly recommended brand.


As you have probably realized from the above, fatigue is very complicated health condition and involves multiple pathways and systems. Most people assume their fatigue is a result of “ adrenal fatigue,” but it is much more complicated than that. 

If anxiety is causing your fatigue to use some of the powerful strategies outlined above. A whole system-based approach is necessary to really make a difference and create a positive upward spiral of low stress, low inflammation, positive mood, resistance to infection, and healthy mitochondria.

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Medically Reviewed ByEvan Hirsch, M.D.

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