ADHD and fatigue: Why am I exhausted?

ADHD and fatigue: Why am I exhausted?

Reviewed by:
Divya Khosla, MD
Staff Psychiatrist
at Talkiatry
March 12, 2024
In this article

When we think about ADHD (attention-deficit/hyperactivity disorder),  we think about hyperactivity—it is, after all, a part of the condition’s name. where you find yourself much more active than other people around you. But, adults with ADHD also report a phenomenon that’s less well-known: fatigue. While this may seem paradoxical, when you have ADHD your brain tends to be more active throughout the day compared to the average person, so it's natural to experience feelings of fatigue as a result of expending all that energy.  

If you feel like you may experience ADHD-related fatigue, you’re not alone. While fatigue isn’t an official part of an ADHD diagnosis, many adults living with ADHD have reported experiencing brain fog, low motivation, and mental fatigue throughout their day. In this article we’ll talk about this connection and explain different strategies that can help as well as a few different treatment options.


Get virtual care from psychiatrists that take insurance

Get started

Does ADHD make you tired?  

ADHD, or attention-deficit hyperactivity disorder, is a neurodevelopmental condition that affects both children and adults. People with ADHD often experience symptoms of inattention, hyperactivity, and impulsiveness, leading to a disruption in daily functioning and development. Though not yet part of the official criteria for ADHD, feeling tired during the daytime has been reported by an increasing number of people living with the condition.  

Feeling tired is also a common side effect of many prescribed ADHD stimulant medications when they start to wear off later in the day.

ADHD symptoms and related factors that could cause fatigue  

While researchers have not yet determined if or why ADHD causes fatigue, there are a number of possible explanations, many of which have to do with sleep problems.  

Hyperactivity  

Hyperactivity is one of the major symptoms of ADHD, and is characterized by excessive movement and a constant need for stimulation. The more hyperactive you are, the more you’ll find yourself struggling to sit still and engaging in other restless behavior. This hyperactivity can make it hard for you to wind down before bedtime and keep a regular sleep schedule, so you may find yourself in a state of overall fatigue.  

Hyperfixation  

Another common symptom of ADHD is hyperfixation, which is when you focus intensely on an activity, object, or person. This intense hyperfocus has the ability to consume your attention, make it difficult to transition to other activities and switch between tasks. Intense fixation can cause you to lose track of time and stay up late, and you may find that the amount of sleep you get, as well as your sleep quality, is negatively affected.  

Low dopamine levels  

Another possible explanation for the connection between ADHD and fatigue involves dopamine. One of the things this neurotransmitter does is help regulate sleep and help you feel awake during the day. Research shows that the brains of people with ADHD produce lower dopamine levels, which can impact your overall sleep quality as well as your ability to fall and stay asleep throughout the night.  

Sensory overload  

People living with ADHD also experience issues with sensory overload, which means they are much more sensitive to certain stimuli, like loud noises, bright lights, and strong smells. If you have ADHD, these sensory stimuli can be both distracting and overwhelming. Trying to focus on certain tasks or socialize in the face of this overstimulation can be exhausting and cause tiredness.  

Other factors that contribute fatigue  

Many people with ADHD experience other conditions or issues in addition to their ADHD diagnosis. (When you have more than one condition it’s called having comorbidities.) These other conditions, much like the ADHD symptoms listed above, can also lead to fatigue.  

Sleep disorders

People who have ADHD also most commonly struggle with sleep disorders, because ADHD impairs the regulation of brain activity and this often affects sleep patterns. Common sleep issues can include insomnia, restless leg syndrome, and sleep apnea (trouble with breathing while asleep). Depending on their intensity, all of these can cause daytime fatigue, cognitive issues, and problems with executive function, like sustained attention.

Researchers have found that the more severe the breathing problems, the more it affects their cognitive abilities. When the breathing disruptions are mild, it can lead to some trouble paying attention and using those mental skills we call executive function. If you think you have sleep problem, reach out to your doctor or another healthcare professional who can provide you with medical advice.

Anxiety  

Anxiety disorders are another mental health condition that can accompany ADHD. Anxiety may exacerbate ADHD symptoms like fidgeting, hyperactivity, and difficulty focusing, which can result in overwhelm and stress. If you have anxiety, it might present itself through symptoms like constant worry and racing thoughts—which can contribute to tiredness and make it difficult to calm down and rest. Without proper treatment, anxiety can cause trouble sleeping, poor appetite, muscle tension, and increased heart rate, too.  

Depression  

Like anxiety, depression can accompany ADHD as well. Since major depressive disorder  is known for overwhelming your nervous system, fatigue is actually one of its main symptoms. That means depression may exacerbate ADHD symptoms like issues with concentration, low energy, and tiredness. Many people with depression find that the feelings of sadness and hopelessness can make even simple tasks feel both overwhelming and exhausting. Additionally, depression can cause changes in appetite and sleep patterns, making you feel even more tired than usual, too.  

What is ADHD burnout?  

If you have ADHD, the fatigue and stress of your symptoms can lead to a state of mental, physical and emotional exhaustion. Though not a medical term, “ADHD burnout” is a commonly used term to describe this exhausted state.  

Anyone (not just people with ADHD) can develop symptoms of burnout during difficult periods in life and it usually develops in response to long-term, chronic stress. Unmanaged mental health conditions, however, have been known to make the chances of experiencing burnout much more likely.  

Burnout typically causes a general worsening of a person’s overall mental health, including their ADHD symptoms. For some people, “ADHD burnout” can actually mimic signs of depression, worsening the fatigue we talked about earlier and causing them to become more sad and easily frustrated. When untreated, this can create a cycle where people fall behind in a number of different areas of their lives, and that creates more stress, worsens burnout, and makes it even harder to catch up.  

Related article: What to know about ADHD spouse burnout

Common signs of “ADHD burnout”  

  • Lowered productivity and poorer performance at work or school
  • Feeling overwhelmed, like you want to run away or escape from responsibilities
  • Feelings of mental fatigue and constant exhaustion
  • Low self-confidence coupled with high self-criticism
  • Lack of motivation and drive to complete tasks
  • Anger and resentment toward responsibilities, obligations, and other people
  • Irritability and mood swings
  • Increased procrastination, including avoiding people, obligations, and tasks
  • Physical health problems associated with chronic stress

Many of these signs can also overlap with other conditions as well as general stress and fatigue. If you are experiencing burnout, and think it might be related to ADHD you should talk to a doctor to find out more. If you’re not sure where to start, take Talkiatry’s free online assessment. We’ll match you with a psychiatrist who can help you understand your symptoms and whether or not they’re related to a mental health condition.  

9 Ways to treat “ADHD fatigue”  

Living with ADHD and any related fatigue can be challenging at times, but there are a number of things you can do to help make a difference. Here are some psychiatrist-backed tips to combat your fatigue.

Break tasks into smaller manageable goals

Large tasks can feel overwhelming and drain your energy quickly especially when you have ADHD and have trouble finishing things. Try breaking down tasks into smaller, more manageable chunks. Set specific goals for each chunk and take short breaks in between to recharge. For instance, if you're facing a daunting task such as cleaning your entire house, break it down into smaller, more achievable chunks. Start with one room at a time or divide the cleaning tasks across multiple days. This approach helps maintain focus and prevents mental exhaustion.  

Pay attention to diet and exercise—and stay hydrated

Eating a healthy diet with a nice balance of fruits, vegetables, whole grains, and lean proteins can help provide you with enough nutrients to battle daytime fatigue. Eating nutrient dense foods can support energy levels throughout the day—without the afternoon crash you usually get from highly processed foods and low nutrient foods. Maintaining proper hydration levels is another way to lessen fatigue symptoms, which you can do by drinking enough water throughout the day.  

A regular physical activity can also help maintain effective sleep and boost your energy levels, which can help improve your concentration, and reduce symptoms of fatigue.

Work on your sleep routine

Good sleep hygiene involves building consistent habits that help you sleep better. Try to go to bed and wake up at the same time each day, establish a relaxing bedtime routine. This could include activities like reading a book, taking a warm bath, practicing relaxation techniques, or listening to calming music. Avoid stimulating activities and strenuous physical activity just before bed, as well as electronic devices that emit blue light, as they can interfere with your sleep. More on that next.

Limit your screen time

Too much screen time isn’t just bad for your sleep habits; it can also lead to mental fatigue and a lack of focus. Try setting limits on how long you spend on your phone or computer—especially before bed—to see if it helps you feel less exhausted during the day.

Stay organized

Create a prioritized to-do list or use a planner or calendar to stay organized. Prioritizing tasks help with time management since you can focus on what needs immediate attention and prevents wasting energy on less important activities. Using visual reminders can also be especially helpful if you have ADHD to stay on track of what’s next instead of multitasking and help reduce mental fatigue.

Manage your stress

Stress management techniques like deep breathing exercises, meditation, and mindfulness can improve your overall quality of life and help lower your stress, which can help you better handle your ADHD symptoms and energy levels.  

Try ADHD medication  

As far as ADHD treatment, psychiatrists can prescribe a few different kinds of medications, including stimulants, like methylphenidate, and antidepressants. Remember, it can take time to find the right medication and dosage so it’s important to talk to your healthcare provider about how you’re feeling as you adjust to a new medication. Take note of any side effects, including any changes to your sleep, and try to keep a log of how well the medication is or is not working.  

If you’re thinking about speaking with a professional you might consider Talkiatry. We are a national psychiatry practice that provides in-network care, and we treat ADHD with a combination of medication and therapy. You can fill out this free online assessment to get matched with a psychiatrist and schedule your first virtual visit.  

FAQs

Here are more details about the relationship between ADHD and fatigue.

Can ADHD make you tired?

Yes. Both ADHD symptoms themselves, as well as conditions that commonly co-occur with ADHD—like depression or anxiety—can cause fatigue and even sleepiness during the daytime.  

Does caffeine make people with ADHD tired?

The short answer is that it depends. In people with ADHD, caffeine can have the opposite effect that it does in other people. Caffeine can cause thoughts and urges to slow down, which, in people with ADHD, can feel like exhaustion. Caffeine can also interfere with sleep patterns. However, in some instances, beverages with caffeine can improve focus and motivation.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

Dr. Divya Khosla, MD, is a board certified Adult Psychiatrist and board eligible Child and Adolescent Psychiatrist. She received her undergraduate degree from Case Western Reserve University in Cleveland, Ohio, and her medical degree from Ross University, completing all of her clinicals in Maryland, D.C., and NYC. She completed her adult psychiatry residency at The Ohio State University in Columbus, Ohio. Then she returned to the east coast, where she completed her child and adolescent psychiatry fellowship at Nassau University Medical Center in East Meadow, New York.

Dr. Khosla has participated in a variety of innovative academic clinical research, and has presented research at annual national meetings of the American Psychiatric Association. Her robust clinical experience with varying demographics at different clinical sites around the country has allowed her to treat patients in an evidence-based way, tailoring treatment to an individual’s specific needs.

Although Dr. Khosla’s practice focuses on medication management, she also implements supportive therapy and motivational interviewing in sessions to allow for a more comprehensive approach to treatment. Her clinical interests include depression, bipolar disorder, anxiety disorders, post-traumatic stress disorder, panic disorder, and ADHD.

Read more ›
Related posts
April 15, 2024

Are you born with ADHD?

Read more ›
April 15, 2024

Anxiety vs ADHD: How to tell the difference

Read more ›
March 31, 2024

Qelbree (viloxazine) for ADHD: What you need to know

Read more ›
Top articles
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.

Get virtual care from psychiatrists that take insurance

Get started

Mental health is personal.
So is our approach to psychiatry.

Get started