ADHD and Chronic Fatigue
Tired All the Time? Maybe It’s Chronic Fatigue
If you’re a woman with ADHD and feel like you’re constantly running on empty, you’re not imagining it. Many of my clients come to me saying they’re tired all the time, even after a full night’s sleep. Often, they think it’s just part of managing their ADHD. But in some cases, this relentless exhaustion is actually chronic fatigue. Understanding how ADHD and chronic fatigue syndrome (CFS) overlap can shed light on why you're feeling so drained and, more importantly, what you can do about it.
What is Chronic Fatigue Syndrome (CFS)?
Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a condition characterized by deep, ongoing fatigue that doesn’t improve with rest. Many women with ADHD already feel tired from juggling life, but CFS adds a layer of exhaustion that makes it hard to function—even with what seems like "enough" sleep.
When my clients ask why they feel like they never have energy, CFS is often part of the picture. ME/CFS isn’t just about feeling tired; it involves neurological and immune system dysfunctions that can take a heavy toll on your body.
Common Symptoms of ME/CFS:
- Persistent Fatigue: Fatigue lasting more than six months, not caused by physical exertion, and unrelieved by rest.
- Post-Exertional Malaise (PEM): Symptoms worsening after physical or mental activity, often for days or weeks.
- Sleep Problems: Unrefreshing sleep, insomnia, or irregular sleep patterns.
- Brain Fog: Difficulty concentrating, memory issues, and slowed thinking.
- Physical Pain: Muscle and joint pain, frequent headaches, or a sore throat.
- Orthostatic Intolerance: Dizziness or fainting when standing for long periods.
- Immune System Issues: Sensitivity to light or sound, frequent infections, or flu-like symptoms.
Why ADHD and Chronic Fatigue Overlap
A common frustration I hear from my clients is, "I can’t tell if my fatigue is from ADHD or something else." This confusion makes sense because ADHD and chronic fatigue share overlapping symptoms—like exhaustion, brain fog, and sleep disturbances.
1. Mental and Physical Exhaustion
ADHD already puts a lot of strain on your mental energy. Trying to stay organized, manage tasks, and keep up with life demands a lot of brainpower. Over time, this mental load can lead to physical exhaustion, especially if you’re constantly overcompensating for ADHD-related difficulties. Chronic fatigue adds another layer of tiredness, where even small tasks leave you feeling wiped out.
2. Sleep Problems
Many women with ADHD experience sleep issues, which are also a hallmark of chronic fatigue. Conditions like insomnia, restless legs syndrome, and delayed sleep phase disorder are common in ADHD, meaning your brain doesn’t get the deep rest it needs to recharge. Even when you get 8 hours of sleep, you might wake up feeling just as tired, further fueling the cycle of fatigue.
What Does the Research Say?
Studies on ADHD and chronic fatigue suggest they might share underlying causes, like inflammation or immune system dysfunction. Here’s what current research tells us:
1. Inflammation and Immune Dysregulation
Some of the latest studies point to inflammation as a potential link between ADHD and chronic fatigue. People with ADHD often show higher levels of inflammatory markers like interleukin-6 (IL-6) and C-reactive protein (CRP)—both associated with immune system issues. Chronic fatigue, in turn, is linked to immune dysfunction and chronic low-grade inflammation.
For example, a 2024 study by Quadt et al. found that children with ADHD traits were more likely to experience chronic fatigue later in life, pointing to inflammation as a potential trigger for fatigue syndromes.
2. Neuroinflammation and Brain Connectivity
ADHD and chronic fatigue also share a connection to neuroinflammation, or inflammation in the brain. This disrupts neurotransmitters like dopamine and serotonin, which are crucial for regulating mood, attention, and energy. Women with ADHD, who often already have altered dopamine pathways, may be more prone to chronic fatigue because these disruptions make it harder for the brain to regulate energy efficiently.
3. Stress Responses and Emotional Regulation
A common struggle I see in my clients with ADHD is the impact of emotional dysregulation. Constantly feeling overwhelmed, anxious, or stressed depletes mental energy reserves over time. When you're always on high alert due to ADHD symptoms, your body can reach a point of burnout—often called adrenal fatigue. This can contribute to both mental and physical exhaustion.
Why Are Women More Affected?
The connection between ADHD, chronic fatigue, and gender is something that cannot be overlooked. Many of my female clients experience worsened symptoms due to hormonal fluctuations during menstruation, pregnancy, or menopause. These hormonal changes can trigger spikes in ADHD symptoms, especially fatigue.
Women with ADHD also tend to internalize stress more than men. They may mask their symptoms or try to appear “in control” by overcompensating, which uses up more mental and emotional energy. Over time, this can lead to chronic fatigue, leaving many women feeling drained but unsure why.
Why ADHD Sleep Problems Worsen Fatigue
Sleep disorders are a huge factor in the overlap between ADHD and chronic fatigue. Whether it’s insomnia, restless legs syndrome, or a circadian rhythm disruption, sleep problems are more common in people with ADHD. Poor sleep not only worsens ADHD symptoms but also contributes to chronic fatigue.
It’s a vicious cycle: the more your ADHD disrupts sleep, the more your fatigue builds, making it harder to function day-to-day. Unfortunately, even when you think you’ve slept enough, ADHD-related sleep issues can leave you feeling just as exhausted as before.
Broader Issues: Misdiagnosis and Misunderstanding
One of the biggest issues I hear from clients is the confusion over where ADHD ends and other conditions like chronic fatigue begin. Women with ADHD are often misdiagnosed or have their symptoms dismissed as stress, anxiety, or simple tiredness. This delay in proper diagnosis can prolong the feeling of being stuck in an endless cycle of exhaustion.
Doctors may not always connect the dots between ADHD and chronic fatigue, leaving many women without the right treatment plan. If this sounds like you, understanding these connections is the first step toward getting better care.
What Can You Do About It?
If you’re struggling with ADHD and chronic fatigue, there are strategies you can implement to regain control over your energy and well-being.
1. Prioritize Sleep Hygiene
Set a consistent sleep schedule and stick to it. Use calming routines like dimming the lights, reading, or meditating to wind down before bed. If sleep issues persist, consider speaking to a healthcare provider.
2. Balance Activity and Rest
Gentle exercise like walking or yoga can improve your energy without triggering burnout. Make sure to pace yourself and listen to your body—resting when needed is critical for managing chronic fatigue.
3. Nourish Your Body
What you eat has a huge impact on your energy. Focus on a balanced diet with whole foods, lean proteins, and plenty of fruits and vegetables. Limit caffeine and sugar to avoid energy crashes, and stay hydrated.
4. Reduce Inflammation
Since inflammation may play a role in both ADHD and chronic fatigue, consider incorporating anti-inflammatory foods like omega-3s, turmeric, and leafy greens. Meditation, deep breathing, or gentle movement can also help reduce inflammation in the body.
5. Break Tasks into Smaller Steps
Feeling overwhelmed? Break tasks into manageable chunks. This makes it easier to conserve mental energy and avoid burnout.
6. Seek Professional Help
If fatigue is impacting your quality of life, it’s time to consult a healthcare provider who understands both ADHD and chronic fatigue. A therapist, doctor, or specialist can offer targeted treatments, including therapy, medication, or lifestyle adjustments to manage both conditions effectively.
When to Seek Help
If your fatigue persists despite trying self-help strategies, it may be time to consult with a professional. Fatigue can sometimes be a sign of other health conditions like thyroid problems, anemia, or depression. A thorough evaluation can help you pinpoint the cause and find the right treatment.
Kristen McClure: Neurodivergent-Affirming ADHD Therapist and Coach with 30 years experience in North Carolina and South Carolina Offering virtual therapy and coaching services across North Carolina, including Ashville, Raleigh, Durham, Wilmington, Greenville, and more. Also serving major South Carolina cities such as Charleston, Columbia, Greenville, Spartanburg, Rock Hill, and more.