What helps with PTSD-related exhaustion?
November 15, 2017 12:53 AM   Subscribe

I have been in therapy for a few years to deal with complex PTSD. It has made a world of difference with the emotional and cognitive aspects of trauma, but I still struggle with the physical symptoms of PTSD (like overactive nervous system and digestive stuff). The hardest of these to deal with is being tired all the time. Assume I have gotten all my levels checked, eat healthy, and sleep decently well. What else is worth trying?
posted by anonymous to Health & Fitness (13 answers total) 19 users marked this as a favorite
What about yoga? It has outperformed medication for PTSD (here's a yoga-related excerpt from Bessel van der Kolk's book about trauma, and here is a general collection of research into yoga and PTSD).

(I love and recommend the "Serenity Yin Yoga" iOS app, which allows you to put together your own routine--as short as five minutes or as long as 90-- all of which is done lying on the floor holding multi-minute poses, sometimes with pillows propping up your limbs, while the teacher says funny things in a Scandiavian accent. It has a pronounced effect on my own nervous system.)
posted by hungrytiger at 1:23 AM on November 15, 2017 [7 favorites]

What about CBD? The mechanism is very different to THC, it's available over the counter, there's no harm in trying, and many people with PTSD say it makes a huge difference.
posted by DarlingBri at 3:42 AM on November 15, 2017

I would also suggest CBD. Not psychoactive at all, and sometimes leads to complete abatement of those symptoms stemming from PTSD. However it's availability has changed pretty drastically based on where you are in the country since it was recently classified as a schedule I drug. It is still readily available in started that have ended cannabis prohibition, but is hit and miss in other states.
posted by furnace.heart at 5:26 AM on November 15, 2017

Antidepressants and/or marijuana.
posted by bile and syntax at 7:35 AM on November 15, 2017

When you say sleep decently well, do you mean that you actually get as much sleep as your body needs or just the 6-7 hours/night modern society thinks you need? Have you tried getting 8-9 hours of sleep consistently? It is super annoying to have to maintain the sleep schedule of a small child as an adult, but it's the only way I can function decently (with similar, though not the exact same set of issues you're facing).
posted by snaw at 8:37 AM on November 15, 2017

A dear friend of mine recently underwent ketamine therapy. For years, she'd been dealing with complex PTSD, autoimmune disorders, and chronic pain (among other issues). After two weeks (six treatments), her life was absolutely changed for the better in ways I would never have allowed myself to hope for. She also doesn't have migraines anymore! Best of luck!
posted by kimota at 8:47 AM on November 15, 2017 [2 favorites]

L-Tyrosine supplements in the am, 5-HTP supplements in the pm. Also, magnesium at night.
posted by jbenben at 9:11 AM on November 15, 2017

(Previously dx'd with PTSD, am a trauma therapist.) One of the things that I have found the most valuable both in my own life and with people I see is managing nervous system states through regulation of the vagus nerve. If I am activated before trying to go to sleep, I have regulate my system first or I just don't go to sleep, whether I'm taking medication or not, my body tends to "fight it off."

Here is the chart that I like to use for determining quickly what state my system is in, and then the other side has a list of regulation strategies that I use.

Here is a great guide to understanding polyvagal theory. When I regularly use these strategies I am a lot less fatigued.
posted by fairlynearlyready at 10:11 AM on November 15, 2017 [6 favorites]

Re: difficulty of acquiring CBD, Reddit has a CBD forum with a list of vetted companies that sell mail order to all 50 states.
posted by hungrytiger at 12:37 PM on November 15, 2017

Have you undergone a sleep study to rule out sleep apnea? I have been clinically depressed for most of my adult life, but using a CPAP machine has eliminated my need to nap constantly.
posted by Napoleonic Terrier at 5:46 PM on November 15, 2017

Have you considered that your tiredness might have a separate cause? A sleep study will show whether the quality of your sleep is messed up in some way. Sleep apnea is super common, and for most people who get it diagnosed and treated, their daytime sleepiness goes away after they get on the CPAP. Depending on your situation, you may also benefit from wakefulness-inducing medications such as something like modafinil or armodafinil.
posted by Stewriffic at 5:47 PM on November 15, 2017

I've been reading a bit about tremoring, although I haven't tried it. Might be worth exploring. There are FB groups that can answer questions and offer suggestions.
posted by vignettist at 9:04 PM on November 16, 2017

Re: difficulty of acquiring CBD, Reddit has a CBD forum with a list of vetted companies that sell mail order to all 50 states.

That forum lost credibility when it was discovered that the only companies that made the list had affiliate links. r/CBDinfo avoids that problem.
posted by DarlingBri at 8:34 AM on November 17, 2017

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