Dr. Laura Rubiales: Addressing fatigue after a social predator

By Laura Rubiales, ND, LAc

If you find yourself drained and tired after an experience or relationship with a social predator, these are my suggestions: Cut all ties with them and those with whom you will get the social predator’s garbage. Try to reach some kind of emotional neutrality about the situation so you are not giving them your mental and emotional energy anymore. A skilled therapist can be invaluable in this process.

I understand that this is much easier said than done when the predator was an intimate partner or affected your safety in the world. See if you can revitalize yourself with activities that recharge and soothe you…. Mine are yoga classes, time in nature, naps, proper sleep at night, bodywork and time with friends with whom I can let down my guard.

If after a couple of weeks, you still find yourself drained, consider a medical workup.

When the fatigue is debilitating and keeping you from being productive, consider asking your doctor for the following tests:

  • Complete blood count (CBC) — if you are really tired, it should be done with a white blood cell differential.
  • Complete metabolic panel
  • Thyroid Stimulating Hormone (TSH)
  • Free T4 Thyroxine and Free T3 Triiodothyronine — these are different kinds of thyroid hormones
  • Serum B12 — B12 is nutritive for nerves and blood cells. Low B12 can cause depression and fatigue from anemia.
  • Ferritin — stored iron
  • Vitamin D

Also, allow their expertise to guide you if they think additional tests need to be ordered. You general practitioner can order the tests (but might not if he or she is a narcissist focused on quick visits that don’t get to the cause of your issues). Insurance coverage depends on your health plan.

As a naturopathic doctor, I look at optimal values and not just for L’s or H’s (for low or high) next to the test. I find having hormones and nutritional values optimized can make a huge difference in someone’s ability to cope with daily life after trauma.

Also, some things to keep in mind are keeping blood sugar stable. Stress hormones fluctuate in response to dysregulated blood sugar. Smaller meals with protein and protein before eating sweets will help to stabilize your blood sugar.

Many people have issues with sleep after trauma. If you are depleted after a trauma, I recommend eight and a half to nine hours of sleep a night.

If all the above testing comes back normal, consider testing adrenal hormones. I like to see cortisol ranges throughout the day. There are various labs that look at salivary cortisol at four times of day to see its variations. Optimal treatment if you have depleted or dysregulated adrenal hormones should be individualized to your needs.

Another important consideration for fatigue/exhaustion after trauma is possible depression. Medication may be necessary. Or alternately the depression may be able to be addressed with other treatment modalities such as therapy, acupuncture and neurotransmitter support.

Restoring energy after a social predator can take time. It will take less time if you go NO CONTACT to preserve your sanity and vitality.

Dr. Laura Rubiales conducts medical workups as part of her healing retreats. For more information, visit: Urban Retreats for Renewal and Recovery After Narcissistic Abuse



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If you can afford it (I couldn’t afford medical care, for years afterwards, NO health insurance was affordable after I turned 50, until ObamaCare came along), get blood advice is to see a doctor regularly, get any shots you missed having, mammograms, allergy testing (if affordable). Eat regular meals, as little junk foods as you can, drink lots of fluids (lay off the booze if possible), no smoking..and rest, lots of regular sleep. Naps if you need them. You will likely find out just how TIRED you really are, after you’ve left him/her. Sleep, naps, good foods will help a lot. If too many activities leave you exhausted, drop some for now. Give yourself plenty of daily ‘slack’. Saying NO to unneeded anything will help. I had to learn how to say NO and mean it. Let go of any unnecessary stresses. Long walks help.

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