When was the last time I got a good night's sleep? I don't know. Usually I can only sleep for maybe two hours a night (if at all). This means always feeling run down. You open your eyes, and you're not sure. Am I just waking up? Or, am I dissociating as I try to wake up?
Violent symptoms still happen. But, you do your best to try and have some sense of being grounded.
Protect yourself at all costs.