My Brain Is Very Sluggish. Help!
October 26, 2019 9:38 AM
I am having a very hard time with my brain. I am not sharp at all. I am having trouble communicating, comprehending etc. I feel perpetually sluggish mentally.
Details inside
I am having a very hard time with my brain. I haven't been very good to it recently. I have been under tons of stress. I have awful racing thoughts, ruminations etc. My brain is always working on stuff. I don't know if it is just worn out. It has been "busy" like this for decades, but I was always able to read, comprehend, communicate and make decisions.
I started anti depressants a couple of years ago and am on an SNRI and still trying to get off of an SSRI. I started smoking pot nightly a couple of years ago. I sleep about 10 hours every night. I don't know if I have a dopamine issue. I've heard that treating for serotonin and not dopamine can mess with executive function.
I don't know what is the culprit and what to do about it. I spend a ton on healthcare and don't feel super confident about seeing a neurologist and getting good advice. I "need" marijuana to calm down at night. CBD doesn't help.
I want to start meditating.
Advice?
I am having a very hard time with my brain. I haven't been very good to it recently. I have been under tons of stress. I have awful racing thoughts, ruminations etc. My brain is always working on stuff. I don't know if it is just worn out. It has been "busy" like this for decades, but I was always able to read, comprehend, communicate and make decisions.
I started anti depressants a couple of years ago and am on an SNRI and still trying to get off of an SSRI. I started smoking pot nightly a couple of years ago. I sleep about 10 hours every night. I don't know if I have a dopamine issue. I've heard that treating for serotonin and not dopamine can mess with executive function.
I don't know what is the culprit and what to do about it. I spend a ton on healthcare and don't feel super confident about seeing a neurologist and getting good advice. I "need" marijuana to calm down at night. CBD doesn't help.
I want to start meditating.
Advice?
A neurologist can be good, and a CT scan even better, just to make sure you don't have a physical cause for your more recent symptoms. Another potentially interesting point of data to collect, if you can find a cost-effective way to obtain it, is genetic testing (e.g. GeneSight) related to your specific receptivity to psychotropic medications.
In the meantime, Mindfulness Northwest offers a variety of online resources for meditation, including recordings for guided meditation and general learning resources.
posted by katra at 10:42 AM on October 26, 2019
In the meantime, Mindfulness Northwest offers a variety of online resources for meditation, including recordings for guided meditation and general learning resources.
posted by katra at 10:42 AM on October 26, 2019
I literally just saw my very smart doctor about this. He basically said, "it's the stress, dummy. you need to meditate for 20 minutes a day, and cut out some of your responsibilities."
In your case, it's probably a good idea to cut out the nightly pot smoking to see if that changes anything. It could be interfering with the quality of your sleep.
To deal with the symptoms of anxiety and insomnia (without drugs), you also need some CBT tools. Have you ever done CBT, with a well-trained therapist? Per my doctor, all my CBT tools alone would not be enough to address the executive function problems caused by stress, but they are essential tools.
Finally, in the interim, I am finding this book on adult executive function skills to be really helpful: Smart but Scattered Guide for Success.
posted by schwinggg! at 10:46 AM on October 26, 2019
In your case, it's probably a good idea to cut out the nightly pot smoking to see if that changes anything. It could be interfering with the quality of your sleep.
To deal with the symptoms of anxiety and insomnia (without drugs), you also need some CBT tools. Have you ever done CBT, with a well-trained therapist? Per my doctor, all my CBT tools alone would not be enough to address the executive function problems caused by stress, but they are essential tools.
Finally, in the interim, I am finding this book on adult executive function skills to be really helpful: Smart but Scattered Guide for Success.
posted by schwinggg! at 10:46 AM on October 26, 2019
A neurologist can be good, and a CT scan even better, just to make sure you don't have a physical cause for your more recent symptoms. Another potentially interesting point of data to collect, if you can find a cost-effective way to obtain it, is genetic testing (e.g. GeneSight) related to your specific receptivity to psychotropic medications.
FWIW, my Very Smart Doctor said I didn't even need any bloodwork to look into my symptoms. With the existence of many stressors, he was confident that the cause of my executive function issues (memory, mostly) was stress. A CT scan (which exposes your brain to a ton of radiation) would be total overkill. He just asked a few questions to figure out if I was having actual memory loss or not. If the OP is having other neurological symptoms, then additional testing might be necessary, but those were not mentioned.
posted by schwinggg! at 10:49 AM on October 26, 2019
FWIW, my Very Smart Doctor said I didn't even need any bloodwork to look into my symptoms. With the existence of many stressors, he was confident that the cause of my executive function issues (memory, mostly) was stress. A CT scan (which exposes your brain to a ton of radiation) would be total overkill. He just asked a few questions to figure out if I was having actual memory loss or not. If the OP is having other neurological symptoms, then additional testing might be necessary, but those were not mentioned.
posted by schwinggg! at 10:49 AM on October 26, 2019
Lots of things can cause "brain fog," only a small fraction of which are intrinsically brain problems. Some of it is lifestyle -- diet, stress, sleep debt -- and some is systemic illness -- hypothyroidism and anemia being the biggest two. See your PCP who can check for the latter and can send you to a neurologist if there is something else going on.
To help with racing thoughts etc, CBT is made for that. I have also heard good things about Headspace (an app) but haven't used it myself.
posted by basalganglia at 11:41 AM on October 26, 2019
To help with racing thoughts etc, CBT is made for that. I have also heard good things about Headspace (an app) but haven't used it myself.
posted by basalganglia at 11:41 AM on October 26, 2019
A neurologist can screen for neurological symptoms, including reading, comprehension, communication and making decisions, and then make a determination about the need for a CT or MRI scan. I fortunately had a Very Smart dental assistant who identified one of my neurological symptoms, which led to orders for testing that included a CT scan that found the tumor sitting on my frontal lobe. It very well could be stress, or a reaction to medication, or an interaction of medication with cannabis, but ruling out physical causes without testing when symptoms warranted it could have been a fatal mistake in my own experience.
I do find that doctors are now far less likely to brush my concerns off as stress when I report symptoms, and actually investigate potential physical causes and make referrals to specialists. On a related note, a consult with an endocrinologist may help with hormone issues that may be involved.
posted by katra at 11:54 AM on October 26, 2019
I do find that doctors are now far less likely to brush my concerns off as stress when I report symptoms, and actually investigate potential physical causes and make referrals to specialists. On a related note, a consult with an endocrinologist may help with hormone issues that may be involved.
posted by katra at 11:54 AM on October 26, 2019
I fortunately had a Very Smart dental assistant who identified one of my neurological symptoms
I'm assuming this was a symptom that suggested the existence of an organic brain issue, not just general complaints of memory loss and "brain fog." I'm comfortable with my doctor's explanation that an organic issue is only present in a very, very small subset of cases. If everyone who felt stressed and sluggish went to a neurologist for a CT scan, we'd end up with many more iatrogentic brain tumors than actual brain tumors.
posted by schwinggg! at 11:59 AM on October 26, 2019
I'm assuming this was a symptom that suggested the existence of an organic brain issue, not just general complaints of memory loss and "brain fog." I'm comfortable with my doctor's explanation that an organic issue is only present in a very, very small subset of cases. If everyone who felt stressed and sluggish went to a neurologist for a CT scan, we'd end up with many more iatrogentic brain tumors than actual brain tumors.
posted by schwinggg! at 11:59 AM on October 26, 2019
Just to support one possible systemic cause of mental fog mentioned by basalganglia above, I take hands free voice notes while driving and transcribe them at home. From the period when I had undiagnosed hypothyroidism my voice was scratchy, slow and my thoughts confused or disorganized. There are other symptoms, but a blood test can solve the question. Purely FYI.
posted by forthright at 1:23 PM on October 26, 2019
posted by forthright at 1:23 PM on October 26, 2019
I'd start with your GP to rule out things like anemia or thyroid issues. Are you seeing a psychiatrist for your meds? If not, that would be another place to turn. I have issues like you describe when I'm in a depressive episode.
I know there are apps out there for meditation. I can't recommend one because I find meditation doesn't make me feel good.
Also, the pot may be interfering with your cognitive functioning. I'm not a doctor or a partaker, but it can act as a depressant (quite likely since you're taking it for sleep).
Stress. Yes. Diet. Maybe. Sleep apnea? Something to ask your GP about.
posted by kathrynm at 1:42 PM on October 26, 2019
I know there are apps out there for meditation. I can't recommend one because I find meditation doesn't make me feel good.
Also, the pot may be interfering with your cognitive functioning. I'm not a doctor or a partaker, but it can act as a depressant (quite likely since you're taking it for sleep).
Stress. Yes. Diet. Maybe. Sleep apnea? Something to ask your GP about.
posted by kathrynm at 1:42 PM on October 26, 2019
Zen Mind, beginner's Mind (PDF) (by SHUNRYU SUZUKI First Master of Zen Center, San Francisco and Carmel). Although it's sorta nicer to have the physical book...
Try giving that a read and see if it's going to work for you.
posted by zengargoyle at 2:39 PM on October 26, 2019
Try giving that a read and see if it's going to work for you.
posted by zengargoyle at 2:39 PM on October 26, 2019
Nthing that pot can make you feel vague and sluggish, as do lots of other things.
I'm also wondering if it's possible that you have undiagnosed Type 2 Diabetes. I developed it in my 40s and the thing that finally got me to the doctor to find out what was up was feeling very foggy. People who carry fat around their midriff are particularly prone to T2. The glucose sensitivity test is a bit gross from all reports, but way better than kidney failure or nerve damage or amputation of extremities from undiagnosed Diabetes.
Not sure if this applies to you but the combination of drugged sleep and being overweight can increase the likelihood of sleep apnoea. That can produce brain fog.
posted by mewsic at 10:17 PM on October 26, 2019
I'm also wondering if it's possible that you have undiagnosed Type 2 Diabetes. I developed it in my 40s and the thing that finally got me to the doctor to find out what was up was feeling very foggy. People who carry fat around their midriff are particularly prone to T2. The glucose sensitivity test is a bit gross from all reports, but way better than kidney failure or nerve damage or amputation of extremities from undiagnosed Diabetes.
Not sure if this applies to you but the combination of drugged sleep and being overweight can increase the likelihood of sleep apnoea. That can produce brain fog.
posted by mewsic at 10:17 PM on October 26, 2019
Food intolerances are a very well established cause of brain fog. Less proven but very likely they can trigger anxiety, depression and racing thoughts like you've described. Non-coeliac gluten intolerance is a very well known trigger of brain fog but there are other kinds of food intolerances as well.
As well as meditation etc it's definitely worth looking into this and other possible physical causes mentioned above.
One thing to consider, do you have long-standing, chronic, low-level health problems as well as mental stuff? For example, food intolerances often go hand-in-hand with skin problems (dandruff, itchiness, dry skin). Anemia can cause weakness, cramps and dizziness. If you have these (or other) kinds of chronic problems, see if you can find a doctor who can link them up to brain fog and anxiety/self-medication.
posted by riddley at 12:48 AM on October 27, 2019
As well as meditation etc it's definitely worth looking into this and other possible physical causes mentioned above.
One thing to consider, do you have long-standing, chronic, low-level health problems as well as mental stuff? For example, food intolerances often go hand-in-hand with skin problems (dandruff, itchiness, dry skin). Anemia can cause weakness, cramps and dizziness. If you have these (or other) kinds of chronic problems, see if you can find a doctor who can link them up to brain fog and anxiety/self-medication.
posted by riddley at 12:48 AM on October 27, 2019
FWIW it took me a while to feel normal after stopping an SSRI, like six months. If you haven't checked in with your docs about your progress with med switch, it wouldn't hurt to ask.
posted by Rube R. Nekker at 7:08 AM on October 27, 2019
posted by Rube R. Nekker at 7:08 AM on October 27, 2019
Exercise, exercise, exercise. And it doesn't have to be major working-out, either.
I do loads of stretches everyday and a little bit of light weight-lifting for about 20 minutes total, - barely work up a sweat. And I walk everywhere.
This will make you feel way, way better, and fix your response to all the stress.
And if you eat right, and get your gut micro-biome working properly again, you'll be fine.
Been working for me for 5 years now.
posted by dustpuppy at 9:37 AM on October 27, 2019
I do loads of stretches everyday and a little bit of light weight-lifting for about 20 minutes total, - barely work up a sweat. And I walk everywhere.
This will make you feel way, way better, and fix your response to all the stress.
And if you eat right, and get your gut micro-biome working properly again, you'll be fine.
Been working for me for 5 years now.
posted by dustpuppy at 9:37 AM on October 27, 2019
> To help with racing thoughts etc, CBT is made for that. I have also heard good things about Headspace (an app) but haven't used it myself.
I use it, and it's great. I don't do the meditation lessons but instead use the "sleepcasts," which put me to sleep within a few minutes (I sometimes wonder if they turn evil 10 minutes in, because I would have no idea). Maybe try that to fall asleep instead of marijuana?
If you have an Alexa, say "Alexa, please play Cat Marina" to it. That's my favorite sleepcast and I believe you don't have to pay for it if you access it that way.
posted by The corpse in the library at 11:53 AM on October 29, 2019
I use it, and it's great. I don't do the meditation lessons but instead use the "sleepcasts," which put me to sleep within a few minutes (I sometimes wonder if they turn evil 10 minutes in, because I would have no idea). Maybe try that to fall asleep instead of marijuana?
If you have an Alexa, say "Alexa, please play Cat Marina" to it. That's my favorite sleepcast and I believe you don't have to pay for it if you access it that way.
posted by The corpse in the library at 11:53 AM on October 29, 2019
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posted by seemoorglass at 9:59 AM on October 26, 2019