Is this anything?

June 16, 2021 8:28 PM

I've been having a bunch of weird minor mental reactions and body symptoms during the pandemic. Not sure what they add up to. Depression, anxiety, bourgeois malaise... or just the pandemic? Worth seeking extra help for?

Maybe relevant: late 20s, AFAB, working from home, finishing up PhD (you'll see that I had some problems with this in my question history, though things have happened so that the finish line is visible, thankfully). I have had, thankfully, a decent social life during the pandemic with a small pod of friends, but I still feel that I'm spiraling.

Mostly I'm looking for a potential diagnosis (e.g. matching symptoms to named problems) and potential solutions that worked for you. Yes, you are not a doctor. But any advice you provide will be very helpful in giving me better keywords than my current providers. I've described these symptoms to them and not gotten much help. I'm in therapy biweekly (though I just asked to change to weekly) and I do have health insurance and a doctor who knows my medical history.

So, here's what I'm dealing with lately:

* I have a lot of trouble getting out of bed. Often I have to lie there for an hour or two arguing with myself, or entice myself with snacks, or have an upcoming meeting that requires me to get out of bed NOW (and then I'm late to the meeting).
* I have a very hard time making my body do things in general (move, etc).
* I fall asleep very easily. Sometimes I'll sit on the couch and wake up half an hour later.
* I'm often too tired to "go to sleep properly" and will pass out on whatever available surface, wake up at a weird hour, and exert maximum effort to get up and brush my teeth and sleep properly.
* I feel constantly tired and amazed at others' energy.
* My most entertaining and frequent activity has become: staring at the ceiling thinking for hours. Obsessive rumination over people, problems, failures...
* Getting less and less work done, to the point where I'm so far behind on things that I want to give up. Much less capacity for my PhD work in general (I maybe work 4 hours a day, much of it random managerial stuff and meetings that I do while procrastinating on the core PhD stuff that seems to demand a focus that I don't have). And I definitely work ~10x slower.
* But on the other hand, increased obsession with my weird personal projects or other passing things that I later have a hard time understanding.
* After a particularly hard deadline, even for things I care about, I just let things slip, and often end up in a crying fit and contemplate how great it would be to passively not exist.
* People have told me that I feel very distant. I have a lot of trouble getting close to people I like.
* Mood swings (irritation & obsessive worrying), especially noticeable during the pandemic, to the point where I started birth control recently just to try skipping my period to see if no PMS would fix the problem.
* I'm actually pretty socially fluent... or so I thought until I went a small party and couldn't think of a single thing to say the whole time. My mind just went totally blank and I was very tired, "out of it," very detached from emotional life.
* Decreased appetite.
* Emotions come to the surface at weird times, like during a massage, and then I want to cry very badly.
* Brain fog.
* More frequent nightmares about childhood trauma.

Again... I don't think I experienced any these things at all, or to such a high degree before the pandemic. I mostly want to just stop being so slow/tired/detached!

Things I DO NOT feel, btw: sad, suicidal or at risk of self-harm. I actually still feel very much attached to life, health, relationships, local community, my personal projects, etc.

I have been told I work a lot, so it could be very advanced burnout (i.e. particular to my working situation and the PhD grind, rather than a mental disorder). But I've also been told that burnout is a neoliberal lie... so who knows? (Tongue in cheek!)

Any advice is deeply appreciated!

posted by icosahedron to Health & Fitness (22 answers total)

It could be due to stress or depression but it might be a good idea to rule out any physical causes like low thyroid levels, not enough vitamin D or diabetes. If you're not getting anywhere with your doctor, it's a good idea to see a different doctor for a 2nd opinion. Sometimes a fresh set of eyes can help.
posted by stray thoughts at 8:41 PM on June 16, 2021 [3 favorites]

Here is a very common screening tool for depression. It sounds to me like you would actually score pretty high. You do not need to feel sad or suicidal to be depressed. Talk therapy is great but sometimes adding in an antidepressant can help you start functioning semi-normally again faster than therapy. Talk to your therapist about it although you probably need to see your doctor for a prescription.

I think you should also get into to see your primary doctor asap for checkup. Thyroid problems are just one of the things that can cause at least some of your symptoms and I"m sure there are a number of other things that should be ruled out. A sleep study might also be appropriate.

Also, if there is any way you can get some good regular aerobic exercise into your day, it can actually work as well as better than antidepressants in treating depression. I know you don't need one more thing that you are failing to get done, but if there is way that you exercise, you might find you start feeling a little better pretty quickly.
posted by metahawk at 8:44 PM on June 16, 2021 [4 favorites]

The brain fog, tiredness, things like brushing teeth taking all my energy, mood swings, decreased appetite, rumination, and passively wishing I just didn't exist all are spot on for my depressive episodes. This is absolutely worth seeking help for. You mention you don't particularly feel sad and that's actually really normal, even though a lot of people seem to believe depressed = sad. Depression often brings me like, lower than my capacity to feel things like "sad" and I more just feel detached and apathetic.
posted by augustimagination at 8:45 PM on June 16, 2021 [7 favorites]

Also, this sounds like it is having a big impact on your day to day functioning. It is not just some "weird minor symptoms". Please don't minimize the situation - this is a real problem and you are entitled to get professional help.
posted by metahawk at 8:45 PM on June 16, 2021 [12 favorites]

Also ruling out (or in!) things like thyroid or vit D deficiency would be really good too! metahawk mentions physical activity & moving around, which is good, but it can also be the case that an antidepressant is what helps you get to a place where you can do things like that, so please don't feel like you have to try all sorts of things yourself and leave medication as a last resort. You can be on depression meds and try other things like physical activity at the same time, it's not a lab experiment. (I don't mean this as a jab at metahawk's specific comment, just reading it made me think of how in some groups there's a lot of emphasis on doing everything but meds before "turning to" meds and I don't think that's healthy to do if you really are depressed)
posted by augustimagination at 8:49 PM on June 16, 2021 [2 favorites]

This sure sounds like textbook depression to me! Sadness is not always a part of it, because depression masks and warps emotions in unusual ways.

One thing I have explained to folks who ask me about my experiences with depression is that it is a physical thing, that I feel in my body. Yes, it is my mind, but the symptoms are quite often physical. And current studies are investigating the idea that depression is at least partially an inflammatory problem - something that I have absolutely begun to believe is the case for me as I’ve had great results when I’ve changed things like my diet and activity levels and taken medication for preventative cardiac care that has a side benefit of helping inflammatory symptoms.

A lot of the things people suggest to depressed people sound undoable in the moment - go for a walk! Eat fresh vegetables! Get a good night’s sleep! And it’s like, fuck you, if I could do any of that I wouldn’t be in this situation. But there are absolutely things that doctors and therapists can do to help you be able to do those things. Medication for depression and sleep rhythm is not a cure, but rather assistive devices. Therapeutic techniques are the same. So too are things like sharing your struggles with loved ones, sharing burdens, stuff like that. Then you can start small, like adding some hummus and carrot sticks to your shopping so you have a fast snack with lots of fiber. Or setting a regularly scheduled hangout with your friend so neither of you need to find time for it every week. Or having a snack basket in the bathroom to motivate you out of bed. Honestly maybe for you you should keep bedding in different spots so you can just cozy up and have good sleep wherever you plop. Whatever works!

Good news is that it’s treatable, and common, and absolutely nobody is going to judge you about it, especially right now.
posted by Mizu at 8:50 PM on June 16, 2021 [5 favorites]

There are a bunch of different kinds of depression. This sounds like it could be diagnosed as persistent depressive disorder, or dysthymia (not to be confused with a thyroid disorder, but, yeah, you should also get your thyroid blood work done).

When you mention your “current providers”, is any of them a psychiatrist? If I were you, I would try to see a psychiatrist. I know that it can be tricky with insurance considerations etc. Medication might be a good approach to this problem, though, and there’s a real advantage in getting treatment from a psychiatric expert rather than a GP.
posted by mr_roboto at 9:06 PM on June 16, 2021 [1 favorite]

Deeeeeeeeepression, yo.
posted by We put our faith in Blast Hardcheese at 9:19 PM on June 16, 2021 [4 favorites]

yes. as mentioned, textbook. the giveaway is the spot-on description of
- 'rumination', an actual clinical symptom, mentioned twice.
- sleep disturbance.
- inability to focus or work effectively.

don't conflate sadness and depression; discrete phenomena.

at the very least, see a therapist to help identify what is and is not a problem for you, and if you want to work on it (therapeutic goals).
posted by j_curiouser at 9:55 PM on June 16, 2021 [1 favorite]

You're ticking an awful lot of depression boxes. (Depression does not just mean suicidal or sad - for me, it's closer to a failure, in general, to thrive - to live, to progress.)

Also... have you had Covid? Some of those things sound like the way the Covid fatigue hits me on days where I'm trying to slip back into depression. (I've had a lot of positives come my way as a result of the pandemic, and my mood has REALLY improved after leaving a job at the end of Nov 2020, despite immediately coming down with Covid, and dealing with tons of after-Covid nonsense, including fatigue - and yet there's still a lot of your description that feels true to me myself, if not at this particular moment, but sometime in the last year.
posted by stormyteal at 10:02 PM on June 16, 2021 [2 favorites]

Could you possibly be iron deficient? I have been, and I was exhausted all the time. That plus burnout-related depression, maybe. The pandemic has made it so that we have had nothing to look forward to for a year, plus endless working (or endless job searching for some). That is a recipe for depression even for people who are typically not depressed in normal times.
posted by Knowyournuts at 10:30 PM on June 16, 2021 [2 favorites]

I feel the same way, just had bloodwork done and nothing’s wrong with me (apparently). Commenting mostly in solidarity. I’ve had depression before, sometimes quite badly, but I’ve never had this profound sluggishness, lack of investment in my future or reduced appetite.

I really think (for me) it’s related to the “real world” being conspicuously absent from our lives, and just losing the sense of what all of this is for. I’ve considered going back on the antidepressant I tried several years ago (and which worked) but haven’t yet. But medication might be something to explore, even if it’s short term.
posted by stoneandstar at 12:29 AM on June 17, 2021

Do you or could you have started snoring and/or have sleep apnea issues? Do you think you could be grinding your teeth in the night (has a link to sleep apnea)?

Falling asleep on the spot, like when you sit down on the couch, might be that you are not getting restful sleep. Many of the other things you mention could stem from chronic lack of sleep.
posted by AnnaRat at 1:02 AM on June 17, 2021 [3 favorites]

I also want to ask if you could have had Covid? I had it before they realized it was in the USA, back in late January 2020, but didn’t realize it until maybe 3 months ago. A lot of what you’re describing is what I’m dealing with. I’m not disagreeing with people suggesting it could be depression, though, because depression (and feelings of doom! What fun!) can be part of Long Covid. I’ve discovered that a lot of weird health things I thought were age related, or symptoms of something terrible like cancer, are actually Long Covid.

(We’ve moved a tv into the bedroom, so that when I inevitably fall asleep while we’re watching something, I don’t have to spend literally 2 hours forcing myself to get up so I can “get ready for bed”. This all really sucks, but it’s a relief to at least know why it’s happening.)
posted by MexicanYenta at 1:59 AM on June 17, 2021

I finished my PhD feeling similarly (way pre-covid) so it could ‘just’ be grad school. I (and most of my friends) ended up in therapy and I couldn’t have finished without. Medication, physical activity, vitamin D or B are also things that helped my cohort.
posted by hydrobatidae at 4:06 AM on June 17, 2021 [1 favorite]

Agreeing with everyone saying to get bloodwork done, especially vitamin D and iron testing.

Lots of these symptoms, especially the fatigue and even the emotional lows/rumination, might stem from something as simple as a deficiency and can be alleviated with some OTC supplements. Low vitamin D can really do a number on your emotional and physical wellbeing and since many of us have spent all winter indoors, it's a likely cause. IIRC some countries are actually recommending that everyone take supplements because it's such a widespread issue.

If your doctors are reluctant, you may need to straight up ask them for a full blood panel to rule these things out. Once you've cleared those things off the list, you can start tackling other possible causes.
posted by fight or flight at 4:40 AM on June 17, 2021

This is EXACTLY what my depressive episode was like, and I had it at your age and also while in a grad program. It was hell! It’s actually kind of good to hear you describe going through the same thing, because it was such a confusing experience, since it felt like such an intensely physical problem.

What worked for me was a low dose of thyroid medication, a moderate dose of generic Wellbutrin, and daily exercise (can just be ten minutes but always outside). Highly recommend you try medication sooner rather than later, and maybe start with Wellbutrin rather than an SSRI if that’s possible.
posted by rue72 at 4:56 AM on June 17, 2021 [2 favorites]

That sense of exhaustion and distance from everyone is exactly what my depressive episodes feel like.
posted by missjenny at 6:16 AM on June 17, 2021 [1 favorite]

I agree with everyone above re: depression but also getting blood work done. However, wanted to provide a keyword that might help describe some of your experiences to your doctors: anhedonia.
posted by brook horse at 6:26 AM on June 17, 2021 [1 favorite]

^^^ "nothing. feels. good. at. all."

great addition, brook horse.
posted by j_curiouser at 7:55 AM on June 17, 2021

This matches up pretty well with my experience of depression.

how great it would be to passively not exist.
That's called being passively suicidal and it absolutely counts as suicidal in terms of "oh god, get thee to a healthcare provider."

* Emotions come to the surface at weird times, like during a massage, and then I want to cry very badly.
Yeah, that checks out. I had weird bursts of panicked crying when I was very depressed and exercising. My body was like "oh, we're being active right now? I have a backlog of nasty emotions to work through. Open the taps!" If you are comfortable talking to your masseuse, you can ask them about this phenomenon, I'm sure you are not the first person to get emotional on the table.

Here is your broad to-do list, based on my experience:
* See a psychiatrist about getting on medication. Getting your meds right may take a while, I'm sorry to say, but it is worth doing.

* Let people know what's going on, as much as you can, so they can cut you some slack and proactively offer support.This includes professional/academic folks as well as friends and family. You're not going to get through this without a lot of understanding and support, so fostering that early is important.

* Do some research into resources that support chronically ill and disabled people. Whether or not you want to consider yourself a person with a disability (identity shifts can be hard), the fact is you are coping with an enormous illness, and managing that changes what your life looks like. There is expertise available for this! Some places to start: Spoon Theory, Fork Theory, Unfuck Your Habitat, etc.

Take it easy on yourself and take plenty of breaks. I'm so glad you made this post, I am sending you warm thoughts and long distance hugs.
posted by snerson at 8:05 AM on June 17, 2021 [1 favorite]

This is how my depression manifests also, like others have indicated. You're ticking a TON of boxes with your list above. It took me sooooooooooo long to figure out I was suffering from it because I didn't feel sad/crying/suicidal (as I had always come to understand depression previously), it was more like I had absolutely NO energy whatsoever even with adequate rest, and although I was fully functioning and everything in my life was mostly chugging along okay and my relationships were good and all that, everything felt like an enormous struggle to find that "activation energy," even things that were ostensibly supposed to be fun or enjoyable. I just couldn't get interested in anything at all. It just so happened that around this time my doctor put me on a low dose of Wellbutrin solely in order to counteract side effects of another drug, but within a couple weeks I woke up feeling like I was emerging from an enormous fog and that's when I realized just how bad it had become. Wellbutrin made it possible for me to do all the other things that are supposed to help relieve depression...sunshine, exercise, eat better, etc. I am not sure I could have accessed the energy to do those things without pharmaceutical help first.
posted by anderjen at 8:43 AM on June 17, 2021 [2 favorites]