Why is my husband zoning out all the time?
January 13, 2011 12:48 AM   Subscribe

Why does my husband zone out/get confused/lose his train of thought throughout the day? This has been happening for over a year. He spoke to his GP, and was told to drink more water, get more sleep, and take breaks between computer screen time, but none of these things seem to help.

Both of us are worried about it, especially since we can't find a reliable and consistent way of alleviating the problem. The 'episodes' can be as short as 5 minutes, as long as several hours. He says he has a huge amount of trouble concentrating, following the thread of any conversation, or being able to contribute anything. If I ask him a question while he's feeling like this, he kind of smiles sadly and literally cannot respond coherently. He is a programmer, so spends over 8 hours a day in front of a computer, but this is a fairly new development, whereas he's been a computer nerd since he was a pre-teen, so we're not sure why it would suddenly manifest in this behaviour. It happens both at work, at home, and when we're out in public, so I don't think it's related to any particular environment.

Has anyone else dealt with something similar? I've asked him to see his GP again and try to push them for more answers, but he's reluctant to, since he dislikes making a fuss. In the meantime - any ideas, mefites?
posted by catch as catch can to Health & Fitness (40 answers total) 6 users marked this as a favorite
I have no medical knowledge, but if he were a friend or relative I'd urge him to go talk to another Doctor. Potential fuss vs potential brain tumour? No contest.
posted by doublehappy at 12:52 AM on January 13, 2011 [1 favorite]

Is he aware that it's happening during the episode? Afterward, does he realize that it happened or does he have no recollection of it?

This happens to me when I'm having something like a blood sugar crash from not eating enough protein. The key is that I'm consciously aware of it happening and I can usually correct it by telling people "hold up, I need to eat some string cheese before this conversation goes any further."
posted by joan_holloway at 12:53 AM on January 13, 2011 [2 favorites]

How old is he? It may be something neurological but many of these are age dependent.
posted by vacapinta at 1:02 AM on January 13, 2011

Non-responsive during an episode is a lot more than just being a bit tired. He really should go back to another doctor for another opinion on this, and to emphasise that he's non-responsive - I'd advise that you go with him, because you can describe what's happening from the outside.

One of the first things that comes to mind (note that this is just an idea, not a diagnosis, and he doesn't fit a classic pattern) is absence seizures, which I'm mainly mentioning because they're very much treatable. Having got the brush off from his doctor the first time it might feel difficult to go back, but if it might be something that can be treated and made to go away, it might be more of a 'carrot' to get him there.
posted by Coobeastie at 1:46 AM on January 13, 2011 [1 favorite]

Petit mal seizure? Although, from my (somewhat limited) understanding, the seizures only tend to last for minutes, and not hours.

I would see a neurologist post haste, if I were you. Best of luck.
posted by humpy at 2:06 AM on January 13, 2011 [1 favorite]

sorry Coobeastie had it...I just repeated it!
posted by humpy at 2:08 AM on January 13, 2011

You might maybe want to have a look at fugue state disorder or depersonalization, and see if one of these matches up with your husband's symptoms, especially if the episodes seem to be brought on by stress.

Don't hesitate to ask his GP for a referral to a neurologist. Tell your man that it's not "making a fuss". It sounds like a serious problem that deserves further investigation by a specialist since your GP's suggestions to alleviate the symptoms don't seem to be working.

(IANAD etc.)
posted by empatterson at 2:20 AM on January 13, 2011

Worth ruling out as causes:

iron deficiency

vitamin D deficiency

sleep apnoea

fibromyalgia (fibro fog is infamous)
posted by with the singing green stars as our guide at 2:23 AM on January 13, 2011

I used to have petit mal/absence seizures, and this doesn't sound quite right - I missed chunks of time completely, and wasn't interactive.

But I think he should see a neurologist. Not that I'm thinking it's anything dire, but I think this is worth investigation by someone who's a brain expert. After all, he's a brain worker, and he only has the one brain.
posted by gingerest at 2:31 AM on January 13, 2011

Your husband reminds me of me, a bit. No explanation to offer, but my dad does the same thing. Do either of your parents-in-law?
posted by cogat at 2:59 AM on January 13, 2011

Whilst I am not a doctor or at all related to the medical community, my undergrad training was in Psychology with a focus on neuropsychology.

They drilled into us that in treating patients that have potential neurological matters, that it was always best to start with the worst-case scenario (brain tumour) and work backward. This is due to the fact that there are tremendous opportunities for treatment of neurological problems but time is of the essence in ensuring full recoverability.

Thus, you should start from that tack and work backward to lower-level disorders. If you find the process to be confounding and slow, you may have to push quite hard but it will be worth it in the best case for piece of mind and surety and in the worse case for the best chances of full recovery.

Good luck and make sure that you engage family and friends for support if the news begins taking a turn for the worse.
posted by nickrussell at 3:15 AM on January 13, 2011 [1 favorite]

Can you explain the nature of the "zoning out/getting confused" a bit more? I sometimes do that these days -- where I'm in a conversation, but sometimes zone out and am woolgathering when someone else is talking -- and I'm almost certain that it's a sleep-deprivation thing.

But the degree of "zoning out" I get isn't that bad; I'll have trouble focusing if someone is telling me something lengthy and complicated, but if they were to say, "yo, are you listening?" I'd snap back into focus. If it's just that, then that's one thing; but if, say, he were unable to name what year it is or who the president is during these "episodes," say, that's something else again.

I wonder if maybe refining the details of what you mean by "spacing out" to a doctor would help -- because "zoning out" doesn't sound bad, but there are a lot of different shades of meaning to "zoning out," and I think you're referring to something more serious than I'm doing. And, maybe your doctor's definition is more like mine, so he's thinking it's nothing bad -- but if you were to come back with a more detailed description ("when it happened last week, I asked him in the middle of it if he could remember the name of the vice president, and he asked me what a vice president WAS first before saying, 'wait, it's Al Gore, right?' "), that may step things up.
posted by EmpressCallipygos at 4:30 AM on January 13, 2011

You are both worried about this so you are definitely right to pursue this with the GP. A legitimate medical question is not "making a fuss". As others have said, it seem like a referral for a neurologist is in order as well, just to be safe.

He needs to go in to see the GP again, and, as EmpressCallipygos says, he needs to be clear to the GP about the issues he is having, and not downplay the nature of the "zoning out".

When he goes in to see the GP, the GP should do tests, particularly blood work, to check things like levels for his thyroid, blood sugar, Vitamin B12, Iron, and checking Vitamin D as well can't hurt. Sleep apnea is definitely also something to check out. Even if the GP pursues all these things, I would not let your husband leave the doctor without a referral for a neurologist.
posted by gudrun at 5:45 AM on January 13, 2011


I'm not medical nor psychological at all so this is just a personal observation...

Does he work hard? Long hours? Eat on the fly? Do you have kids? Money problems? Has there been a recent change in your circumstances? It may not be a medical problem; it may not be a 'problem' at all. If he is a focused, hard working person who is under a pressure then he may just be pushing himself too hard.

Maybe he just needs an outlet: something to break up the time and give him a reason to stop focusing. Smoking, for example, solves this problem. Maybe one reason why it is so prevalent. Maybe taking a coffee break; 15 minutes every couple of hours when it's OK to just mess around; surf/chat/wander/whatever.

Always having something to look forward to helps me too; holidays/birthdays/events etc.

Like Empress says; it all depends on what you mean by 'zoning out', and on being sure that you are talking about the same thing.
posted by BadMiker at 5:47 AM on January 13, 2011 [1 favorite]

If it were my "I don't like to make a fuss" and "Oh, I don't need a doctor" husband, I would call the GP, demand a referral to a neurologist, and go with him to the appointment so he couldn't downplay anything. I would not give my husband a choice. I would not fuck around with my husband's brain! And if it turned out I overreacted, OH WELL, I'd overreact way more if I thought it was necessary to protect my husband or child. My doctor-reluctant husband could say, "It was just my silly wife being overprotective," whatever. Someone needs to be.

I know nothing about medicine or brains, but this sounds scary and I don't think either your GP or your husband are taking it nearly seriously enough.
posted by Eyebrows McGee at 6:02 AM on January 13, 2011 [4 favorites]

I had spells similarish to this, like I was pushing on the accelerator of my brain and...nothing. Or 20% of normal brainpower would fizzle into the brain carburator. Everything was foggy and far away. I took b12, drank more water and cut out coffee. And it turns out that I had pretty bad hypothyroidism, which was caught only upon routine blood draw at an annual physical. I should have said "Please check my thyroid" long before that though. So now I'm all about telling people: get your thyroid checked!
posted by hecho de la basura at 6:04 AM on January 13, 2011 [2 favorites]

If I ask him a question while he's feeling like this, he kind of smiles sadly and literally cannot respond coherently.

This is alarming. Do you have a video camera or video capabilities on a phone or other device that you can grab and document this for a doctor? In the meantime, if he hasn't had a full bloodwork panel that needs to happen as soon as possible.
posted by Lyn Never at 6:25 AM on January 13, 2011

I have moments that seem like what you are describing. For me, it can be a couple of things. It can be that I am overstressed and overtired and my mind sort of goes to sleep. Putting it charitably, it might be a form of meditation. But honestly, if feels like my brain is sort of stuck in a processing loop somewhere. My dad would do this too. I think it is my subconscious mind working through something.

Other times, it is me being obsessed with something. A problem that I just can't get away from, or trying to search for a memory or interpretation that is "on the tip of my tongue/brain." Like trying to remember a person's name, a word or a song title that I KNOW I know, and just can't make it work. Like above, my brain is stuck in a processing loop.

And other times, it is me suppressing a mood swing. I am irrationally irritable, angry about something I have no control over or just being childish about something. And I do not want to shit on anyone's pancakes, so I shut down.

The test for me is to ask me to try and plan something during one of these events. I literally cannot imagine anything that is not in the present.

But hard to tell if that has anything to do with your husband's issue. It could be a wide variety of things. One easy thing to try would be to go to Target and buy a cheap blood sugar tester. When he gets to feeling this way, have him test his sugar. This way, you can rule out or rule in blood sugar issues.

Another thing (besides the more obvious ones) is to make sure he is eating enough foods with tryptophan in them. That is a chemical precursor to serotonin among other things, and I have also noticed that when I am having a mood swing or brain fart moment, I can look back and see that I haven't eaten enough for the last couple of days. A big bucket of chicken usually makes things better. I shit you not. (And it isn't just eating- if there is no tryptophan in it, I will temporarily feel better, but then crash even worse. Tryptophan smooths it out.)

posted by gjc at 6:50 AM on January 13, 2011 [1 favorite]

When you say he cannot respond, are you inferring this from his behavior or does he later describe it that way?

As others have said, this sounds like it could be an absence seizure or otherwise neurological. Ask for a referral to a specialist, but until then resist the urge to google symptoms and worry yourself.
posted by phrontist at 6:53 AM on January 13, 2011

He spoke to his GP, and was told to drink more water, get more sleep, and take breaks between computer screen time, but none of these things seem to help.


If I ask him a question while he's feeling like this, he kind of smiles sadly and literally cannot respond coherently.

He needs a specialist. And new GP. Because "drink more water" in response to "can't respond coherently" and "going on more than a year" is a bullshit response and I would no longer go to that person for a sore throat, never mind spacing out for a couple of hours.
posted by A Terrible Llama at 8:52 AM on January 13, 2011 [5 favorites]

One data point - I take a drug (medicine) called Lamictil (generic = lamotrigine) prescribed by a psychiatrist. We increased my daily dosage relatively substantially. I experienced significant short-term memory problems and periods of "disconnection" shortly after increasing the dosage. We decided to lower the dosage and the problem went away in about the same time frame it arose. If he is taking a similar drug, then it may be worth mentioning to his doc. Many GP's aren't up to speed on the effects/side-effects of current drugs that fall outside their typical daily experience.
posted by nickjadlowe at 9:37 AM on January 13, 2011

He should drink more water, get more sleep, take breaks between computer screen time, and get daily outdoor exercise if possible. And, he should document these events and go right back to the doctor and insist on getting care for this. Or go to a different doctor.
posted by theora55 at 9:56 AM on January 13, 2011

This happens to me. I have atypical migraines. The lack of ability to talk is tied to the migraines. I would describe it more as a serious disinclination to talk than a physical inability. I used to get pain with the headaches but usually don't anymore, now I just feel very disconnected and spacey. Anyway I am on a low dose of anti-seizure medication and haven't had a migraine in a year. I also have been very lucky and had minimal side effects from the anti-seizure drugs, which I gather can be quite serious. I'd definitely recommend seeing a neurologist and also tracking food/ sleep/ other stuff versus the episodes so he can look for patterns. Bright lights give me headaches, so does squinting, when I first needed glasses and didn't realize it my headache incidence went way up for a while.
posted by fshgrl at 10:07 AM on January 13, 2011

This could be a sign of sleep apnea. Doctors sometimes misdiagnose this as it is not picked up on a blood test etc. Does he snore? Does he appear to stop snoring or breathing for short periods in his sleep? Spouses are usually the first ones to notice the signs of apnea but even spouses can miss this when it is not too pronounced and occurs mainly while the spouse is in a deep sleep.
posted by caddis at 10:45 AM on January 13, 2011

Does he work hard? Long hours? Eat on the fly? Do you have kids? Money problems? Has there been a recent change in your circumstances?

This has been happening to me for the past month since my workdays went from around 8-9 to 12-14. My words get out of order, and sometimes I stop talking in the middle of a sentence. Even when I'm typing shit out, like now, I fear I'm not as cogent as I used to be.

I tend to snap out of it on the weekends when I have to do less work. Does your husband ever get a chance to not be working? Holding complex data schemata in your head for hours at a time can tend to temporarily impede regular function, at least that's what happens to me.

Still though, if it worrisome to you, force him to a specialist.
posted by thsmchnekllsfascists at 10:46 AM on January 13, 2011

Zoning out is one thing. Inability to speak or respond could be TIAs (transient ischemic attacks), mini-strokes. It could easily be something much more benign, but I heartily second the idea that you need to get to a doctor who will take this seriously, and a neurologist if possible.
posted by LobsterMitten at 11:14 AM on January 13, 2011

My husband gets a bit like this when he has to write code. I can often tell if he has been working on code during the day - he's zoned out, he doesn't hear/understand questions the first time I ask them, and overall seems "not to be there" or a bit autistic, whereas other intellectually challenging work just makes him tired.

But it's never been as bad as the episodes you describe! If I tell him "Hey, snap out of it, you're being nerdy!" he always manages to concentrate and respond normally, and once he's back in the "normal world", he doesn't have trouble concentrating. Nthing the recommendation to take this very seriously and find a neurologist, and to go with him to the appointment to describe the problem.
posted by The Toad at 11:23 AM on January 13, 2011

Is he taking any medication? Some come with a side effect of "brain fog".
posted by P.o.B. at 12:36 PM on January 13, 2011

I agree completely with what A Terrible Llama said. As you describe it, the GP you're seeing is dangerously dismissive of your husband's symptoms. He might not have anything serious going on, but damn, it sure sounds like it's worth investigating properly.
posted by hootenatty at 12:42 PM on January 13, 2011

Thanks to everyone for your answers, especially those of you who talked about personal experience with similar.

Some added info/clarification:

- He just turned 30. Relatively healthy, varied diet; I think deficiencies where that's concerned can reasonably be ruled out. No medication. He works incredibly hard at his job, and it has become a more stressful environment within the last year. I didn't want to jump to the conclusion that it could be that, in case there's no direct correlation, but some of you have said that it could be caused by stress/overwork, so that's something.

Thank you to those who have suggested sleep apnea; I have noticed irregular breathing in his sleep and he often snores, but thought it was just, you know, snoring. I will be on the lookout and keep it in mind for future doctor visits.

- When I said that he cannot respond 'coherently' to questioning, I should clarify by giving an example. Last night, we had an engineer in to discuss our broken boiler; my husband was present, standing there, apparently listening to what the guy was saying, but there came a point when the engineer asked, 'Have you got insulation in your loft?' and I couldn't remember, so turned to my husband, and he just shrugged his shoulders and said, 'I can't...' and smiled in such a way (I've gotten used to this smile) that said, 'I can't interact right now; I'm having a lot of trouble staying present in this conversation.' He can still speak, enough to say that he's not focusing, etc., but he can't actually follow the thread of a conversation, or hear a question and think of an answer. So he's totally aware that he can't focus, and can articulate it to some degree, but cannot really converse. At the times when I've been present during these, he says 'I'm sorry' a lot, because he finds it embarrassing, but that's about it. If he does try to converse about something, it goes something like this:

Me: 'What movie do you feel like watching tonight?'
Him: '...What about that one...with...um...'
Me: '...'
Him: '...It has...I can't quite...'
Me: '...'
Him: 'I don't...sorry...um...I can't focus...'

So, yeah. This is frustrating and scary for me (and frustrating and embarrassing and potentially career-busting for him, but he doesn't seem to be worried in a general 'this is a signal of something wrong with my body' kind of way). Thanks for y'all's input; I am nagging him every day about scheduling an appointment. I'll report back if/when we get some more info.
posted by catch as catch can at 1:38 PM on January 13, 2011

If I ask him a question while he's feeling like this, he kind of smiles sadly and literally cannot respond coherently.

This is alarming. Do you have a video camera or video capabilities on a phone or other device that you can grab and document this for a doctor? In the meantime, if he hasn't had a full bloodwork panel that needs to happen as soon as possible.

That's what I was going to say. Set up a videocamera (digital cam in video mode, or anything with video capability) on a tripod so you can just grab the whole thing, turn it on, and point it at him during his next episode. Stick a piece of paper or something with questions on it so it's handy and ask him the questions while you're recording: "What is your name? What is today's date? Where were you born?" etc. These are the kind of questions they ask you in ER and also anesthesia recovery (in my experience) to make sure you're coherent: questions you should be able to answer even if you're sleepy or sick.

Take that video with you when you go to your NEW doctor to get a full physical workup with complete bloodwork, sleep study, and referral to a neurologist. Take it to the neurologist, too.
posted by galadriel at 1:49 PM on January 13, 2011

I'd definitely make a return visit to the doctor, but tell him that very description of that incident and tell the doctor that that is what's happening rather than just describing it as "zoning out." That may be what's blocking you, that your doctor simply has a different idea of what's been happening.

It happens, though. I read about something like this happening in a James Herriot book, of all things; a family kept on bringing in their puppy and saying the puppy was throwing up a lot, and Herriot was treating him with a lot of anti-nausea medication that wasn't working. Then one day the family brought the puppy in again saying that it was still vomiting -- only when he was in the exam room, the puppy projectile vomited a yard and a half.

"Wait, is THIS what you've been talking about all this time?" Herriot asked. Yes, the family said, it was. And that's what finally lead Herriot to the right diagnosis -- finally knowing that it was projectile vomiting instead of regular vomiting.

....My apologies for talking at length about puppy urp, but my point is that sometimes if you think your doctor isn't quite getting what you're talking about, trying to list the specific symptoms in as much detail as possible can help. "Zoning out" has a lot of different shades of meaning, but "here's a word-for-word conversation we had during one of these episodes" can give a doctor a clearer picture and can sometimes make them realize, "oh, THAT. Oh, that's different...."
posted by EmpressCallipygos at 1:50 PM on January 13, 2011

Aphasia (roughly, problems with speaking or understanding language) is a word that might be useful for your searches and in talking to the doctor. Aphasia is a sign of some kind of brain damage - stroke, tumor, something else. Take it seriously and get to a better doctor.
posted by LobsterMitten at 3:19 PM on January 13, 2011

Another term that might be useful is delirium which can include sudden confusion or inability to respond sensibly. When he has these zone out moments does he feel like he's confused or disoriented, doesn't know what day it is, that kind of thing? Or is he oriented but just can't talk?

I would call a doc and say he's having recurring episodes of aphasia and delirium over a period of a year and say you want a referral to a neurologist.
posted by LobsterMitten at 3:26 PM on January 13, 2011

(Obviously: only say that to the doc if it seems true based on the descriptions of those terms at the linked pages.)
posted by LobsterMitten at 3:58 PM on January 13, 2011

catch as catch can, I think there is one thing you need to be aware of. People like me saying your husband should be checked for things like vitamin deficiencies have a reason for saying that.

Vitamin deficiencies are not necessarily caused by poor diet. For various reasons, sometimes the body loses the ability to process/absorb certain vitamins properly. Pernicious anemia is caused by a lack of intrinsic factor. Intrinsic factor is a protein produced by the stomach that binds to vitamin B12. The combination of vitamin B12 and intrinsic factor is absorbed in the lower part of the small intestine. When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12. I know two people with very serious Vitamin B12 deficiencies (Pernicious Anemia). Though Pernicious Anemia is rare before the age of 30, one male friend nearly died from it before he was diagnosed properly (the neurologist he was seeing never thought to do a simple blood test to check his B12 levels for more than a year), and our friend was in his early 30s when this happened. Symptoms of Pernicious Anemia can manifest as mental confusion, memory problems, etc.. So when people say that your husband should have blood work done, in addition to seeing a neurologist, we have good reasons to recommend that.
posted by gudrun at 9:23 PM on January 13, 2011 [1 favorite]

I recently spent some time with someone who was experiencing TIAs and she would space out like this. She was somewhat able to respond, but only enough to smile sweetly and stammer enough to let us know she couldn't follow what was being said or fully understand what was being asked.

There were a number of health factors contributing to her TIAs, but I thought I would mention that they did present similarly to your husband's state since you are looking for possible problems to look into.
posted by Felicity Rilke at 10:56 AM on January 14, 2011

I just wanted to follow up to this question to say that gudrun hit the nail on the head exactly. His blood test results came back today, and he's been diagnosed with pernicious anemia. I think the diagnosis has raised more questions than it answers, but being able to put a name to the issue is really helpful. Thanks mefi!
posted by catch as catch can at 1:14 PM on August 19, 2011

Wow, I just saw your update. I am so glad they figured this out! I am hoping that treatment with high amounts of B12 will help your husband soon.

After being diagnosed myself with pernicious anemia a few years ago, I now am much more aware that this problem is often not tested for, when a simple blood test can diagnose it. I tend to always suggest testing for it in ask mefi health threads because of my experience, and humbly hope I was perhaps of some small help to you both.
posted by gudrun at 12:51 PM on August 21, 2011

As a further update to this question, my husband had a loss of consciousness resulting in a fall last week, and he is now in hospital being monitored. The doctors that have seen him don't believe that the pernicious anemia is in any way related to the zone outs now, but think that he is experiencing very short absence seizures, with the zone out/confusion episodes being the postictal periods rather than the seizures themselves. He's yet to have all the tests, but I thought I'd throw the new info out there in case anyone ever comes back to this question.
posted by catch as catch can at 3:49 PM on October 2, 2011 [1 favorite]

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