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Mental Health (Expert Forum)
Brain fog, dizzy, weird symptoms-could this really be just anxiety/depression??
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Brain fog, dizzy, weird symptoms-could this really be just anxiety/depression??
by mjk216, May 24, 2006 12:00AM
After living a perfectly normal (some say fortunate) life for the past 32 years, things went horribly awry starting 6 months ago. After a particularly bad cold, I was left with a raspy voice, which quickly progressed to a constant lump-in-the-throat sensation. ENT put me on Prednisone. The next day, I ended up in the ER thinking that my throat was closing. ER doctor gave me an additional megadose of Prednisone. The Prednisone did nothing but make me feel extremely lightheaded, which stopped as soon as I stopped taking the Prednisone.
About 6 weeks after stopping Prednisone, I began to feel extremely dizzy and off-balance. (I.e., not the same as when I was taking Prednisone). Constant state of disequilibrium and BRAIN FOG: thinking now feels like "work," trouble remembering names, dates, etc., lightheaded and "floaty," hard to carry on a normal conversation without sounding like a ditz! This from a person who has a Master's degree and a 4.2 GPA! I just can't focus. My current job involves heavy intellectual writing and requires 110% cognitive function at all times, so the brain fog is quite distressing to me.
Since then, it's been one symptom after the other: eye pressure, heavy-head, chest pressure and pain, tingling and numbness in my lower left leg/toes and arm/fingers, heart palpitations and premature ventricular contractions, fatigue, feeling like I can't catch my breath, blocked/full ears and esophageal spasms. In addition to the symptoms in the preceding paragraph.
I've been to every doctor/specialist and had every test in the book: 3 laryngoscopies, upper GI endoscopy, throat culture, 2 chest x-rays, lung tests, EKG and echocardiogram, EEG, nerve conduction testing, sinus CT scan, ophthalmology tests, hearing test, numerous blood tests (including tests for anemia, white blood cell count,syphilis, blood sugar, thyroid function, and inflammation/autoimmune disorders), tuberculosis PPD test, x-ray of entire spine, balance/vestibular testing, including ENG tests, sleep study, and MRI of the brain, with and without contrast. All normal, EXCEPT that the ENG testing showed some "indifference" the vestibular response of my left ear. Vestibular rehabilitation therapy has only helped slightly; VR therapist is stumped.
I finally went to see a clinical psychologist, thinking she could help me deal with all of this. After listening to me for 30 minutes, she determined that this was all due to anxiety & depression, and wants to put me on Zoloft. Now my PC doctor, who's wanted to dismiss me as an "anxious female" from the start, just wants to medicate me w/ Zoloft rather than listen to me. Could all of the above really be due to anxiety/depression? My stress level's fine-only "anxiety" is not knowing what's wrong with me! If it is anx/dep, can it be treated effectively w/o medication? I've seen all the Zoloft "horror stories," so I'd like to use it as a last resort. Can cognitive-behavioral or other type of therapy work on its own? Thanks.
About 6 weeks after stopping Prednisone, I began to feel extremely dizzy and off-balance. (I.e., not the same as when I was taking Prednisone). Constant state of disequilibrium and BRAIN FOG: thinking now feels like "work," trouble remembering names, dates, etc., lightheaded and "floaty," hard to carry on a normal conversation without sounding like a ditz! This from a person who has a Master's degree and a 4.2 GPA! I just can't focus. My current job involves heavy intellectual writing and requires 110% cognitive function at all times, so the brain fog is quite distressing to me.
Since then, it's been one symptom after the other: eye pressure, heavy-head, chest pressure and pain, tingling and numbness in my lower left leg/toes and arm/fingers, heart palpitations and premature ventricular contractions, fatigue, feeling like I can't catch my breath, blocked/full ears and esophageal spasms. In addition to the symptoms in the preceding paragraph.
I've been to every doctor/specialist and had every test in the book: 3 laryngoscopies, upper GI endoscopy, throat culture, 2 chest x-rays, lung tests, EKG and echocardiogram, EEG, nerve conduction testing, sinus CT scan, ophthalmology tests, hearing test, numerous blood tests (including tests for anemia, white blood cell count,syphilis, blood sugar, thyroid function, and inflammation/autoimmune disorders), tuberculosis PPD test, x-ray of entire spine, balance/vestibular testing, including ENG tests, sleep study, and MRI of the brain, with and without contrast. All normal, EXCEPT that the ENG testing showed some "indifference" the vestibular response of my left ear. Vestibular rehabilitation therapy has only helped slightly; VR therapist is stumped.
I finally went to see a clinical psychologist, thinking she could help me deal with all of this. After listening to me for 30 minutes, she determined that this was all due to anxiety & depression, and wants to put me on Zoloft. Now my PC doctor, who's wanted to dismiss me as an "anxious female" from the start, just wants to medicate me w/ Zoloft rather than listen to me. Could all of the above really be due to anxiety/depression? My stress level's fine-only "anxiety" is not knowing what's wrong with me! If it is anx/dep, can it be treated effectively w/o medication? I've seen all the Zoloft "horror stories," so I'd like to use it as a last resort. Can cognitive-behavioral or other type of therapy work on its own? Thanks.
Doctor's Answer
by Roger Gould, M.D., May 29, 2006 12:00AM
, May 29, 2006 12:00AM
This is almost a typical story of the way generalized anxiety presents these days. Yes, psychotherapy can help without medications, and I would recommend that. But you can do a safe trial of medications that are directly at the anxiety, not depression. Ask your doctor for a brief trial of xanax or klonopin, then start therapy.
I knew that it was anxiety and depression, but some people have anxiety and/or depression and don't realize it. It sounds like you have anxiety. And I'm sure the dr. here will be able to help you figure some things out and I'm sure that if you took some type of medication you would feel a whole lot better and it doesn't mean you will have to take it forever and I had withdrawals from effexor xr (and the withdrawls were yucky) but I was fine after a couple weeks and it was well worth taking the effexor because it helped and it worked and I am fine now. If I ever get depressed again, I'm going to try therapy first or a combination of therapy and medications.
I hope you feel better soon.
I absolutely know that depression can cause the brain fog. I've been very depressed and had the same thing happen. I to have always taken pleasure in my intelligence and my love for reading and literature. During depression, I couldn't even read a page and tell you ten minutes later what it said. It actually gave me a headache to try to read or even think too hard. It was hard to even hold conversations with people because I couldn't really follow what they were saying. After my last bad spell, luckily I am in education and had time off during the summer and I found that the only remotely intellectual thing I could do was listen to books on tape. Somehow listening to it seemed easier than trying to read which was so frustrating, I wanted to cry.
I had also always enjoyed what I considered to be my quick wit. But my reaction time in depression was so incredibly slow and I could never keep up my end in witty banter.
Medication can help with all theses things. In my experience, it may get a little worse the first week or two, but then slowly over time it gets better and then after a couple of months I'm back to my old self. My understanding of how it works is that part of your brain is under functioning and it takes a while before it can get back to normal function.
Best of luck.