this has to be more than just anxiety snd depression

[crazykoalabear]

I am 43  years old and  have been diagnosed with generalized anxiety and depression for over 15  of those years.   Have been in meds  on and off (xanax, lexapro, effexor,  and now trazodone)   and while those indeed curb my anxiety a  little and my depression,  there is one symptom they never cure:- MY  CONSTANT  MIND  FOG.  it us accompanied by fatigue  and my occasional  panic attack,  plus a  recurring insomnia.   the symptoms seem to have been worsening within the last few months,  bringing  the  attention of my  supervisor.

I  graduated from veterinary  medicine 14  years ago  and  got into private practice, but to me it is like I  have just got off school every day. I  have never been  able to recall what I have learned,  CONSTANTLY double  guess my  decisions.   Making  diagnoses  is a  constant  battle.   Always perceive all the cases as if they  were the first time I see  them ,   forget treatment protocols,  and when talking to clients  sound very insecure  and many  times " get out of my head  and tell  myself... WHAT THE HELL ARE YOU TALKING ABOUT?   YOU DON'T EVEN KNOW IF YOU HAVE THE RIGHT DIAGNOSIS  SO SHUT  THE *** * UP!" All of this in front of them. I am sure some of them coul read my eyesand feel my insecurity too..

it's a  horrible  feeling  to sabotage myself  this way,  but can't avoid it.   when I just graduated, I thought it  was because I  was too green  and needed to study more,  learn more  so I  have hundreds of veterinary books for reference, but no matter  how many  times I  review them, it is like the first time i read them,  nothing wants to stick in my brain.

not only that,  even my diagnoses are  mistaken many times, or say things that shoul be obvious or I an  left blank on the way to treat  something as easy as  an ear  infection

I always blamed  this  to my anxiety  and  depression, but  there has to be something else at work.   this issue is affecting  me  not  only emotionally,but  also  professionally.   I'm loosing my confidence and with that my clientele too.

don't know what to do.   the mind fog also extend to daily life,  and everything is  just  grey.   have difficulty  dealing with people because I  don't understand  them  most  of  the  time.   many  times,  humor does not make sense  to  me and they think I am  kind of...ODD.  I know im not supid because I graduated with good grades from vet school , though I admit had to wirk harder than the rest to get my degree.

Recent  physical exam  with  my dr  reveal I  have a  moderately severe anemia he's been treating,  and I  know that could be a  reason of the worsening of my symptoms, but feel  that  there is something else  underlying all these other symptoms.   can someone please help?   Has anybody felt like this?

Is  there anything I can do to  fix this?  I even  thought if  writing this profession  but my financial  responsibilities  persuade me not to do it.  

PLEASE HELP... SOMEONE!!

[nursegirl6572]

I agree that the insomnia could be the culprit, if it's bad enough.  Even mild recurring insomnia would cause serious focus and memory issues.  Anemia can also add to these issues, if not cause them.  Also, the meds could be contributing.  Long term use of some of these psych meds have been known to cause memory/concentration issues.

Could also be an undiagnosed ADD type of thing.  I would definitely recommend continuing to work with both your doctor and mental health provider.  You understand how a diagnostic/assessment process works and you know that sometimes it isn't always straight forward.  Sometimes it takes some time, many different studies and some different docs (with different perspectives) to find a reasonable solution and treatment plan.  I think it's logical to look at all of these as possible causes.  Being that this is not brand new to you (as you admit struggling in school also)...I would be more inclined to think that maybe there is something undiagnosed (ie ADD, learning disability).

I'm sorry you're going through this.  In the meantime, there are things you can do to help improve your functional level and confidence at work.  Cheat sheets are okay, write things down if you have to. Use a digital recorder to help you recall info easier.  Everyone learns and retains info differently.  You could be having a harder time performing in stressful situations because your work ethic is good, you don't want to let anyone down, therefore you're constantly second guessing yourself.  You DO have the knowledge, it didn't go anywhere.  Most likely, your confidence is holding you back most of the time.  Once you start second guessing yourself, you spiral downhill and then don't trust any of your instincts.  There are all kinds of cognitive therapy exercises (even cognitive therapy) you can try to help you be more effective at work.

After rereading your OP, I'm really wondering about possible ADD.  There is an adult presentation of that, or some people just were never diagnosed, hence the working extra hard to learn things.  You can't be subpar intellectually or you wouldn't have the job you do...therefore I wonder if the issue is more an ADD type disorder, or some kind of learning disability, where you struggle to PROCESS information.  That seems consistent across the board for you, whether talking about your education, your communication with clients, or jokes.

Best to you, please update us when you can!

[t0mr]

Have you ever had a concussion or trauma to the head.  It might not even have to be obvious trauma but from internal or circulatory reasons that can't be seen yet.  There is a great documentary about Iraq/Afganistan veterans that come back from the war and have similar inability to function.  Before recently everyone was grouped together as having PTSD/anxiety/panic.  The documentary shows a man who tells the story about how he was told it was his fault he was not improving from PTSD.  He could not do his job and his brain didn't work anymore.  So he was diagnosed wrongly for 4 years and blamed for not getting better.  Well it turns out that he like 10s of thousands of veterans have suffered concussions from things like IEDs and may have brain damage.  But the damage was so fine in many cases that it could not be seen by conventional MRI.  They now have an advanced brain injury center for the military and the MRI has 100 times the image resolution than they had before.  Now people are seeing why they are in pain and they are mad nobody believed that there was something else going on beside PTSD.  

Here is the link to the 60 minutes program called "Invisible Wounds of War":

http://www.cbsnews.com/video/watch/?id=50146231n  

Moral of the story: Psychology/Psychiatry hangs around until science and technology are advanced enough to give an accurate reason to a condition.

Have you had an MRI that came back negative?  Brain fog is what is happening to these veterans in many cases.  

[crazykoalabear]

I agree...I have told my doctor about ADD, but he thinks I  can't  have it since I  did well on school.  I  think  he  does  not  know  much about adult ADD,  which is different  from the children's ADHD.  Maybe need a psychiatrist,  since this is my  general practitioner. I  have a  few books on ADD I've been  reading.  I also  thought about  some other  conditions like a  mild  asperger.... but nothing  fits  the  whole  gamma of   symptoms.

As far as the insomnia, he recommended I  use some Lunesta  which  do far does not seem to help much.  I  am  doing aromatherapy  which has had better results,  but might  talk to him about some other treatment.  I will  even recommend him  the  one you  propose.  I agree... sleeping  disorder could really ruin your day

Thanks a  million  for  your valuable input!!!

[JGF25]

Did the doctor address your insomnia?  Not sleeping can cause a whole host of problems including brain fog.  I didn't sleep for a few months and let me tell you, at the end of it I was a basket case.  You can't help yourself when you are tired.  You can't think straight let alone talk straight.  You are obviously intelligent because you graduated from veterinary college.  It just seems to me that you are not addressing all of your problems.  The anxiety and depression are being treated with the medication.  But the insomnia is not.  I have to treat both.  I have to treat the OCD/anxiety with Wellbutrin and I have to treat my insomnia with klonopin.  

Also, what about menapausal issues?  If you are menapausal or peri-menapausal there could also be hormone changes going on.  

AND I'm going to add ADD into the mix.  Have you thought about that as well?  It is not uncommon to have both ADD and anxiety or ADD and OCD.  I have ADD (undiagnosed) and OCD.  That may be why you had to work harder to get through vet school.  Now couple ADD with insomnia and I'm surprised you can remember your name.  

Just some things to possibly talk to the doctor about.  

Take care.