Where to go from here?

[Old Warrior]

53 yo male.  Have been active entire life.  2+ yrs ago, had two episodes tachycardia-stress echo showed "no ischemic heart disease and excellenct response to exercise".  About 8 months ago, started having "brain fog"--not headache or vertigo, but almost.  Went to MD.  MD did physical, including thyroid function--all is well.  MD said probably have anxiety/depression due to life's adventures over the past couple of years.  I fell off my bike and shattered a hip--long rehab and lifestyle changes--my mother died, I had two children get married, our oldest child and his little family moved 11 hours away, and we had major changes at work (I was the office director).  MD prescribed Celexa.  I tried 10 mg qhs for about 1 week--caused sleep disturbances and bizzare dreams. I tapered off over the next week. I have been going to a counselor for about 5 sessions.  She is not comfortable that my physical symptoms are consistant with just anxiety, said I might want to check with a neurololgist.
Over the course of the past 8 months, I have had almost no releif from the brain fuzziness.  I still ride my bike daily, but some days are tougher than others.
MD gave me a script for Xanax last week.  Took 1/2 pill one night without much effect.  Took whole pill next night and it knocked my socks off.  No more of that.
This past week has been especially tough, but that may be due in part to the fact that I also have a cold, and that makes my head stuffy as well.
I am a bit alarmed as my HR has been in the mid 70's the past several mornings, and it is typically in the mid 40's--doesn't feel like I am getting much rest at night.  don't know if this is related to the cold or the anxiety.  this hasn't been the case for the entire 8 months, so I am attributing it to the cold.
Can I work through this without the meds, if it is anxiety/depression?  Should I go find a neurologist?  I also have days when my neck also feels "tired"--no pain, but just feels fatiqued.  Can all of these symptoms be due to brain chemical imbalances?  BTW--I have tried 5 HTP and Sam-e, with no significant change.  I am taking Omega 3 (fish oil), B complex and sub-lingual B12.  I would really like to just feel robust again--it has been a long time.
Thanks

[Roger Gould, M.D.]

this has been going on long enough, and you have had enough physical exams to justify a good serious course of psychotherapy without medications.  Yes, if this is anxiety/depression as it sounds like, you can work it through without medications...I have a full practice, get good results, and not one of my patients is on medication.  but you must be convinced that your therapist knows what he or she is doing.  Since you did have a head injury, you should remain alert for the possibilty of trauma playing a role, so if specific symptoms come up, you should reconsider a neurological exam along the way.

[Old Warrior]

thanks Dr.  By way of clarification, I had no head injury, but have had some orthopaedic adventures.  How do I find a good psycotherapist?  The one I have been seeing is kind, but I just scheduled in with her through our EAP.
One thing this has done is to give me much empathy for those who struggle with anxiety/depression.  I used to be one of those "just tough it out and get over it" folks.  I think part of the problem is that I have been trying to just muscle through life.
Thanks again

[Kalio1]

I agree, the counselling might be a big help but I can't help but think you might still be dealing with a physical health issue. Have you been thoroughlly evaluated? I'd have more investigation done. Have you had your liver checked out? Liver issues can be hard to pinpoint and diagnose but can cause some of your complaints.

Im not saying that you do but if you have any past drug use, either IV drugs of any kind or intranasal coke use or received blood transfusions or blood products prior to 1992 you should be tested for Hep C.

[cheeps]

get yourself a sleep study. My doc has been after me for two years about my depression...sure i have some having been through some of the same stuff you have, I'm 49. Turns out I have Sleep Apnea and my problems are from not getting any REM sleep even though I'd stay in the bed for 9 hours. If you snore, are tired during the day, have body fatigue, or brain fog, you may have Sleep Apnea. Google it and read. Sara

[piper123]

Hi,
I had a 6 months of body illness starting with a kidney stone and then a case of giardia. I was presribed several meds over a short amount of time and to make a long story short my body went into defense mode. Suddenly I became really anxious about my health and really tired, my brain was fuzzy- I just wasn't my self. No matter what I tried, exercise, talking about it... I even was recommended by my doctor to try some anti depressants.. I was on Lexipro and klonopin- I felt out of it and just wanted to feel normal again. The worst was the brain fog..... after a recommendation I began to see a Naturopathic Doctor... It has change my life... Naturopathic doctors treat the body as a whole and because the meds were not working she took me off them and begain to treat me with a mixture of high quality vitamins and a diet.... with a mixture of eating (and not eating) certain foods at certain times and mixing them with certain vitamins- The change was dramatic. The change was relatively quick and I can not tell you how much better I feel. Hey it can't hurt trying maybe it will help you as well... The naturopathic dr. did not disregard the helpfulness of drugs in certain situations, but if they don't work- they is another way to go about it. make sure they are certified by the american association of naturopathic physicians... the website is www.naturopathic.org
hope you feel better.