The last couple weeks have been a confusing time for me. I have found myself in somewhat unfamiliar territory emotionally and physically. About three weeks ago I made a casual observation that my mind had become somewhat muddied. My cognitive processes seemed much slower and my memory had gone to pot. I was having a great deal of trouble recalling names from the previous chapters of my life, and I couldn’t seem to remember to do anything. Theses memory problems were most troublesome because I work as a salesman and forgetfulness is bad for business, but as time passed they worried me a little more.
Along with the mental cloudiness my temper was getting much shorter and as time passed my wife and I barely spoke without ending up making some sort of short, frustrated, and angry comment toward each other. About a week ago I began to notice I was doing things that made no sense, like forgetting steps of repetitive tasks I have completed thousands of times, and was becoming distrustful of myself which in turn was causing a marked increase in my anxiety levels. I had just come to the realization that I was beginning to slide downhill quickly when this weekend the tension with my wife exploded into a real open argument. She basically asked me what the hell was going on that I was repeatedly doing things that made no sense, or failing to do things that were obvious. It seems the greatest source of frustration on her part was that I had turned into a complete idiot.
The only other time I recall having these types of memory problems was right after my son was born. The sleep deprivation affected my memory, and I had a lot of problems with work until I figured out a system to deal with it. In time a slept again and the problem passed. I was never unduly angry in those days and I don’t remember feeling like I was in mental molasses I just forgot everything that happened in the course of a day. This time around my mind doesn’t feel quite right most of the day. I can’t focus and I forget things I am supposed to do moments after I am told I need to do it. I have always been a little absent minded, but of late it is becoming a safety hazard. You certainly don’t want me to be operating any heavy machinery, but my job requires me to drive the roads every day.
Over the past few days I have browsed through the ever dangerous WebMD reviewing the symptoms of depression, Chronic fatigue Syndrome, and whatever else sounds good. This can be counterproductive exercise and as my wife correctly points out, if I try hard enough I can make myself fit any of the criteria. It reminds me of taking Psych 101 in college. When we got to the chapters on actual psychological disorders the professor warned us that we would all think we had undiagnosed mental problems before it was over. It seems everybody has a few of those symptoms at some point along the way it becomes more a matter of severity. I have written before that WebMD is a hypochondriac’s best friend.
I had my last medication management appointment two weeks ago which was just before I started to become aware of the depth of my forgetfulness. I did talk to him about still having some problems sleeping and being slightly more anxious than I would like to be. The sleep problems are better than when they first started in July, but it can still take me 45 – 90 minutes to fall asleep. The average is about an hour. I have also begun to have a little trouble staying asleep waking up two or three times each night. I would say on average I have had 5 – 6 hours of sleep a night for the last four months. Some nights have been less some nights more. I have always needed about eight hours of sleep to remain functional and it appears that the prolonged lack of adequate sleep has begun to take its toll. The slow creep of the fatigue seems to have snuck up on me a bit so I didn’t feel it coming.
The question I ask myself now is why am I not sleeping properly? Back in the summer it was clearly anxiety driven, but that explanation doesn’t really make a lot of sense now unless I have become so numb that I hardly feel it anymore. Am I depressed? I don’t feel sad, but I also don’t seem to give two shits about a lot of things that I really enjoy. I have chalked it up to lack of energy, but that takes you back down the path toward depression. When you add it all up, anger, insomnia, loss of interest, and then put it the context of my history it sure sounds like it could be, but I don’t feel a great deal of sadness. If this is depression it has been disturbingly insidious in its arrival.
When I was talking to the doc a couple weeks back I asked him about SSRI medications. Most folks who will read this are aware of my distaste for these medications. I find the sexual side effects intolerable. I have only ever taken Celexa and Lexapro as they are supposed to cause the least incidents of these side effects. I asked the doc if there was any chance that one of the other medications would not lead to the sexual dysfunction. I was surprised at his answer. He indicated that the wider allowable dosing schedule for Zoloft would allow him to start with much lower effective doses and it was possible that we could use the medication to augment the Wellbutrin without getting to doses high enough to trigger side effects. Of course the only way to know would be to try and there are no guarantees, but he seemed to think it was worth a shot.
So it appears I have a decision to make. Of course I have allowed myself to reach the point where decision making is difficult. It is hard to muddle through the pro and cons when your brain is moving so slowly through a fog. I keep thinking if I could just get some rest things would be ok, but that rest never seems to come. I am taking a few days off in a couple weeks, maybe I can get some rest then, and come to some sort of intelligent decision.