Brain fog and Bodily Exhaustion

[Susan Jane]

The symptoms that are the hardest to deal with are physical exhaustion and brain fog. Trying to deal with CPTSD, depression and anxiety is very difficult when my physical health holds me back. I am so out of it that I can hardly begin to deal with the underlying causes. It’s as if my body is stopping me from getting to the roots. If I had a slightly clear head, maybe I could cope better with the depression. Eating right, showering and getting groceries are almost impossible. Do other people have this as well?

 

[Sideways]

I’ve definitely experienced the physical exhaustion in a big way in the past.

It’s counterintuitive, and incredibly hard, but for me the science that promotes physical activity as the way out of the exhaustion was on point. The less I did each day, the more exhausted I got.

Which is incredibly hard. It means acting in spite of how you feel which seems like an almost impossible battle each day. But setting small goals can be helpful:)

 

[Susan Jane]

I try to get moving and also forced myself to play some cards with the other patients. I feel slightly better when I do these things. The walk opened up some feelings and I was able to cry. It makes me feel slightly real, and more in touch with myself. I know that sounds strange but when I am severely depressed I don’t feel emotional just numb and sure that I can’t go on. Thanks for the tips.. I hope to keep up the small wins.

 

[Sideways]

Doesn’t sound strange at all - not feeling like a zombie can be amazing, even if it’s sadness or grief that breaks through, it’s something! And it’s signalling that there’s movement in your system away from complete shutdown, which is something to be optimistic about. Major depression episodes don’t tend to change in big dramatic ways, we inch ourselves out of it.

When I was really depressed, I kept a daily Function Meter. It was a way to track my function - objectively, how am I doing? Because I know if I just leave it for my brain to assess, my brain will tell me I’m doing terrible and spiralling down!! It also allowed me to have a visual reminder of my wins each day, to maximise neural plasticity in favour of recovery.

It was just a list (on old fashioned paper - the physicality of it was important to me) of 10 daily activities, and each day I’d tick off what I’d done, for a daily score out of 10. Like a SUDS score, but for ADLs.

The activities were a mix of easy to moderately challenging, but all geared towards behavioural activation. Think: eat 3 meals, shower, change my clothes, go for a walk, leave the house, talk to someone, brush my teeth twice. Seeing myself tick things off helped rewire my brain from that stuck / hopelessness / helplessness place that depression both fuels and feeds on. And it helped me get basic function back on track - if brushing my teeth before bed gets me an extra tick, and extra point for the day? Then I’d do that, rather than not. And my brain is confronted with 5/10, rather than the 0/10 that it’s telling me is all I can manage.

I know you know a lot of this. And it’s stuff you’ve noticed in yourself - for example, despite feeling like you absolutely cannot get out of bed, somehow we pull off getting to therapy each week… That’s the deception of depression, and the downward trend that behavioural activation tends to help break. Knowing in advance “my brain is going to tell me I can’t”, and doing the thing anyway.

For me? Physically tracking those achievements somewhere was critical. Otherwise I wake up the next day and my brain has already brushed those wins under the rug so it can remind me how hopeless everything is.

So, thanks brain, but actually even though it feels like I can’t get out of bed, yesterday I went for a walk AND played cards with the ladies and that opened me up to my emotions again. I’ve got it right here, written down, to remind me that I’m capable of this.

You can do this. It’s not easy. It won’t happen quickly. But going for a walk, socialising over a card game (requiring actual concentration!!) is actually 2 epic wins when you’re neck deep in a depressive episode. Take those wins, celebrate them, know that’s the exact momentum that will steadily bring you back out of this dark place.

(Sorry for the long post - I just relate a LOT to your experience!! And want you to know it does get better, and it is worth it).