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Thank you for writing this.

Last December I started getting some kind of weird 'fog' in my head. I didn't take it seriously when it first started and thought it would go away on its own. But instead it became worse and I got severely cognitively impaired. My speech got slow, I forgot basic words, I forgot names of people I knew, my logical thinking was impaired. It improved a little bit but I'm still incredibly cognitively impaired.

I spent hours searching online, using complex search queries and APIs to gather a lot of info on other people that report the same symptoms. This wasn't because I felt anxious, but I just really wanted to continue with my life ASAP and my symptoms seemed very vague. The conclusion was that, besides some medical causes, people with the same symptoms usually had anxiety.

Since I don't feel anxious or depressed and it appeared suddenly I still want to rule some medical causes out. But it is comforting to know that when all medical causes are ruled out, there is still a huge chance of it being just anxiety.

You may want to attempt to improve your sleep. Foggy head with reduced cognition and memory loss are pretty major symptoms of long term inadequate sleep. They’re very common symptoms that parents of young children complain about, and can have some very long recovery times. Personally it took almost 6 months to recover once my first child started sleeping through the night. All it takes is an hour a night deficit for an extended period of time to really impact mental acuity, but you might not notice because it’s almost enough on a daily basis, and by the time the cumulative effects show up, it’s not always obvious sleep is the culpret.

Thank you!

Actually right around the time my cognition became bad the quality of my sleep also got worse. I sleep 8 hours every night but most days I don't really feel rested, although I neither feel sleepy during the day. I've done a sleep study and I'm seeing a neurologist specialized in sleep later this month to hear the results, I hope he has an idea.

I had a really rough month where my 2yo was jet lagged and waking up crying multiple times a night. After that I've had two months of anxiety on and off, this is really helpful. Have always suspected that sleep could have been the trigger but didn't realize that an hour a night could make such a huge difference. Cheers!

And of course this is a self-reinforcing downward spiral. Sleep quality destroyed by kids, underperformance in all areas of life due to sleep deprivation, anxiety and stress due to underperformance, making it harder to get to sleep...

I was going to say the same. That sounds like my on chronic sleep deprivation, and as you say, after months or years of sleep deprivation it can take weeks of consistent good sleep for the symptoms to fade.

I experience brain fog about once every two weeks in exactly the way you describe and I've thought it's anxiety as well. I tried describing this to a psychiatrist and a cardiologist and neither of them took me seriously and said it's nothing. The only thing that helps me is meditation followed by weightlifting, and it helps tremendously. The hard part is that it always occurs around late-morning/early-afternoon, so if I'm at work I just have to suffer at my desk and get nothing done for the rest of the day.

I came across the mental disorders 'depersonalization' and 'derealization'. People usually describe it as feeling foggy or like a dream. Maybe that might be what you mean and help you explaining it.

The 'depersonalization' is probably the 'fog' I'm talking about. But I know that sleep deprivation can also cause it, so I hope that I have something treatable related to my sleep.

I had this problem and assumed I was just getting older and dumber... In my defense my thinking was impaired at the time. I had a sleep apnoea so I echo people mentioning sleep issues as a potential cause.

Sounds like Sleep Apnea, maybe get a sleep study.

Did you by any chance get tested for glandular fever?

Ok I'll bite: glandular fever is commonly known as Mono. What that got to do w/ the heart problem and anxiety?

They're not replying to that comment, they're replying to the comment about the brain fog.

Have you had any mood / behavioral changes from the lexapro? I similarly stacked up a ton of doctor visits due to dizziness, chest tightness, blood pressure spikes, etc...

My doc is leaning towards the same generalized axiety /panic disorder, but were currently experimenting with just taking an antihistamine to calm down. "Real" medication is the next step, but, honestly, the thought of having to take something "altering" for the rest of my life is itself anxiety causing.

The most bizarre thing with the whole whole anxiety business was its sudden onset. Everything was fine, and then one day it wasn't.

Lexapro preserved my personality shockingly well. A friend who took it said the same thing. We felt like ourselves the whole time, just without so much anxiety. If you drink caffeine or consume sugar, the "altering" thing is already out the window. And it doesn't have to be your whole life. I'm off it after a few years.

The only downside to lexapro was that my anxiety and depression were partly if not primarily the result of a bunch of poor mental models and resulting poor life choices. I believed a bunch of mean shit about myself, and so looked after myself with a commensurate neglect. On the meds, I kept living poorly; I just wasn't so acutely distraught about it.

It did work to alleviate my anxiety, and in the process train me to catch panic attacks early and think myself out of a spiral. I'm glad I took it when I did, because it helped and I didn't have the courage or wherewithal to go to therapy that early in my life. But I'm also glad I'm off it.

Unless your anxiety is seriously debilitating, I would suggest you spend 6 months in CBT / talk therapy, before going on medication. Or go on em but also do therapy simultaneously.

Either something in your mind is generating this anxiety, and it's worth it to get under the hood and treat the underlying issue. Or it's truly random, and it's a good idea to train your mind to be resilient to such things.

We initially tried Metoprolol for, but we found that while it stopped the palpitations, the panic attacks still happened just as often. For me, Lexapro really was a win/win drug. My personality hasn't changed much aside from the fact that my overall emotions are a bit more muted. If my normal emotional range is a 0-10, on Lexapro it's closer to a 3-7. There are some sexually related side effects that you may want to look up as well. I have personally experienced some, but I don't consider them serious by any means.

And my attacks, like yours, just started happening out of the blue one day. No real prior warnings.

Similar situation. I kept going to the doctors for a while, but they insist everything is fine.

I’ve got anxiety in general, but also some more specific health anxiety from a history of being obese. I’ve fixed the issue now, but the statistical reason to believe that _this time_ there’s actually something wrong doesn’t help the anxiety.

I spend a lot of time convincing myself that yes, I can in fact breathe right now, and no, I’m not actively dying of a heart attack. Very stressful situation

Had almost exactly the same problem, down to identical symptoms -- same side of my body, etc.

My guess it that it's due to some supplements I was taking years ago (chiefly 5-HTP and magnesium) causing chest pain and/or heart palpitations, and the experience of that etching trauma into my psyche in a way that makes me experience physical symptoms. The worst part is that it feeds on itself, until I was sitting on a sidewalk having a panic attack causing massive hyperventilation and crushing chest pain, certain I was having a heart attack, barely able to dial 911.

Unfortunately it took $8000 in hospital bills from multiple emergency room visits to figure this out.

Similar experience, including multiple trips to the ER fearing my imminent death. Still waiting for the bill on the latest one. The first time it happened I had dialed 911 on my phone but stopped short, fearing the impending life-ruining debt it might plunge me into. Thankfully it wasn't actually a heart attack, but the fact that people even have to stop to make a risk assessment like that is dystopian.

As for the symptoms, it is indeed astonishing how "physical" anxiety can be. Most people conceive of anxiety as just an emotional state, and think a "panic attack" is what you have when you're really nervous about a math test and get a cold sweat. The true horror of a real panic attack can't be described to someone who hasn't experienced that level of mortal terror.

And it's definitely true that once the trauma is "etched" into you like you describe, your mind can reconstruct it again much more easily. I find physical sensations that used to be mildly annoying, like a stomach cramp or post-exercise exhaustion, can summon the anxiety right back again.

The scientific evidence for the long-term effectiveness of SSRIs is dubious at best, so I'm attempting a more comprehensive life change to improve my outlook, including trying to build stronger connections with people and community. Isolation is one of the most intense causes of depression and anxiety, among other health problems, so addressing it is a good idea for anyone.

It is saddening to hear that the fear of resulting financial debt due to hospital bills, stopped you short from dialing 911 in such a precarious situation.

There goes my fantasy that in the west at least health care was top notch and affordable compared to Africa.

The propaganda we export out of the US regarding our wealth is self-delusion. A lot of people here believe many fantastical things that should be trivially dispelled by skimming GoFundMe's Discover page.

What? We're far wealthier in the US than the vast majority of the world. It's not propaganda, it's data and fact.

Healthcare and education are generally more expensive here than in Europe, but people also get paid more here and keep more of their salaries than in the rest of the developed world. Goods are much cheaper in the US than in Europe and we generally enjoy more material wealth than the Europeans.

You are deluding yourself with your bigotry against the US.

Why do you attribute this to 5-HTP and magnesium? I take both, and other nootropics, and also experience similar symptoms when I’m stressed.

5-htp is associated with increased anxiety / panic attacks. Found out after I got one. (Racing heart, palpitations out of nowhere, spent a night in hospital doing bunch of heart tests.) There is very little research on it, because it's not patented, but try pubmed etc. iirc it increases anxiety especially in the first days, weeks then it levels out.

For me it was palpitations from 5-HTP. Heart skips a beat, then sudden extreme vertigo and anxiety skyrockets. This happened several times a day.

And magnesium caused a dull, ever-present pressure/ache in the left side of my chest that went mostly away (except when I'm very anxious) after I stopped taking it.

That's interesting. I've actually found that it, coupled with other nootropics, reduces my anxiety by quite a lot. I've been taking it for a couple months and haven't had any negative side effects. I used to get "racing heart", palpitations, HBP, and other symptoms when I'm stressed (which now I'm attributing to the general bucket of "anxiety"), and these supplements really help calm my nerves throughout the day and I haven't had many symptoms since.

I had a very similar experience. Started when I was 25 after a 3 month stint of being unemployed. It started with a panic attack (which I thought was a heart attack at the time), and I ended up going to the hospital, a cardiologist, sleep clinic, gastro, etc. until eventually came to the conclusion it was nothing wrong with my heart but rather panic disorder.

I take a low dose of xanax now and all the symptoms went away and I no longer have panic attacks. I'm working on finding a better daily medication, but it completely changed my life to have a temporary solution after 3+ years of struggle and suffering with panic attacks multiple times per week.

So I just have to ask because I've experienced tons of panic attacks but also have very strong family history of death by cardiac arrest -- Is there a subjective, experiential way to differentiate between the two? I always assume it's a panic attack "and if it's not just die in bed" but...

The problem is that both heart attacks and panic attacks share a variety of symptoms and even just learning about certain symptoms of heart attacks (after our CFO died of one about a year back) has made those symptoms manifest during my panic attacks. The other thing that makes this difficult is that anxiety attacks, panic attacks, and heart attacks don't have consistent symptoms among all individuals.

So it's really a crap shoot. I had a lot of cardiac work done, so I can pretty confidently say for the next decade or so, barring go through any drastic lifestyle changes, that my heart isn't going to go out on me. But I also found ways to mentally explain all the symptoms I was experiencing and deescalate myself.

Problem: "My chest is hurting." | Question: "Am I hyperventilating?" Problem: "My jaw is hurting." | Question: "Am I clenching my teeth?" Problem: "I feel short of breath" | Question: "Can I force myself to do breathing exercises?"

I agree with what jdsfighter said - you should go to the doctor to get some confidence that there isn't some sort of underlying heart issue. After that though, it's really a mental game that requires/required some therapy.

My panic attacks last from 3-10 minutes typically and can go up to 90 minutes. I wear an Apple Watch which would (hopefully) let me know if I had an arrhythmia. I also check my heart rate when I'm having a panic attack (which sometimes doesn't help) and I try to see if it's consistently going up, or if with deep breathing I'm able to get it to go down. Lastly, I have the xanax, which usually fully kicks in within 10-15 minutes. My attacks have the shortness of breath, feeling like I can't catch my breath, rapid heart rate, tunnel vision, etc. I try to find a calm/quiet space to relax, listen to my Calm app, and if I'm lucky, lay down for a bit.

Same! I even got my appendix removed and probably didn’t need it. My cardiologist is who finally told me that it was anxiety and convinced me.

I never took medication though. Just cut back on caffeine and lots of rest once I get wound up.

>>I had a variety of symptoms and none of them immediately seemed to shout "anxiety" to my physicians

This is usually not true in most cases, it's actually something a good GP will explicitly consider by asking you the questions.

Maybe it was not possible due to something about your example, but it's recognized all the time in similar cases.

It's also a case for having a regular doctor in some form, because it's easier to recognize based on how well they know you.

I'm a doctor. I can tell you that even if I think a middle aged man with chest pain has anxiety he's still getting a full cardiac workup. Even a 20yo woman with anxiety will get a cardiac workup. It doesn't sound like these doctors missed anything based on this story. It sounds like they were ruling out the stuff that'll kill you quickly.

I don't see where we are disagreeing? I'm not arguing against triage.

GPs were mentioned - I'm simply stating that it's not uncommon that a patient comes to see a GP questions are asked to elicit the role of stress and anxiety in the situation as appropriate.

This does not rule out other care or take precedence over it as you know.

Reading your comment now I also don't see where we are disagreeing. Though, I didn't say we are disagreeing, and I don't see why we need to.

Edit: Did you by any chance edit your comment? I swear the word "miss" was in there.

My mistake then in inferring that.

I don't recall making such an edit, usually I would note a change in semantic meaning, I believe the primary error was inferring a contradiction.

Thank you for clarifying.