Hey. I'll try to keep this short. I've been dealing with varying degrees of mental health issues for about the last 8 years(18-26). Doctors seem to be running out of ideas, so I'm looking for input based on reactions to things I've tried -- either for medications, specific areas to look at, tests to ask for, etc.
Current issues: extreme fatigue, anxiety, depression, cognitive function not what it was, can't execute basic things that will improve my life. Internal clock utterly fucked. Wake up 5-20 times/night. Get HUGE burst of energy at 1am. Tired the rest of the time. When I try something to improve one issue, it worsens others. E.g. improving fatigue worsens anxiety/probably increases suicide risk, improving depression worsens cognitive functioning and fatigue, improving anxiety worsens cognitive function, improving cognitive functioning worsens anxiety, etc.
Brief Medical History:
Sleep onset insomnia @ 5 yr old
Tourettes @ 10yr old
Chronic Migraines @ 10-18(then they basically stopped, 20-25/month to maybe 1 every month or two)
Pneumonia, Chronic Bronchitis/COPD out of nowhere at 17
Fatigue starts @ 18yr old, steadily worsening until now
Hypothyroid diagnosis @ 18(6.5 TSH), medicated for a while then stopped, now floats around 3 TSH / 24 FT4 unmedicated
Hypogonadism diagnosis @ 18, treated with Testosterone 100mg/wk
Anxiety @ 18-19ish, steadily worsening until now
Depression @ 23ish, steadily worsening until now
ADHD Diagnosis @ 24
Autism Diagnosis @ 25
Shingles @ 25
Sleep Apnea @ 25(haven't had full sleep lab/can't afford it, can't afford cpap, trying to get mental health to point where I can work and do this)
Medication/Supplement/Drug reactions:
Paxil: Turned me into a zombie(was when I was a kid)
Lexapro: First week I experienced happiness/appreciation/calm to a level I hadn't in years, after that was numb and lost my personality/motivation and wanted to kill myself/escape. Quit at 2-3 weeks.
Cymbalta: Same as Lexapro
Celexa: Same as Cymbalta/Lexapro. I'm not sure if I should try to push past the point where I'm suicidal and feel like I've been lobotomized. Maybe?
Vortioxetine: First week was probably close to mania/hypomania. Within 6 days had bad reaction that I went to the hospital for: blood pooling in feet enough that within 10 seconds of standing my feet were numb and swollen, high fluctuating heartrate(slow, to very fast, etc etc), shaking, myoclonic jerks originating from a mid-lower spine location. At hospital BP was 180/something. They basically dismissed it as sides from the drug and let me go once my BP dropped a bit. I quit the antidepressant after that, and had the myoclonic jerks for a few months.
Wellbutrin: Seemed to help energy and motivation, but created way too intense agitation, especially during sleep.
Tianeptine: Helps anxiety/mood a pretty decent amount. Have taken 25mg 2x/day for about a month long period, twice. Similar effects both times. I'm not currently taking it because I'm trying to find out what my issues are when unmedicated so I can reduce variables.
Adderall: Tried this for a few weeks, found it less effective than Dexedrine
Dexedrine: Used this for about a year and a half at 30-40mg/day (20/20, 20/10). This was fairly miraculous at first. Suddenly could effectively groom, clean house, socialize, actually get things done, didn't have anxiety, didn't really have depression although I still didn't experience common emotions like happiness/appreciation. Near the end it still helped like this, but also had mild mood swings and was fairly robotic. Quit this after shingles, since now it seems to cause nerve pain.
Ritalin: Less strong than dexedrine, but similar. Also makes me experience positive emotions more frequently. Unfortunately, while dexedrine removes anxiety, this seems to create it. And also causes the nerve pain.
Vyvanse: Just didn't find this as effective as dexedrine, felt weaker/lasted shorter duration even at equivalent dosage.
Concerta: Same as vyvanse.
Atomoxetine: Increased energy and focus, but also created a strong drive to suicide, stopped it within a couple weeks.
Modafinil: First time taking this it was like being awake for the first time. Suddenly could easily socialize with people and articulate myself and wasn't in a constant state of "ugh". Have never taken it for more than a month at a time. Currently have a prescription for it(Apo-Modafinil), and while it drastically increases energy, it seems to have an overall negative effect on mood -- strong agitation.
Pregabalin: Got this for shingles, and the result was that despite having crippling nerve pain I was actually in a somewhat calm/happy mood compared to my norm. A lot more desire to socialize. Dulled mental capacity quite a bit though, and withdrawal was hellish.
Phenibut: Have only dabbled with this. 1g gets rid of anxiety entirely and improves mood quite a bit, haven't used it enough to determine it's impact on cognition or energy. 500mg gets rid of most anxiety and improves mood slightly.
GHB: Tried this once, made me happy and calm and energetic.
Klonopin: Tried this once, completely got rid of anxiety. Stopped taking it due to risk of memory issues,.
Ativan: Basically ineffective, very very mild blunting of anxiety.
Caffeine: Neutral effect on energy, positive effect on mood and motivation, sometimes relieves anxiety sometimes creates it.
Nicotine: First time trying the gum it entirely got rid of anxiety, improved mood, focus, and sociability quite a bit. Still seems to do that, but my baseline is worse so it's not as noticable.
Alcohol: Totally relieves anxiety, helps mood, actually increases energy. That being said, I avoid it.
Psilocybin Microdosing: Improved mood, energy, focus, sociability, ability to articulate myself, ability to empathize with people, suddenly appreciated the people in my life, could actually enjoy things. I have no fucking clue why this helps so much. I microdosed for a few months daily and it was the best period of my life, but I don't have access to it anymore, and also am just sorta apprehensive of medicating long-term with something like this.
Testosterone: At first this drastically improved mood, energy, anxiety, etc. Still does compared to not taking it, but it went from improving everything to just keeping me alive, essentially.
Magnesium: Improves sleep quality, mildly reduces anxiety.
Fish Oil/Flax Seed: Improves mood slightly, reduces allergies
Choline: 600-900mg GPC seems to calm me a bit, reduces nerve pain.
B12/B100: Seems to improve energy and reduce anxiety slightly
Ketogenic diet: Been doing this for a while since I had some bad reactions to high-carb meals(stumbling, vision field becoming white, blood pooling in extremities). Those issues stopped, so still do this.
So based on all this, I'm not really sure where to go. I know I need sleep studies, endocrinology appointment, etc. But those are all 6-12 months away, and I need to make it so my life doesn't fall apart in the mean time. I'm essentially too fatigued to function, and my job sorta requires my brain to work well, which it's not currently doing. I could try dexedrine again and hope it doesn't cause nerve pain this time. I could use modafinil to improve my energy and use something like phenibut to reduce the anxiety, but while it seems less risky than benzos, it doesn't seem great. Based on how much GABA related drugs seem to improve my life, I'm guessing it's an issue that needs to be addressed in some way. Not really sure if there's a better way than phenibut to deal with it. I think I likely have some serotonin related issues based on how drastic antidepressants effect me the first week(e.g. I definitely never experience happiness or appreciation unmedicated, whether in a bad period or not). But they all turn awful in week two to the point of intense desire for suicide. I'm curious if bipolar is worth looking into given how strong the effect of vortioxetine was in the first week. In general I just have no fucking clue what to do anymore. If anybody has any ideas of what I should look into based on my past reactions to things/history, I'd appreciate it a ton. Thanks.
