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Ask HN: How to restore cognition after years of trauma? I feel slow and dumb
119 points by dezeiner on Jan 6, 2023 | hide | past | favorite | 87 comments
From impaired long-term and working memory, clarity of thought, mental agility, to executive function, it feels like the depression and anxiety caused by trauma have completely blunted my mind to a debilitating degree. Acquiring, integrating, and productively applying information is an enormous challenge. In meetings, I feel like a mental sloth. I've tried a variety of antidepressants, psychedelics, and supplements, to no avail. Talk therapy has done little.

Has anyone been able to cognitively recover?




I've been struggling with this for years and I've made tremendous progress in 2022. Here's what worked for me:

- developing a regular aerobic exercise routine. Starting my day with a walk or run makes such a difference, I feel like a different person after I exercise

- reducing/cutting out substances. I love cannabis but I recognize that it exacerbates my ADHD symptoms, reduces my desire to connect socially and reduces my cognitive ability. Alcohol disturbs my sleep as well. If I don't keep tight limits on my consumption and take long breaks between use, my mental health declines significantly

- find a constructive activity that you love to do. I've fallen in love with painting. It gets me off the screens and relaxes me while giving me a sense of personal accomplishment and growth. It gives me space to appreciate myself and cultivate self-compassion and love. Don't try to make it a side hustle, just something that you enjoy and helps you unwind

- practicing a self-care/personal space cleaning routine. I still struggle with this and by no means keep a 100% clean house all the time. But I know that no matter how bad I'm feeling, I always feel a little better after cleaning. If I'm having a really bad day, I try to clean at least one room in my house (and once I do one, I usually feel motivated enough to do more)

- psychiatric drugs have not worked for me personally, but that certainly doesn't mean they won't work for you. The key to recovery is making them a part of a larger commitment to your overall health. You cannot simply take a drug and ignore the other aspects of your life. Americans have been conditioned to think that a pill solves everything, but this could not be further from the truth


> psychiatric drugs have not worked for me personally, but that certainly doesn't mean they won't work for you. The key to recovery is making them a part of a larger commitment to your overall health. You cannot simply take a drug and ignore the other aspects of your life. Americans have been conditioned to think that a pill solves everything, but this could not be further from the truth

Fellow ADHD'er here, and I am starting to realize this too. I made it through more than 2/3 of my life without treatment, but have sought treatment for almost a decade now. In hindsight, I am not actually sure the treatments really helped as much as I thought they did during those times. I sometimes wonder if the psychoactive effects of treatment merely make me perceive like I am more productive than I am in reality.

I believe the treatments obviously had an effect, but the benefits came with their own costs. Therefore, I feel like I have consistently had a net-gain of 0 improvement. Treatments seem to help with more physical symptoms than mental i.e., lessened hyperactivity but not much improvement in executive functioning.

I feel like I was promised a panacea with how doctors, research, and various anecdota describe the effects, but have been left with a more disappointing reality. I have been debating stopping treatment, but I fear there could be negative repercussions as well.


Good god, if you’re feeling slow or dumb DO NOT SMOKE WEED. From personal experience and that of my friends, weed severely affects attention span and mental focus.

I experimented with it as an alcohol replacement. I had to stop because I’d forget the point of my sentence before I got to the end.

My buddy is a great guy but cannot focus. He’s worse when he’s been smoking. My nephew too. He utterly fails to understand verbal direction after he has been smoking. Also my two friends in jr high went from sharp and smarter than me to barely keeping up. I know that’s not science, but it’s good enough for me (and there’s no scientific study that disagrees)

I’m not anti weed (it’s legal where I am and I’ve used it and had fun) but if you need to focus, please for the love of god, avoid the stuff.


Thank you so much for this comment. And to OP for posting this question. Reading both your posts I felt as if someone had read my mind. I really appreciate the time you took to ask and share you experience.


Yes. I'm still recovering (in year 5 of therapy) but notice a night and day difference in my capacity to focus and be present and alert.

> Talk therapy has done little.

I honestly don't think recovery from trauma can be achieved without psychotherapy. You can cover it up, but it's still going to impact your thoughts, feelings, and behaviors to some degree. You might get lucky with things like psychedelics, but finding the right therapist and right therapy will bring about change more consistently.

The challenge, however, is that there are many styles of therapy and many styles of therapists. Also, there are different types of trauma (eg. shock trauma, complex trauma, attachment trauma) that require different approaches to treatment. I was lucky in that I found a therapy and therapist that worked for me in my first try. My partner, however, went through 7 therapists over the course of a few years before they found a good fit. Any decent therapist will not be offended if you tell them you feel therapy is not going anywhere, in fact it's in their code of ethics that they need to help you find a better fit.

What works for me isn't going to work for you, but here's my opinion (that you didn't ask for) on therapies that are better at treating trauma than CBT or "traditional" talk therapy: Internal Family Systems therapy, EMDR, the NeuroAffective Relational Model, and Somatic Experiencing / Sensorimotor. AEDP and Coherence Therapy are also decent options. If CBT is all that's available, at least try to find TF-CBT (trauma-focused).


If you have enough saved up. Take 1 year of work, disconnect from the rat's race, go to parties, go dancing, chill at a park, let people look down on you for being unemployed. Hang in there, buy only the things you need.

Slowly you'll realize what's important, you'll find yourself. And you'll come back stronger than ever, with a different attitude towards careers, jobs and you'll learn to be human and just BE.

EDIT: YMMV, Not advocating for social isolation and complacency


I’m in the exact position as the OP. In fact this feels like a description of myself. I could barely achieve the simplest of tasks, so I quit my job. I just did nothing at home for a bit, now I’m backpacking. It’s been 2 months and so far my mental health hasn’t improved one bit. I still feel like my brain is trapped in mud; anything that requires minimum mental effort takes an insurmountable amount of energy. I’m not any happier. I might even be less happy. The only good thing is that I’m no longer letting people down. I’m not convinced I’ll feel any better in a year.


If today you only had 20% to give, and you gave it. You gave 100%.

If today all you could do was: Brush your teeth then go back to bed. You've accomplished.

We are not PRODUCTIVITY MACHINES. We are humans, just like birds are birding, squirrels are squirreling, bees are beeing?

I'm not saying to stay complacent, but we humans in this current society have set ourselves for failures.

OMG! I'm not making 250k a year, i'm a failure, I don't have a TRILLION dollar startup, I'm a failure (not saying you feel this way) but you get my point.


> If today you only had 20% to give, and you gave it. You gave 100%.

> If today all you could do was: Brush your teeth then go back to bed. You've accomplished.

I think this is especially important to remember during the negative self-talk cycles. For awhile I would try and push through telling myself things are in the past, I have moved on and it's time to look forward etc and would fail miserably. Then would hate on myself for failing my expectations on top of losing my ability to connect thoughts like I use too, or even come up with new ideas or see how systems worked anymore. So I started traveling regularly, 8-10 intl trips a year (with a few domestic) and while there were flashes of brilliance, mostly it was as dull and numb as everything else, and only slightly helped with life satisfaction, but not so much for the cognitive issues.

After a few years the slivers of color started coming back into my world, then covid hit. Right around the start I came down with long covid for about 12-18/mo (I assume, my mental processing felt like it no longer existed/got even worse than before and that it would never come back this time).

The negative self-talk cycle started back with a vengeance. At one point I started having panic attacks which I never had before, and at the time, didn't know what was happening. It forced me to accept the small steps forward. Where, if today I can take a shower, put on clean clothes and go to the grocery store and systematically go through the isles picking up each item without getting annoyed by other people "in my way/front of what I need", it was a successful day. With bonus points if I acknowledged other peoples existence or engaged in pleasantries with someone (most likely the cashier). These kinds of actions/goals were not the types of things I ever thought would make me feel like I had a successful day. Learning to see success in way that success was measured by what I could do - really changed things for me.


> OMG! I'm not making 250k a year, i'm a failure, I don't have a TRILLION dollar startup, I'm a failure (not saying you feel this way) but you get my point.

I struggle with this thinking. My job is nothing glorious -- boring, plain SWE state government work. I feel unvalued and unchallenged, but I also do not feel confident enough in my abilities to make any meaningful changes. What if I leave and/or and can't find anything? What if I find something and cannot perform well enough to keep it?

I feel like I am not "ready" to leave because I need to gain more valuable skills and knowledge, and I won't get it at my current position (Gov isn't really known for being up to date or using highly valuable tech stacks). I know I could probably accomplish more if I buckled down and put in the work, but I just don't have the mental energy or drive to do so for some reason.

But what if I do land some killer gig? Will I finally be happy? Probably not, and I never want work to be my entire life -- just a means to fund other areas of my life. So, I often flip-flop on if this whole "career game" is even worth playing. . .


I was in a similar position to you a couple of years ago. Burned out and quit my job, burned through my savings instead. After two months I felt no improvement and was beating myself up for being a failure, but after ten months I felt oddly re-energised, and ready to resume working.

I don't know what changed, I think it was just time taken to recover my mind. I wish you the best, it's a difficult state of mind to be in.


Thanks for the comment, really appreciate it! I was kind of expecting a gradual change but it’s good to hear other people have been in the same boat.


Same here. I started feeling much better only after 9-10 months off work (stay at home parent). Then returned to the same grind and one year later quit with a plan for a longer break. But after 7 months found a great matching job for me and wanted to go to work again.


After years of burnout and depression, I've just finished 6 months sabbatical and in retrospect, I think mental improvement started at ~4 months in. After 6 months I felt like I went back 5 years.


Reminds me very much of this SNL skit https://www.youtube.com/watch?v=TbwlC2B-BIg


Imo, that's perfectly normal and to be expected. If you're part of a bad system, leaving that system will often be worse at first, but hopefully better in the long run.


This is risky advice. Many (most?) people need social context to create meaning and will get depressed if they don't have a job to do and people relying on them. Look at what happens to people when they retire.


Yes this is what I discovered. Being on your own for extended periods without anything to do can be terrifying and even worse for mental health.


Not advocating for social isolation! Maybe work is where you find meaning socially. But there are : church, gym buddies, so many other social outlets.

I'm saying it's okay to not WORK for a living. You can work on hobbies, things that bring you joy, volunteer, but just not be on a 9-5 schedule and just chill for a while, to recover.


I agree. I did exactly as the above comment suggested, and ended up much more depressed after the fun time ran out.

Definitely take time off, but impose a limit on how long you are completely aimless for, or without feedback that you're growing in some way.


What happens to people when they retire?


Appreciate your advice, but this is generally what I've done in the past year, save for a few gigs, and it has only worsened my mental health due to the lack of structure, stimulation, and engagement that having work and colleagues usually brought.


I did this and then spent two (unplanned, additional) years trying to find another gig. I burned through maybe 2/3 of my savings doing this, and that made for a lot of stress and some dark days.

A break from work is definitely a good thing, but I'd add the suggestion that you get as solid a promise/prospect of re-employment as possible to eliminate stress during your time off.


Okay, I understand this likely not what you were expecting as an answer, but this is based on my own personal experience as well as reading I did before changing my way of eating (specifically the meta-analysis of dozens of scientific papers in Gary Taubes "Why We Get Fat")

Switching to a keto diet (under 20 net carbs a day) had an immediate and lasting effect on my mental acuity, mental health, energy levels, and overall wellness. I had persistent brain-fog stemming from stress, overwork, bad health habits, and a case of Mumps which left me feeling like a shadow of my former self.

Within 36 hours of changing the way I ate, I felt like I was finally back to myself. I had my quick wit, energy to dig into problems, and a desire to move and do things instead of rest, eat, and wallow.

I'm happy to talk more about it if you're interested, but I'll keep this brief and simply say that trying a 3 day experiment where you keep net carbs (carbs minus fiber) under 20 per day may have a dramatic effect and give you the energy to begin to address other root causes.


Just please pay attention to your electrolytes while trying this. I'm a big fan of keto. However please learn how the body responds. You may need to purposefully add electrolytes (yes including salt) to offset what ends up being flushed out. Often people can become light headed, experience sick like feelings (aka keto flu), and even pass out. All due to a need for electrolytes.


Great to see someone share another data point for keto. I shared my verbose anecdote above.


I experienced what you're describing after my first company failed 8 years ago. It was pretty scary to think my brain might be permanently damaged.

However, after 3-5 years, my capacity for critical thinking basically returned to normal. To this day, my working memory still seems worse, but it's unclear whether that's simply because my days are now filled with crazy amounts of multitasking.

All said, the major effects you're describing subsided after a few years for me. I did some talk therapy, and I also spent a good amount of time redesigning my personal values to not include extrinsic variables (such as being intelligent).

The biggest thing I did was just waiting for my body to recover. Be patient and if you're anxious about the time it's taking, then spend some time realigning your values to your reality, which will help relieve your anxiety.


The Body Keeps the Score lists a variety of therapies, and trigger warning, contains details about traumas of people the author has interviewed. Good luck.


I second this book. Somatic therapies and IFS helped me especially.


For me, general low energy and brain fog for years was low thyroid level. Your level could have been declining for a while unrelatedly, but at the same time, as your trauma. In addition to level, after diagnosis and initial mitigation via artificial thyroid replacement medication, I had to switch to natural thyroid replacement. Finally, had to adjust diet too; finally back to a generally decent state. Get checked and rule this out!


When I was in my late 20s, I was taking college courses in the evening after working a 9-5 software job. On the nights where I didn't have to go to class, I usually had homework to do, and I found it really difficult to switch gears after a day at work to get into homework mode.

I'd also joined the company softball team, and I noticed that on the nights where I got back from playing softball after work, it was almost effortless to roll up my sleeves and start on my homework.

It's sometimes difficult to pause an overdue/critical task to go take a 30-45 minute walk, because it just seems like wasting _more_ time. But I've found that after a walk or some kind of exercise break, I often become "un-stuck" on a task that I was bogged down or procrastinating on.


I would go see a doctor but that's what worked for me: - Elimination diet. It took me years to realize every time I eat eggs or food with wheat flour I get brain fog/mild depression for the following 2-3 days, that disappears completely if I abstain from them. - Make sure I get cardio on most days, if you can't run then walk at least 10k steps a day. - 1 cup of good quality coffee in the morning


I’m 11 days into a full elimination diet right now, and also 5 weeks with no sugar wheat, dairy or alcohol. It hasn’t turned my life around, but I feel 10x better already. It’s a really good thing to do - but difficult.


No magic advice from me either.

I will say that as a pretty practical, science-minded person, I generally don't get into stuff that seems like woo pseudo-science. But years back I had an agreement with a neurofeedback practitioner (eeg biofeedback) to accept free treatment in exchange for giving her a journal of my experience. And I still believe it helped me quite a bit. It might be some of the same benefits of meditation, but I had never successfully been able to meditate before doing that.

Other than that, I've only got the same probably-trite-sounding drink plenty of water, get lots of sleep, try to keep up your physical activity levels... drink amino acid shakes...

Best of luck to you.


I was just posting about this too! What style of neurofeedback did your practitioner use? I've been working with someone who uses the EEGer system, and am curious about alternatives.


I don't remember the name, but I had headphones, and stuff stuck to my head with gel, and glasses that would flash lights through my closed eyelids. The part I remember most is it taught me how to "relax" parts of my brain in ways I hadn't before, and which I can do now on demand without any hardware.


Anger. Get angry.

A lot of trauma is internalization. You blame yourself. It's made to be your fault. You're told you're a terrible person. Get mad about what happened to you. Anger is your tool for being pissed off and asserting your boundaries.

https://cptsdfoundation.org/2022/05/31/the-importance-of-ang...


This is insanely bad advice, IMO.

Anger is very hard to control, can easily backfire into self-loathing and cause you to strain existing relationships, which can also further fuel internal anger at oneself. If you get mad about what happened to you and start lashing out at others, you risk isolating yourself and deepening your depression.


I'm studying emotional philosophy and I think it's great advice. Executive function disorders stem from an inability to healthily feel and use anger. If you had a parent who monopolized expressions of anger during your childhood, you're going to have problems with executive function as an adult.

Fear and anger are like look and leap. People who can't feel anger can only look and never leap.


> If you had a parent who monopolized expressions of anger during your childhood, you're going to have problems with executive function as an adult.

Why is this the case?


Anger's the 'do something' emotion. We associate it with the big 'do something' events like flipping over a table, but it also governs everything you do all day long.


Nearly every statement in this entire thread needs to have a 'maybe' inserted somewhere in it.


Second this - it can also cause a split personality, the usual inner monologue becomes abusive as you blame yourself, so you get angry at it, which feeds the condition.


Too much anger is bad. Suppressing justified anger might be unhealthy though. So long as it's moderated, anger can be an appropriate response to some things.


anger/rage is different than violence. You can channel and physicalize anger healthily, but you also have to take it slow when learning how.


I am not a doctor. The biggest thing for me in the last couple of years has been physical health. Exercise, eating correctly, and proper sleep have resulted in a huge improvement in my mental acuity, and relieved a sense of I had of "I'm not operating at my actual capacity."

This advice can feel trite, or it can feel overwhelming. Changing physical habits when you're already depressed is a huge undertaking, and I don't want to minimize it. However, my revelation has been the mind truly is not separate from the body, and taking care of myself by running, lifting weights, falling asleep at the same time has had largely outsized benefits vs any medication or therapy I've tried in the past.


I had a biology professor say something to the effect of "when you have energy that's because you're burning energy." You workout, you get your heart rate up, your metabolism is going, you feel energized and you think better.

Another way to put it is laying around on the coach, eating and sleeping a lot will not make you feel more energized even though you filled up your tank


I share this perspective. I don't have acute trauma behind my anxiety and depression, but I have been through periods of poor self-care wrapped up with those states, and I relate to OP. Exercise, sleep, nutrition, and spending time with even just one person who likes you are pillars of (mental) health, and without them, all the other tools (meditation, psychedelics, therapy) don't seem to have much leverage.


Agreed on mind and body as one. I'm working to address physical health, but it often feels my brain has been irreparably damaged over the course of 2 decades to where no amount of physical health will rewire the necessary circuits to achieve normal function.


That's hard, I'm sorry you have that struggle. I am about as far away from an expert on the brain as it gets, so I don't want to pretend to have wisdom there. The only thing I can say for myself is around Duḥkha, or that life is suffering.

Navigating the balance between self improvement, and being okay with the idea you may never improve to the point you want is hard. I know as much as I wish I could run a 5 minute mile, I was incredibly sedentary in my teens and 20's. It bothers me that I may never become "elite" in fitness because of my past, and that's just a fundamental barrier for me now.

My current thought is trying to find my personal worth in the journey of attempting self improvement, and not having an absolute goal of "I must be this smart" or "I must be this fit" to consider myself valuable. That mindset is easier said than done, though.


> That mindset is easier said than done, though.

Yep, I've found that accepting a new value framework at an intellectual level is far easier than getting your emotional brain to accept it. I've found that having deep conversations with people where you talk about your new value system helps. There's something about the process of sharing your new value system with your friends & acquaintances that hastens the re-wiring of your emotional brain.


This is not meant as a criticism, hopefully more of an inquiry if you so choose. Is it possible that your 'feeling' of your brain being irreparably damaged is actually factually incorrect? And that your assumptions/model of the plasticity of the brain may be wrong and skew a bit negative?

Is it possible that these negative thought patterns are holding you back? Awhile back, I became aware of some irrational negative thought patterns I had myself, and worked on reframing them, and it helped immensely w/ confidence.

Here's a random link on the general idea (can't vouch for all the content, but it captures the idea of this pattern): https://positivepsychology.com/cbt-cognitive-restructuring-c...


This is what therapists have told me, but when my mind totally blanks when asked a question in a meeting, or when I can't vocalize a coherent thought without stumbling over myself, or when I have to read a paragraph 20 times over for the information to stick, I have a hard time believing it's just a negative self-perception.


On examining the negative thought patterns, I think there's at least a couple parts to it:

1. If you very much believe no amount of physical health interventions will have any cognitive effects, then it seems like the probability of you sticking with any sort of health/fitness routine is very low. If in fact, health/diet/fitness DOES have positive cognitive effects (it's been proven scientifically and there are tons of anecdotes), you may end up depriving yourself of a really great thing for improving quality of life and cognition. So examining the possibility that your cognition is not doomed and immune to physical health interventions could greatly increase the odds of improvement.

2. In 2 of your examples, they were social situations. In my experience, negative thought patterns can definitely impact that. I'm saying this somewhat loosely, as I'm not an expert, but have done research in the past on this: Thoughts can trigger bio/physiological responses in the body/brain that can definitely impact cognition.


medicine has been a big factor for me, but I noticed when I started the meds especially (wellbutrin was added to my vyvanse regimen in June), that I was going to bed at the same time and waking up at 8am, I'm a night owl so this is real weird, but since then I've drifted back to old habits, and the meds seem to be less effective, but I guess in retrospect maybe it's just having a better structured day has a lot more bearing than I give it credit for.


I suggest that you check out the work of Sebern Fisher, particularly her book "Neurofeedback in the Treatment of Developmental Trauma", which contains several cases of significant cognitive recovery after trauma. Bessel van der Kolk also has a chapter on Sebern's work in "The Body Keeps the Score", his best-selling book which surveys trauma therapies and the evidence on them.

After reading that material, I sought out a neurofeedback practitioner who works in the style that Fisher and van der Kolk recommend. I've found it helpful and recommended it to family and friends. Several have reported cognitive improvement, including one who said that her "brain fog" was gone.

I've looked into the research literature on neurofeedback and it's unfortunately rather poor, but there are some interesting recent results in the work of Ruth Lanius. My own feeling, FWIW, is that neurofeedback+psychotherapy is able to reach levels of the nervous system that talk therapies alone cannot, because many effects of trauma are encoded in nonverbal parts of the brain.

There are many products out there that use the name "neurofeedback", but if you contact the company the makes the system that Sebern Fisher works with, they will send you a list of practitioners in your area. The recommended approach is to find a psychotherapist who incorporates neurofeedback into their practice. There aren't many of those, but there are some, and in my experience it makes a big difference, so big that it becomes a puzzle why this practice is still so little known.

Whatever you end up trying, please don't give up. It can take a long while to find something that works for you. My experience was that most therapies I tried just didn't go deep enough, and my problems would "snap back" into place no matter what happened in the sessions. It was frustrating. What's different about neurofeedback, in my experience, is that it's able to "talk" directly to the brain in a way that is uncorrelated with the rest of what therapists do. I'm not saying it's for everybody, but it's worth a try if nothing else has helped.


Become a student of energy. Study Tesla’s work. Create art. Yoga.

Surrender to life. Read The Surrender Experiment.

Stop following your preferences and follow your pain in order to rewire.

Learn how to lead with your heart. It’s infinitely more wise than your mind. The mind thinks, the heart knows.


Similar situation... Epilepsy really fucked up my life. It's still so difficult. Anyway, I stopped really caring about work and just focus on being outside, exercising, and a few hobbies. Exercise in particular, especially cardio, helps a lot. I purposefully stay as stress-free as possible. Anyway, I don't have any advice on how to not be an idiot since that's my permanent state due to all of the drugs I'm forced to be on.

I'm at least hopeful that there is going to be a better treatment for me that doesn't involve invasive, prospective brain surgery. That's my way of staying positive.


I'm on a similar path, maybe a couple steps ahead. I have a disease which caused constant severe pain from ages 12-29 (currently 31 y/o). I wanted to die for my entire adult life. 2 years ago I started an elimination diet which dramatically reduced my pain. So I know everyone says this, but controlling diet and other substance intake (alcohol, cigs) is a really big deal.

I also started microdosing mushrooms a year ago. I know you said you tried psychedelics, but I don't know if you've tried microdosing; Before I tried it, I always thought it was ridiculous and kind of an abuse/waste of psychedelics. But I like to say that the mushrooms are teaching my brain how to feel good: Maybe they repair connections in the brain or whatever, but I just needed to kick-start having a good day, so my brain could have an example of how that works.

Another major step was finding a new community...My experience is that when you're depressed, people come to expect it from you. Even if you're in a particularly good mood one day, your friends and family will kind of prompt you to act depressed. They do it out of love, probably, but it makes it that much harder to break the pattern.

One more piece, which may or may not be appropriate for you, is utilizing sex workers. Having trauma and pain, it was always a shitty experience for me to seek physical comfort. If you aren't ashamed of it, paying for affection can be a great way to meet your needs in a simple, non-judgemental way that's less emotionally and physically draining.


> One more piece, which may or may not be appropriate for you, is utilizing sex workers. Having trauma and pain, it was always a shitty experience for me to seek physical comfort. If you aren't ashamed of it, paying for affection can be a great way to meet your needs in a simple, non-judgemental way that's less emotionally and physically draining.

I would caution against this. Many if not most sex workers are also dealing with significant pain and trauma, and by using and abusing their bodies for your own needs, you are likely to be exacerbating this.

See e.g. https://www.adoptnordicwa.org/uncategorized/insights-into-pr... for an account of what sex work is like 'behind the scenes'.


ADHD medication has helped me, but I wouldn't know if that's applicable to you. I think I had it before the trauma and I lost my handle on it, and meds helped me recover.


I have through medication and 8d audio. The magic mixture for me is Vitamin D, Curcumin for anti-inflamation, vyvanse for adhd, and well-butrin for adhd and depression. YMMV, wellbutrin I feel has been the most important addition to the mix. I also feel I ebb/flow and some of my issues stem from long-covid from 2020. I still have days where I totally freak myself out by having an existential brain fart. I'm 43, but it literally feels alzheimerish where I'll be driving in a familiar place and nothing looks familiar at all, or I even feel like I forgot how to drive for a minute. Just total oblivion of ego, I guess. It happened a LOT more in 2020, but once in awhile it happens.


This is not a one size fits all suggestion but works for me; stop drinking, exercise, find a hobby outside of work (I'm doing a mixture of fitness & gaming), ensure work is not the absolute be all and end all of your life (it can be a big part of it sure, but have something else to lean on like a hobby).

Try one small step at a time and keep a journal to see what works and what doesn't; experiment and A/B test yourself. Keep these things as values on a scale of 1 to 10 and grade yourself at the end of each day, try something like shower in the morning and take a run, eat healthier, don't drink, whatever & score it. See what helps. Do that more often and try something else.


Get a better therapist

I had one that was a huge waste of time and money for about 3 months and wrote the whole thing off

I started up again a few months ago with a therapist that specializes more in trauma/family issues and it’s been invaluable


Meditation, therapy, and exercise has helped me a lot.

1. The Mind Illuminated for Meditation 2. Feeling Good book for therapy 3. Your local gym for exercise

It will take some time but it will work.


+1 for The Mind Illuminated (the one by Culadasa)


I second asking elsewhere but as you may want some good news, I'll give you my experience - I experienced Post Traumatic Growth ( https://en.wikipedia.org/wiki/Post-traumatic_growth ).

I experienced a severe 4 month PTSD event in 2019 pre-covid (covid later didn't help), plus 1.5 years of related issues, the psychological side effect of constant depressing stress that couldn't be escaped resulted in physical problems - twitches, verbal stuttering, indecisiveness, emotional swings and regular memory loss (both short term and of the event).

Around the end of 2021 as I recovered I found I had the ability to learn like really, really easily, I did 3 IT certifications in 3 months, MS, Google and an AWS cram, got noticed at work for higher achievement in solving issues there too - winning a hackathon and receiving an unrelated pay rise - it felt like no boundaries and I put this down to the fog lifting. I was still a little unhappy behind the scenes despite this, but by 2022 I felt 95% recovered (I doubt I'll be 100%" as I'm a different person now as a consequence).

Sadly the ability and urge to achieve like in 2021 went away - a window in total of around 6 months I was able to run at this "higher level" without much effort.

Articles on PTG say extroverts are more likely to experience it - I'm introverted but can socialise when challenged or feel like putting in effort (but prefer not to and avoid presentations etc.), so don't get disheartened if you think you may not have the personality for it, just remember to watch out in case it does and take full advantage :)

Extra info: Did 2 sessions a week with a psychiatrist for months - talking - not EMDR or CBT as they weren't as effective* - usually ended up in tears every time and over running - I rarely cried at all up to 2019, and flat out refused to take drugs the doctor suggested because they affect concentration and I didn't want to dull my ability more than it was already.

* They were, but I didn't want to go down that route as one session made me experience a load of events I'd forgotten details of, to the degree it was like hypnosis, I could see more, hear new noises and almost feel the cold touch of things in the memories almost like I was asleep. That was expected but I wasn't warned of it properly.


Not a unique answer, I'm sure, but you cannot feel good without exercising. The challenge can be that you don't realize how out of shape you feel until you're not, and starting to exercise can and usually does feel worse than none at all. Ideally you'll come to enjoy it, but it's a part of the maintenance required for having a human body.


You need to:

1) Figure out the type of person who caused the trauma

2) Learn their psychology/world view (there are books on abusive personalities)

3) Learn to recognise them quickly

4) Have a plan to deal with them

5) Profit (you'll always have the upper hand)

By doing this you take away their ability to do anything. For some types this riles them up, which can be advantageous in eliminating the threat but also dangerous. You can plan for this.

Good luck.


I'm in the same place - or similar enough, anyways. I'd like to find out, too. I'm reading through some of these advice, and my alarm bells are ringing- some of these advice are bad. There are some solid advice, though. Physical activity being one of them, if you're not already doing it.


Throw away your smartphone, go outside two hours a day and exercise for 60 minutes at a time


I took 4 hours/day of a human language class with 3-4 hours of self-study/memorization using Anki. As a result of the class time (9am-1pm), got into a regular and sufficient sleep schedule.

In about 2 weeks, I noticed my short-term memory had improved.


Have you heard of cerebrolysin or (low dose) naltrexone? I’d highly recommend reading much more about both first, but they show promise in brain related issues, especially the former.


Potentially long covid? No trauma but I have felt this recently a bit, no where near debilitating but noticeable, perhaps I'm just aging


Have you had your thyroid levels tested? My problem was mostly hypothyroidism.


Find something worthy to think for, that takes a lot of thinking.


7 years ago I started a startup. I must have burned out at least 4 times each of those years. Several of those burnouts were severe enough to result in trauma, and each time the negative cognitive impact increased to the point I hit some kind of permanent life burnout.

Just like you describe, I was on a rapid decline: major fatigue, fog, indecisiveness, blanking, low confidence, poor social interaction, etc. I tried picking myself up, but it was always short lived: taking a break from work, meditation, exercise routines, self help, etc. The moment a bit of pressure came back at work, I’d crumble.

I have been operating in this ‘limp mode’ for about 3 years - doing what I can to help keep my business afloat (and vice-versa).

After a massive burnout episode (thanks covid), I sought help: antidepressants, counselling, and eventually a bipolar diagnosis (which I guess explains the preceding destructive burnout pattern).

Resent started creeping in - I used to be creative and energetic, and eager to solve problems. Now I felt like an imposter in the business I created; redundant and useless. People started treating me like a basket case - telling me “not to worry about doing this”, or “we can take care of that”. I don’t blame them.

The bipolar medication didn’t really help - a band-aid at best. It flattened by highs and kept me out of most deep lows. I was essentially told this is how it’d be for the rest of my life: on pills, treading carefully, avoiding stress, and accepting my new mundane existence.

I haven’t even mentioned the effect all this has had on my family. My son was born the day I quit my job to startup. All he’s ever know is an irritable and mostly depressed dad. I’m so fortunate that my partner is resilient and held us all together over the years.

Anyway, that’s the context to how I ended up in a similar situation to you. Never underestimate the seemingly permanent and cumulative damage to your mental health and personality as a result of sustained stress, burnout, and depression.

Recently I have been going down various rabbit holes looking for possible ways out of this hell. The most recent one, and by far the most effective, has been (would you believe) diet.

During my period of resent/bitterness, I began to abuse and self sabotage. Over eating, poor diet, alcohol, vaping, actively suppressing desire for exercise, activity, and social interaction. I was sapped of all motivation and energy: Working part time, sleeping in the early afternoon, useless around home.

One evening after excessive drinking and binge eating on fast food, I could see the downward spiral I was on - and it felt like I was getting close to some horrible low: hatred and destructive behaviour.

I am lucky to have a couple of good drinking buddies (who both facilitated my bad health, but also well and truly understood the challenges of mental health). One of them shared a podcast episode by Tim Ferris [https://tim.blog/2022/11/12/chris-palmer-transcript/amp/].

Often in times of heavy fatigue and fog, I’d think “this is way more a physical condition than it is a mental one: what if one is feeding into the other?” Not a new idea, but after listening to this podcast, a two key things resonated:

1) If I could get my energy levels up through some mitochondria / metabolic hack, I could function and begin to get other parts of my life back in order, thus starting a positive feedback loop.

2) Specific to me, and maybe others - the interview mentioned that a keto style diet was used to treat kids with epilepsy. My primary bipolar medication was developed for epilepsy, and the interview references some bipolar studies.

I can report that the keto diet I have prescribed myself is working exceptionally well. 36g of carbs. My energy has improved dramatically - I function fully from 6am-11pm with no fatigue; I almost have my former mental clarity and cognition restored.

With increased energy, I’m waay more physically active, and more likely to exercise. This helps improve my mood, and the positive feedback loop is reinforced. I literally feel a force compelling me to move forward - I have not had that for years.

My experience and current situation could be miles apart from yours, but I believe the key is to find something to break the cycle: slot ut in and create positive feedback loop, that begins to spin up a flywheel. This will allow you to rediscover more things that get the wheel spinning faster and make it harder to slow it down when adversity arrives. (Flywheel analogy from some other podcast, credit to whoever that was).

My chain breaker has been to take carbohydrates out of my diet, and use ketosis as an alternative metabolic state that has given me the energy to sort my shit out. It’s early days, and hey things could turn sour - but I’ve had a taste of my previous normality that I had nearly forgotten, and this puts it within arms reach again.

Hang in there, and do your best to step out of the gloom and take a good look from above to where you could make a small positive intervention that might put you on your path towards your break.

PS: Check with your doctor before making any significant dietary changes.


[flagged]


Maybe don't go to the vegan guy for his opinion on the keto diet?

He might just be a little biased...


He's not alone.

https://www.stephanguyenet.com/nutrition-science-initiative-...

https://www.wired.com/story/how-a-dollar40-million-nutrition...

https://www.realclearscience.com/blog/2021/09/17/gary_taubes...


manipulative. he shows some bad random quotes about how keto carb research was framed in some texts, and then tells that words like that no of great use and science matter. why you show me these words then?


Besides the obvious remedies, do a couple high dose rounds of Cerebrolysin.


OP there is a lot of potentially dangerous ideas on here. I do not know what your situation is or your mindset, but for the love of all things good and to reiterate what you already probably know. Exercise caution when lapping in these recommendations and stick to basic stuff as much as possible i.e exercise and sleep and mental exercises.


This is a terrible place to ask. Seek more professionals. If the currents ones haven't helped you find different ones. No one here has enough context about your life to know what you need. Most people here don't have the expertise you need, no matter how confident they are otherwise. Already 15 comments in, I'm seeing terrible advice.

Good luck and I wish you the best.


The idea that the psych fields are some kind of wizards that have the only secret knowledge that can fix people's problems is probably the most damaging idea out there.

You could find a good psychiatrist or psyschologist who helps you out. You could find a terrible one who makes things worse or get's you hooked on some drug you majorly regret.

Get advice from anyone who you think has something worthwhile to say and ignore this.


I agree that the OP needs to consult with a neurologist, but I don't see anything wrong with asking.


Yes. After 20 years of trauma, I'm finally recovering my cognitive skills. It's like a miracle, I thought they were gone forever. The cognitive losses were THE worst part of C-PTSD. I was, yes, slow and dumb. And now I'm recovering those skills. There IS hope. I can't believe it. But here it is.

20 years ago, had a highly profitable, sustainable business, with a sociopathic co-founder. Stole my money, my ideas, my contributions, my customers, and my reputation in the community. There were credible threats of violence. Fought and lost, over a period of years. Ostracized and shunned. A nightmare.

Started over, from scratch, in a solo venture. Optimistic. But the first random adversity just knocked me cold. My body physically refused to approach the work, answer the phone, or open email. I had just enough energy left, to hand off the existing customers to a colleague. Then I just collapsed. A violent physiological reaction to years of gutting through on willpower.

And that was that, for my high-powered career. Brain non-functioning. Give-a-d*mn, permanently busted. Felt like I lost 50 IQ points. Didn't care.

Over the next 10 years or so, I rebuilt most functions. Re-learned how to sleep, eat, exercise, self-regulate, make friends, build a community, pay bills, keep the house running.

But ... those basic life tasks took all my energy. I couldn't work. Couldn't earn money. My brain, seriously, did not function. Like Shortcake27 said, at least I wasn't letting anyone down. And I would have.

I lived frugally, slowly used up my IRA at a 10% penalty, and tried to figure out what to do. I didn't even have a name for what my problem was.

Long story short(er), 3 years ago, I began working with a Stanford-trained PhD trauma therapist. I'd been "trying to work" for years, to re-launch my business. But I kept doing the same tasks over and over, and forgetting I'd done them. That was the issue that brought me to therapy, along with going broke.

I'm now successfully re-launching the business. My cognition, memory, and work capacity have returned full throttle. It's an amazing feeling. Here's what I've learned.

(1) YES to what everyone else said, about restoring physical health. Sleep, nutrition, exercise, fresh air, regular schedule. Trauma lives in the body. Fixing it starts with caring for the physical body.

(2) No healing will begin, without ensuring PRESENT-DAY safety, emotional and physical. You can't fix past damage, if your body's still incurring present damage. Your body knows, what's safe and what isn't. If there's still some low-level abuse or disrespect kicking around in your life, progress will be hard.

This is challenging. It might mean letting go of some relationships that are comfortable but unhealthy. And then just keeping that space open for yourself, without letting other dramas rush in to fill the void. This was the hardest thing I had to do.

(3) Respect the body's instinct to self-isolate after trauma. Being alone is SAFE. Obviously it's not a long-term solution. But it can definitely be a great short-term solution. It lets the body return to homeostasis, on an animal level.

(4) Have faith that your cognition and mental function can rebuild themselves. I didn't. But my therapist did.

(5) Since trauma lives in the body, it's no different than a broken bone that wasn't set properly. The body's reactions to it are NORMAL, not shameful or weird. If your leg bone's not set right, you won't be able to walk. There's nothing wrong with that. It just IS. It needs surgical re-alignment. Same thing with your cognition. It works just fine when properly treated.

Anyway hope this helps. It would have given encouragement to my past self, to see a story like this. :)

Edited to say, I'm cheering for you, and for all on this thread in a similar situation.


Try being less verbose. Waste not, want not.




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