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Posted by u/dezeiner 3 years ago
Ask HN: How to restore cognition after years of trauma? I feel slow and dumb
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?

defnotahuman · 3 years ago
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

hirvi74 · 3 years ago
> 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.

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more_corn · 3 years ago
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.

puttycat · 3 years ago
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.

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mgmeyers · 3 years ago
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).

kbrannigan · 3 years ago
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

shortcake27 · 3 years ago
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.
kbrannigan · 3 years ago
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.

bingobongobingo · 3 years ago
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.

clint · 3 years ago
Reminds me very much of this SNL skit https://www.youtube.com/watch?v=TbwlC2B-BIg
TylerLives · 3 years ago
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.
jonfromsf · 3 years ago
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.
nvarsj · 3 years ago
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.
kbrannigan · 3 years ago
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.

wnolens · 3 years ago
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.

the_gastropod · 3 years ago
What happens to people when they retire?
dezeiner · 3 years ago
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.
scott-smith_us · 3 years ago
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.

ericskiff · 3 years ago
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.

rbohac · 3 years ago
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.
Guest71022 · 3 years ago
Great to see someone share another data point for keto. I shared my verbose anecdote above.
fairity · 3 years ago
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.

yef · 3 years ago
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.
renarl · 3 years ago
I second this book. Somatic therapies and IFS helped me especially.
bradser · 3 years ago
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!
scott-smith_us · 3 years ago
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.