To wonder what's wrong with my mind?

[DrowningInApathy]

Posting for traffic because I've been searching for answers online and can't find anything helpful, so wondering if anyone has experienced anything similar.

I like my job, it's interesting, I don't find it difficult, I like my colleagues, everything there is fine.
The rest of my life is basically fine as well - family/friends/hobbies - nothing that I can think of that would trigger this.

But for the last few years, I've had times, from a few days to a few months, where I barely get out of bed, don't do anything, don't speak to anyone, don't go to hobby groups etc.
Usually this has been unpleasant but not a huge problem as I've been self-employed, but I recently took a job working for someone else, so it is a problem now.

I'm not sad or unhappy or any feelings I would identify as "depressed". The overwhelming feeling is just apathy and "I can't" or "I just don't want to", with some added anxiety this time because I think I might lose my job over it. But I don't know why my brain thinks I can't or doesn't want to, because consciously, there's really nothing wrong. I have no idea why I have no motivation and interest in life, and I would love to shift that.

I've tried so many things over the years: exercise, meditation, good diet, good sleep, being in nature, cold therapy, talking therapy, anti depressants, anti anxiety meds, all kinds of supplements, hormones, everything I could think of or ever read about. I've researched lots and tried everything that might help. But it still happens and I don't know why and I've run out of things to try to help it or make it stop.

Anyone have any suggestions? I used to be full of enthusiasm and vitality, but I barely remember that version of me now.

Could it be PMDD?

Thank you for the suggestion.

Don't think so - no correlation to my periods and no mood swings, plus it's nothing like the symptoms 2 friends with PMDD had - and hormone treatments haven't affected it.

So sorry that you are feeling like this OP.

Was the change sudden, or gradual?

And do you please mind sharing how old you are?

It does really sound like there is something medical going on, and I would really encourage you to talk to your GP again to see if there are any other things they can do to help. (Perhaps armed with some ideas we can generate on this thread)

Do you think you're neurotypical?

Have you had your thyroid checked? That sounds very similar to how I used to feel.

How old are you op?

Are you 44+? Sounds like the begin in gs of peri menopause

The overwhelming feeling is just apathy and "I can't" or "I just don't want to" Depression can feel exactly like this. I'm not saying you have depression, but it is a myth that depression = sadness.

Early 40s - and yes, I've considered peri menopause and spoken to the GP about HRT & tried both that and going back on the pill - no difference.

Had full spectrum blood tests recently - everything normal, not even low end, just very very mid-range: thyroid, B12, iron, red/white blood cells etc.

Hard to recall if it was sudden or gradual originally, it's been happening on/off for about 7 years now. Now, it comes and goes fairly rapidly - I can be getting on with life fine, and then something I am not consciously aware of triggers it and it's happens for some period of time, and then I slowly crawl out of it again until the cycle repeats some number of months later.

Probably neurotypical. I have some traits, but nothing that I think would reach the threshold for diagnosis. And nothing that presented as a problem in childhood.

Yes, I read about atypical depression, and it fits reasonably well with the symptoms, but there's no actual "life" cause for me to be depressed.

I tried SSRIs in the past, which didn't help (actually made it way worse).
I've tried eating tryptophan-rich foods and taking serotonin promoting supplements, also doesn't help.

I'm not averse to it being depression, I just desperately want to find something that works and makes it stop, and I've totally run out of new ideas to explore!

Maybe anhedonia, a subset of depression which robs you of the ability to find pleasure in things?

I knew someone who had it. It improved with a combination of drugs - I think HRT and buproprion, which is an antidepressant but not an SSRI. It took her some time & experimenting to get the meds right.

Have you got any others symptoms of perimenopause? What hrt did you try? Some women have trouble absorbing different types. I am pretty sure I have adhd but I never would have thought I did in childhood either.

ADHD burnout looks like this - but it could be anything! Hope you find a way forward. X

Given your age, it certainly could be menopause-related, but since hormonal treatments have had no effect, it seems unlikely to be the underlying cause.

Sometimes people don’t respond well to SSRIs - has your GP suggested any other candidates you could try?

Hormones/depression would be the two most likely causes. If you are otherwise well in yourself, my first suggestion would be to try another type of antidepressant. If that doesn’t help, with bloods all coming back normal, it might be time to think of more uncommon causes. Especially since it is affecting your life so much.

Do you have any family history of dementia or stroke? It is certainly more uncommon, but apathy can be one of the first symptoms of early-onset dementia. Has anyone close to you noticed any other differences in your behaviour (apart from the apathy)? It can also be a symptom post-stroke. Hence why my question about if it was sudden, you may have had a “silent stroke”.

I’m not trying to scare you with these suggestions, they are a lot more unlikely than the above, but it seems you might have exhausted a lot of the likely things so just trying to generate some more unlikely ideas for you to go back to your GP with.

Are you autistic? The ‘I can’t’ ‘I don’t want to’ for no good reason you can see sounds a lot like Pathological Demand Avoidance.

Thank you for the suggestion but pretty sure it's not this.

No problem doing things for other people, nor finding the motivation to do it when someone asks me to do something.

It's only things that are of benefit only to me, and that are self-imposed that get hijacked in this way. (Yes it affects work, but my work is very much self-directed, even now.)

ADHD ?

I'd much rather do things for other people too, things I've got to do myself are much harder.

Are you very intelligent? You might have been masking and managing extremely well. I wouldn't rule out trying different forms of hrt and going through an extensive list of symptoms. Mine were many but I didn't realise that's what they were. One type of patch doesn't work for me at all. A low dose didn't work for me either.

Well, this is a bit of a revelation, that someone has made a post describing exactly how I feel sometimes, and others are posting responses which suggest that it isn't usual to feel like that. I just thought it was perimenopause and feeling overwhelmed with stuff...

Ah ok- if it’s better when someone else asks you to do something then it isn’t PDA. I hope you find something that helps.

Anhedonia is possible, might take that suggestion and request for an NDRI to the doctor.

Pretty sure it's not ADHD - tried ADHD meds once at uni for extra focus and they had the NT effect of making me twitchy and restless, not calmer and more focused - totally different to what my ADHD friends report.

Some autistic traits, but very low level. Hard to say as I'm pretty sure I wouldn't meet a diagnostic threshold for that.

HRT - tried patches, and then back on the pill cos I'm still totally regular with periods. Might try to the menopause specialist GP about that as well though, whether there are differences in response to different formulations.

@WhosAfraidOfLittleOldMe
Thanks for the suggestions!

I definitely don't get on with SSRIs, and have been trying to look up other antidepressants, but GPs here seem resistant to it. Maybe I'll try again next week. Maybe NDRIs, as mentioned by @zaxxon .

History of dementia in family - yes, but only at 80+, so unlikely to be generic early onset, but will mention. Stroke seems unlikely (No family history and I'm fit and normal weight), plus the intermittent nature of this makes that seem less likely to me.

But I definitely appreciate all the suggestions, even the less likely ones, anything new that I can bring to the discussions with the GP could be helpful.
Also - apathy is great for not giving a f*, so thank you for the thought, but I'm not scared, just fed up of not finding a solution to it!

That is possible. And has been suggested by others. Problem is, without getting an fMRI, which AFAIK they don't do to diagnose autism, although it does show up different brain activation patterns, I don't think I could ever tell, because I've been masking so long (if that's what it is), that I wouldn't have much belief in either a positive or a negative diagnosis. And honestly, I don't feel like paying £1k+ for private, don't think I have enough symptoms for the NHS to refer me, and anyway it would take years, and there isn't any treatment I'm aware of if I were autistic, so while I would like to know, it doesn't seem that realistic.

Do you have any suggestions for forms and doses on HRT? I still have perfectly regular periods, but did think it could be this, but no real idea what to ask for, so just went with the GPs initial suggestions, which weren't that helpful.
Or am I just stuck with trial and error?

Hiya - just another idea to throw in the pot - it resonates a little bit with me and I have bipolar. I have bipolar 1 - so have experienced mania as well and it’s on the more serious end, but a feature when I was younger was I’d be ticking along feeling good and then would slip into 2-3 months of feeling crap. Tired, very flat in my mood, not even always necessarily teary or emotional… and then would just come out of it.
there are lots of other conditions in the bipolar family, including mood disorders which are more heavily featuring depression.
bipolar has a bad rap, but for me it’s a lot about energy, motivation and hopefulness rather than a big personality change. And it has a very slow cycle of its own.
I also have something slightly different (which may be about being neurodivergent rather than the bipolar) where after lots of stimulation my system has to rest and just really take it easy and laying around helps me recalibrate - normally couple days to couple weeks though.
it could well be something physical obv but thought I’d share my experience in case helpful
good luck!

Thanks @Clustersparkles . Not considered it, shall do some research. Not sure I've ever had a manic phase, but maybe I just don't understand it well enough.

And the ND needing reset space resonates, but it's usually only max 2 days - the "too many people/activities/things" feeling is somehow different to the"apathy" feeling, and passes much faster, but i do know what you mean!