Zombie hell: poor-quality sleep, pain, fatigue, anhedonia, dysautonomic symptoms

This sort of zombie hell has been with me for years, decades even, but is getting progressively worse over the last 1.5 years. My symptoms resemble a blend of CFS/ME, dysautonomia, and some sort of bipolar-spectrum mental illness, with poor-quality sleep being both a trigger and a mechanism that correlates with partial remission or worsening of all symptoms. Some key symptoms explained:

- Pervasive muscle and joint pain, and tendonitis that seems to be inflammatory in nature. Lots of spontaneous cracking, popping, and stiffness in all my joints - especially the ankles which actually make these sounds like some sort of creaky chorus as I walk. Achilles tendonitis, and worsening stiffness in my hands. Muscle pain mostly in my quadriceps, obliques, upper back, and neck. I have a very "stiff" posture and have frequently been told about my robotic-like gait when I walk. All of these issues are much worse after I wake up, and seem to partially fade throughout the day, but never really go away.

- A "wired-yet-tired" fatigue and excessive daytime sleepiness that makes me want to just lie down the whole day and nap it all away, yet makes such sleep impossible because of a pulling compulsion to be moving and doing something.

- Low appetite and a correlation in worsening symptoms and IBS from certain foods. I seem to handle gluten and dairy OK, but salycitates, and foods containing leptins, may be problematic. I eat extremely clean, believe me on that one, and have tried eliminating all of the purportedly problematic food stuffs, to little effect. Following an anti-inflamattory diet doesn't help much at all, certainly not enough to justify the food restrictions.

- A post-exertional malaise like effect if I even begin to push myself too hard physically. This is esspecially troubling seeing as how I'm in otherwise very-good physical shape, and can easilly run a 20-minute 3-mile and lift my bodyweight or more in several exercises, but I can't seem to do these things more than once or twice a week or I'm really going to pay for it. Overall, it seems like my body recovers from physical activity like a man 40-years older than me should.

- Orthostatic intolerance that has made me faceplant. Usually I manage to catch myself against a wall or door jamb, but one of these days I'm going to hurt myself. This also correlates to seeing stars when I'm feeling the fainting coming on, as well as if I simply blow my nose with force.  Other dysautonomic symptoms like low body temperature (~97.0), borderline bradycardia (resting heart rate usually 40-50bpm), pre-hypertension (~130 systolic with a normal ~60-75 diastolic), intolerance to cold temperatures of any kind, hand and feet numbing and body chills on uncovered skin in temperatures under 75-degrees.

- Pervasive brain fog that I "feel" as a numbness in my frontal lobes, throbbing behind my eyes, blurred vision. Serious motivation, attention, and sensory-gating symptoms, which along with the pulling compulsion I feel to always be moving or doing something, earned me an ADHD-C diagnosis.

- Past symptoms of OCD/anxiety that have burned out to non-existence over the years. Instead, I have an everpresent fearlessness and boredom of life. This apathy leads me to try thrilling things like other ADHDers, but with a persistent anticipatory anhedonia that pretty much means I will only get into these thrilling things if they fall right in my lap. I also have a significant degree of consummatory anhedonia, but the anticipatory anhedonia is more troubling as it makes it difficult to find motivation of any kind.

In my mind, this constellation of shit all seems to correlate to sleep. Lack of quality NREM sleep prevents my body from properly healing/regenerating, which drives all of these physical, fatigue, psychological, and inflammatory symptoms I describe. My sleep is extremely fragmented, with at least 4-5 conscious awakenings per 8-hour period. A polysomnograph revealed no apneas, sub-clinical hypopneas, and no limb-movement disorders; however, the same sleep test revealed a REM latency of almost 5-hours, very little stage N3 sleep, and a spontaneous-arousal index of 12/hour.

It seems like my sleep architecture is right screwed up, but just the same, and maddeningly so as it leaves me chasing for answers, I know my body/brain are capable of reshreshing sleep because sometimes it happens. Note: when I'm talking about sleep quality here, that's exactly what I mean. I may appear to sleep just fine, because my circadian rhythm is pretty normal, and I don't have sleep onset or maintenance insomnia; however, it's obvious that I don't. I know this because I have experienced awful sleep, but also good sleep. Unfortunately, I haven't experienced a long enough string of good sleep to fully appreciate the benefits that come with it. In that sence, the poor sleep is recurrent, or even cyclic. On the other hand, there is no rhyme or reason to it, and the longest string of "good" sleep I can ever recall is 3 days. In the rare instance I do get refreshing sleep, all of the symptoms I mention seem to improve, I feel motivated and energetic with diminished pain, but with a sort of derealization anxiety that all seems to resemble a hypomanic episode. I can buy a bipolar-spectrum disorder as another probable diagnosis, but at the same time, I don't think sleep-quality is such a profound trigger for switches between bipolar depression and hypomania - especially in regards to the other CFS/ME and inflammatory-type physical issues.

Medication/supplement wise:

- Methylphenidate, as prescribed for ADHD, only has positive effects if I take it after an inexplicable good night of sleep. If I take it after my normal poor sleep, it increases the zombie-like fatigue, wired-but-tired sensation, and anhedonia.

- Medical marijuana, in the form of strains high in cannabidiol and low in THC, seem to help with the physical malaise for a short duration (1.5 hours), but unacceptably worsens ADHD symptoms and anedhonic symptoms. THC also helps relive my IBS-like symtpoms and make me want to eat, but the negative cognitive effects are too much to make this a viable, daily treatment option for me.

- Ibuprofen, in 600-800mg or larger doses, helps. It also causes a mood boost for me, which tells me there is obviously some sort of inflammatory mechanism, including low-grade encephalitis, also going on in my brain and body.

- NAG, NAC, omega-3 FAs, vinoceptine, B-12, 5-MTHF, chelated magnesium, GABA, aswaghanda, and other supplements recommended for CFS/ME and sleep might as well be placebos for me.

- Ginseng, eleuthero, tyrosine, mucana puriens, rhodiola rosea, ascorbic acid, and other energy/mood and catecholamine boosting supplements have a small, subtle positive effect.

- 5-HTP and melatonin can both knock me out to sleep, but do not correlate to an improvement in sleep quality. Both of these things also seem to correlate with a worsening of depressive symptoms.

- The right amount of alcohol is probably the most reliable treatment option in inducing quality sleep for me. Believe me, I know the science behind alcohol and sleep, but anecdotally, the correlation is too much to ignore. Unfortunately, it's all but impossible for me to use alcohol responsibly given that I am a (relapsing) alcoholic.

- I took a 6-month regimen of 100mg/daily doxycycline as a malaria prophylaxis in the past, which actually improved my phsyical and cognitive symptoms during the duration, but seems to have resulted in a persistent yeast infection. I have treatment-resistant seborrheic dermatitis on my face and scalp ever since, and a possible yeast overgrowth in my stomach during the duration of treatment (no probiotics or good food when you're deployed).

I realize this is a lot to take in, but I think it's important to be descriptive both for my own written record, as well as the benefit of people searching down the line. I have zero faith in my current health-care options, and am ready to seek a doctor out of my own pocket, but I just don't know how to find a competent, non-dismissive doctor. I'm not even sure how to accurately describe myself in the midst of my pervasive brain fog, which is why I take the opporitunity during rare, lucid moments like this. I also don't want a (IMO) copout diagnosis like depression, or fibromyalgia; I want to slay this beast so that I can pull that one foot out of the grave.

Thoughts, ideas, treatment recommendations?  

Edited by Dichotohmy, 13 September 2014 - 10:36 PM.

Hello there,

I do not have any answers for you, but I just wanted to say you might get more of a response to this thread in the Brain Health/Mental Health sections of Longecity Forums.  Just an idea if you dont get too many answers in this section.  Best of luck!

Dichotomy, it sounds like you might have multiple things going on.  I used to have the postural hypotension that you describe, and it was sometimes pretty bad.  When I started taking c60 olive oil, it went away immediately.   If c60 only fixed your hypotensive symptoms and nothing else, it would be a win, but I think it may help some of the other issues you describe.  Are you getting enough iodine?  If you aren't getting 150 mcg in a multivitamin, then try a standalone version.  I like NOW's 225 mcg potassium iodide tablets.  Some of what you describe might be symptoms of sinus inflammation from environmental allergies.  I'd  see an allergist for an evaluation and skin test.  If you can't do that, try an OTC decongestant/antihistamine combo.  If that makes you feel better, allergies are probably part of the problem.  As a source for c60oo, I'd go to carbon60oliveoil.com.  Keep us posted on what you try and whether or not it helps.

Could this be Lyme?

Your issues sound like an autoimmune disease perhaps hypothyroidism with rheumatoid arthritis could be the most obvious recognised medical condition, Feeling cold, low HR and BP, depression, easily fatigued upon exertion, poor sleep and especially brain fog are all the glaringly obvious signs of an underactive/faulty thyroid. Lab tests are not ideal for treating and diagnosing certain forms of thyroid illness as the almost exclusively rely on TSH values when T3/T4 need to be looked into. I would concentrate on the thyroid first as it could be hashimoto's but if its subclinical or full blown hypothyroidism without antibodies I would recommend not taking the medication as its for life and try to correct it naturally. Rubbing iodine into the soles of the feet before bed to see if its being absorbed and for how long until it stops is one way of treating it but a normal doctor will think its quackery. Reading into TSH and how they developed the standards is beyond quackery, its retarded.

If thyroid values turn out fine/perfect then look into xanthines namely caffeine. Do you consume a lot of caffeine and if so in what forms? Always seemingly living in the moment with poor planning and messed up cognition that sways leads me to believe this could be a stimulant/caffeine based problem or at least some issues stem from it, it could be both caffeine and the thyroid together making it seem like you have multiple issues like allergies, joint problems and cognitive decline. 
This is not a recognised condition or even thought to be possible but 10 cases exist in the literature about caffeine 'allergy' the most recent being a young spanish male see 2nd abstract down here: http://onlinelibrary...73.24_53.x/pdf 

You sound like me before I wiped it from my diet with weed/dopaminergic drugs and alcohol only affecting me and basically a human trash can towards other supplements drugs particularly SSRIs and very few minerals herbs or vitamins had an impact. I could take huge quantities of benzos or downers and barely feel them. Its an allergy or a masked cerebral type of poisoning according to some. Others view it as accumulating to form all sorts of joint and even gout type problems as caffeines end metabolite keeps building up. 1st generation anti-histamines like diphenhydramine or promethazine would provide temporary relief if its an allergic response ongoing to caffeine. I believe its a covered up condition i.e. caffeinism by big pharma. Its possibly for people to be allergic to just about anything right? Why not caffeine?.
One could think of a caffeine problem in terms of what is the antidote to anaphylaxis - the antidote to anaphylaxis is epinephrine, caffeine accumulates and is constantly causing its release, even a cup of coffee causes a surge of it.

A Finnish man viewed it differently and has a one of a kind page which if you read his story matches up with a lot of your symptoms, including the more worrying ones http://brainlaunderette.blogspot.fi/ - he was getting signs of CFS/MS and symptoms of schizophrenia and locked away diagnosed as a paranoid schizophrenic when he brought coffee up as his underlying problem. It ended in a huge  battle in the court systems whereby he had to leave the country or be in a nuthouse........personally I cannot tolerate coffee or especially black teas but doctors will usually scoff at you if you bring it up directly,

To baffle them and get some recognition I decided to fuck with them and used to meddle with blood tests by temporarily poisoning myself with coffee to create a huge creatine kinase (CK or CPK -creatine phosphokinase on some forms) surge even when injured with ACL/Lat M tears and inactive.
Have you ever supplemented with creatine for sports or performance enhancement? If you did and it worked very well again (like a steroid) it suggests the above. Caffeine or xanthine poisoning cause creatine to leak out of muscle stores (i gather the brain also) problems with fluid retention, constipation that are idiopathic along with puffiness with skin discolourations is another sign. The british estimated 10% suffered from caffeinism then suddenly shut up about it in the early 80s. Most mentally ill and certainly schizophrenics ingest huge quantities of caffeine not to mention up to 90% smoke. The smoking has been studied and looked into but the caffeine mgs ingested has not even with caffeine related illnesses sneaking into the DSM its almost totally overlooked.

Fibromyalgia is modern BS diagnosis quite possibly a caffeine metabolic related syndrome. I can create 5-6x normal levels with 2 coffees before a blood test & most fibro sufferers have high levels of CK but nowhere near as high as people with muscular injuries or dystrophies. Amost all the symptoms you have seem to be a mix of a caffeine sensitivity/allergy but particularly thyroid avoiding controversial syndromes or problems.

Best of luck 

 

Dichotomy, it sounds like you might have multiple things going on.  I used to have the postural hypotension that you describe, and it was sometimes pretty bad.  When I started taking c60 olive oil, it went away immediately.   If c60 only fixed your hypotensive symptoms and nothing else, it would be a win, but I think it may help some of the other issues you describe.  Are you getting enough iodine?  If you aren't getting 150 mcg in a multivitamin, then try a standalone version.  I like NOW's 225 mcg potassium iodide tablets.  Some of what you describe might be symptoms of sinus inflammation from environmental allergies.  I'd  see an allergist for an evaluation and skin test.  If you can't do that, try an OTC decongestant/antihistamine combo.  If that makes you feel better, allergies are probably part of the problem.  As a source for c60oo, I'd go to carbon60oliveoil.com.  Keep us posted on what you try and whether or not it helps.

 

Could this be Lyme?

I had a history of frequent upper respiratory infections, rhinitis, and sinus troubles (bad nasal congestion, muscous) before I started using an inhaled corticosteroid (flunisolide) three years ago. Since starting that, I have had zero issues with URIs, almost no allergic rhinitis, sinus troubles, or so much as even caught a cold. I really haven't been "sick" for over three years. My upper airway does get congested when I'm laying down, which no doubt impacts my sleep (possible UARs), and sleeping on my side makes that side of my nose eventually close up completely. I breathe a lot better through my nose while laying supine, and seem to sleep relatively better this way, even though the supine position is typically much worse in sleep-disordered breathing patients. My sleep study revealed no apneas, an AHI of around 7, which is sub-clinical for UARs - I kind of wished my sleeping problems were this simple to explain, but apparently not.

Lyme, or some other tick-borne disease, is probably my best hypothesis for what's wrong with me, as I have been bitten by ticks in lyme-prevalent areas several times in my life and found ticks on me even more times - including the first incident over 20 years ago that soon followed in spontaneous flu-like symptoms (summer-time, no exposure to anyone with the flu) and seemed to really be the beginning of this whole mess of zombie-like symptoms and general life decline for me.

On the other hand, there's so much questionable science, outright quackery, and conspiracy theories around the treatment of chronic lyme that even seeking a diagnosis isn't too enthusing to me. Just finding a lyme-literate doctor seems like being able to master some secret Freemason handshake, and the clinical literature for the efficacy of long-term anti-biotic treatment is so questionable, with the treatment so expensive, and side-effect ridden. As mentioned, I did a 6-month regimin of doxycycline, for a competely unrelated reason, that had some improvement for my (at the time) symptoms, but also had some concerning side effects. That 6-month regimin was far from a magic bullet, and I would have to pay for any hypothetical treatment completely out of pocket with little disposable income at hand.  

Your issues sound like an autoimmune disease perhaps hypothyroidism with rheumatoid arthritis could be the most obvious recognised medical condition, Feeling cold, low HR and BP, depression, easily fatigued upon exertion, poor sleep and especially brain fog are all the glaringly obvious signs of an underactive/faulty thyroid. Lab tests are not ideal for treating and diagnosing certain forms of thyroid illness as the almost exclusively rely on TSH values when T3/T4 need to be looked into. I would concentrate on the thyroid first as it could be hashimoto's but if its subclinical or full blown hypothyroidism without antibodies I would recommend not taking the medication as its for life and try to correct it naturally. Rubbing iodine into the soles of the feet before bed to see if its being absorbed and for how long until it stops is one way of treating it but a normal doctor will think its quackery. Reading into TSH and how they developed the standards is beyond quackery, its retarded.

If thyroid values turn out fine/perfect then look into xanthines namely caffeine. Do you consume a lot of caffeine and if so in what forms? Always seemingly living in the moment with poor planning and messed up cognition that sways leads me to believe this could be a stimulant/caffeine based problem or at least some issues stem from it, it could be both caffeine and the thyroid together making it seem like you have multiple issues like allergies, joint problems and cognitive decline. 
This is not a recognised condition or even thought to be possible but 10 cases exist in the literature about caffeine 'allergy' the most recent being a young spanish male see 2nd abstract down here: http://onlinelibrary...73.24_53.x/pdf 

You sound like me before I wiped it from my diet with weed/dopaminergic drugs and alcohol only affecting me and basically a human trash can towards other supplements drugs particularly SSRIs and very few minerals herbs or vitamins had an impact. I could take huge quantities of benzos or downers and barely feel them. Its an allergy or a masked cerebral type of poisoning according to some. Others view it as accumulating to form all sorts of joint and even gout type problems as caffeines end metabolite keeps building up. 1st generation anti-histamines like diphenhydramine or promethazine would provide temporary relief if its an allergic response ongoing to caffeine. I believe its a covered up condition i.e. caffeinism by big pharma. Its possibly for people to be allergic to just about anything right? Why not caffeine?.
One could think of a caffeine problem in terms of what is the antidote to anaphylaxis - the antidote to anaphylaxis is epinephrine, caffeine accumulates and is constantly causing its release, even a cup of coffee causes a surge of it.

A Finnish man viewed it differently and has a one of a kind page which if you read his story matches up with a lot of your symptoms, including the more worrying ones http://brainlaunderette.blogspot.fi/ - he was getting signs of CFS/MS and symptoms of schizophrenia and locked away diagnosed as a paranoid schizophrenic when he brought coffee up as his underlying problem. It ended in a huge  battle in the court systems whereby he had to leave the country or be in a nuthouse........personally I cannot tolerate coffee or especially black teas but doctors will usually scoff at you if you bring it up directly,

To baffle them and get some recognition I decided to fuck with them and used to meddle with blood tests by temporarily poisoning myself with coffee to create a huge creatine kinase (CK or CPK -creatine phosphokinase on some forms) surge even when injured with ACL/Lat M tears and inactive.
Have you ever supplemented with creatine for sports or performance enhancement? If you did and it worked very well again (like a steroid) it suggests the above. Caffeine or xanthine poisoning cause creatine to leak out of muscle stores (i gather the brain also) problems with fluid retention, constipation that are idiopathic along with puffiness with skin discolourations is another sign. The british estimated 10% suffered from caffeinism then suddenly shut up about it in the early 80s. Most mentally ill and certainly schizophrenics ingest huge quantities of caffeine not to mention up to 90% smoke. The smoking has been studied and looked into but the caffeine mgs ingested has not even with caffeine related illnesses sneaking into the DSM its almost totally overlooked.

Fibromyalgia is modern BS diagnosis quite possibly a caffeine metabolic related syndrome. I can create 5-6x normal levels with 2 coffees before a blood test & most fibro sufferers have high levels of CK but nowhere near as high as people with muscular injuries or dystrophies. Amost all the symptoms you have seem to be a mix of a caffeine sensitivity/allergy but particularly thyroid avoiding controversial syndromes or problems.

 

Best of luck 

 

I did a 9-month complete abstinence from caffeine this year, and unfortunately noticed zero improvements. In fact, the fatigue and brain fog was even worse during this time, with sleep being unaffected. Like others with ADHD, caffeine seems to have little bearing on my sleep and doesn't really energize me, though it helps a little with brain fog, restlessness, and attention issues. My CPK levels were completely normal during my last two blood tested within the last 1.5 years.

On the other hand, my vitamin-D levels tested as slightly below the low-end of normal (calcidiol/choleocalciferol = 29 ng/ml). No amount of time in bright, summer sun makes a noticeably positive difference in my constellation of symptoms, though the absence of sun during cloudy stretches makes me feel a little worse. 5000-10000iu of vitamin D3 supplement/daily might as well be a placebo for me as well it seems.

My last blood draw earlier this year revealed normal TSH and T4 levels, though it wasn't an in-depth thyroid test, so I have no idea about T3 or other possible trouble spots. Though, I realize thyroid hormones fluctuate throughout the day. I've personally noticed swelling of my thyroid, times of shedding a lot of hair, persistently brittle nails, and other thyroid-related issues, in addition to the other symptoms I've already mentioned; yet my lipid levels are completely healthy and since I kicked alcohol, I eat whatever I want, when I want, and gain no weight. I have no problem maintaining a very lean build, and in fact, find it physically hard to eat enough food to make me gain any weight. The last time I gained any weight was when I was drinking thousands of calories worth of alcohol every day.  

Honestly, Hashimotos disease seems like it might be possible due to the fluctuation of all of my symptoms. What I mean by that is that I have really bad zombie-like days, and some less common days where I am closer to a functional human, but still not close to where I want to be. 

Edited by Dichotohmy, 17 September 2014 - 10:42 PM.

 

Dichotomy, it sounds like you might have multiple things going on.  I used to have the postural hypotension that you describe, and it was sometimes pretty bad.  When I started taking c60 olive oil, it went away immediately.   If c60 only fixed your hypotensive symptoms and nothing else, it would be a win, but I think it may help some of the other issues you describe.  Are you getting enough iodine?  If you aren't getting 150 mcg in a multivitamin, then try a standalone version.  I like NOW's 225 mcg potassium iodide tablets.  Some of what you describe might be symptoms of sinus inflammation from environmental allergies.  I'd  see an allergist for an evaluation and skin test.  If you can't do that, try an OTC decongestant/antihistamine combo.  If that makes you feel better, allergies are probably part of the problem.  As a source for c60oo, I'd go to carbon60oliveoil.com.  Keep us posted on what you try and whether or not it helps.

 

Could this be Lyme?

 

I had a history of frequent upper respiratory infections, rhinitis, and sinus troubles (bad nasal congestion, muscous) before I started using an inhaled corticosteroid (flunisolide) three years ago. Since starting that, I have had zero issues with URIs, almost no allergic rhinitis, sinus troubles, or so much as even caught a cold. I really haven't been "sick" for over three years. My upper airway does get congested when I'm laying down, which no doubt impacts my sleep (possible UARs), and sleeping on my side makes that side of my nose eventually close up completely. I breathe a lot better through my nose while laying supine, and seem to sleep relatively better this way, even though the supine position is typically much worse in sleep-disordered breathing patients. My sleep study revealed no apneas, an AHI of around 7, which is sub-clinical for UARs - I kind of wished my sleeping problems were this simple to explain, but apparently not.

 

Lyme, or some other tick-borne disease, is probably my best hypothesis for what's wrong with me, as I have been bitten by ticks in lyme-prevalent areas several times in my life and found ticks on me even more times - including the first incident over 20 years ago that soon followed in spontaneous flu-like symptoms (summer-time, no exposure to anyone with the flu) and seemed to really be the beginning of this whole mess of zombie-like symptoms and general life decline for me.

 

On the other hand, there's so much questionable science, outright quackery, and conspiracy theories around the treatment of chronic lyme that even seeking a diagnosis isn't too enthusing to me. Just finding a lyme-literate doctor seems like being able to master some secret Freemason handshake, and the clinical literature for the efficacy of long-term anti-biotic treatment is so questionable, with the treatment so expensive, and side-effect ridden. As mentioned, I did a 6-month regimin of doxycycline, for a competely unrelated reason, that had some improvement for my (at the time) symptoms, but also had some concerning side effects. That 6-month regimin was far from a magic bullet, and I would have to pay for any hypothetical treatment completely out of pocket with little disposable income at hand. 

Lol at the Freemason handshake.  You could defer the Lyme thing for now, and look at the other stuff.  It sounds to me like you do in fact have an allergy to one or more environmental antigens.  The corticosteroid is tamping down the symptoms pretty effectively, but I wonder if it's getting way up into your sinuses.  The fact that you're having congestion at night suggests that the problem isn't fully controlled.  It could be contributing to your symptoms.  I'd look into immunotherapy if you have insurance, and experiment with antihistamine/decongestant preparations.    If you tried some c60 olive oil, you might find that it helps your allergic symptoms, as well as the hypotensive issue.  Iodine is cheap.  A decent multi should have enough; you could take something like Centrum or the Costco version for next to nothing.  Inadequate iodine could contribute to hypothyroid-like symptoms, even if your lab values are ostensibly "normal".

 

Lol at the Freemason handshake.  You could defer the Lyme thing for now, and look at the other stuff.  It sounds to me like you do in fact have an allergy to one or more environmental antigens.  The corticosteroid is tamping down the symptoms pretty effectively, but I wonder if it's getting way up into your sinuses.  The fact that you're having congestion at night suggests that the problem isn't fully controlled.  It could be contributing to your symptoms.  I'd look into immunotherapy if you have insurance, and experiment with antihistamine/decongestant preparations.    If you tried some c60 olive oil, you might find that it helps your allergic symptoms, as well as the hypotensive issue.  Iodine is cheap.  A decent multi should have enough; you could take something like Centrum or the Costco version for next to nothing.  Inadequate iodine could contribute to hypothyroid-like symptoms, even if your lab values are ostensibly "normal".

 

Thanks for the suggestions.

I'll need to research immunotherapy. c60 olive oil is intriguing, and I need to research that as well. High quality, culinary olive oil does seem to have a small, but noticeable effect on inflammatory symptoms for me. Certainly much more so than fish oil, ALA, or other dietary omega-3s.

As for antihistamines, I've tried several first-gen and second-gen OTC types, and they have no real benefit on my nasal congestion while sleeping.

Iodine is something I've questioned, due to the fact that I never use or eat iodized salt anymore. I've half-heartedly tried supplementing with iodized salt, but I'll look into proper iodine supplementation as well.

I'm on day 5 of supplementing with potassium iodide solution, the last 3 days of which I have been at 3mg of KI per day, and for better for for worse, I am collectively underwhelmed by the change to my supplement routine, but with some small signs of encouragement.

My debilitating brain fog, fatigue, body and brain inflammation, poor sleep quality, and all the other significant things I've already mentioned are unchanged, but my libido seems to be on the upswing. I notice that I am actually thinking about sex on occaision now, whereas before I almost never did, and am able to follow through with better performance and a real feeling of pleasure. This is encourgaging because for the longest time, my libido was so bad I would reguarly go 1-2 weeks without even bothering, and even then I only bothered out of an animal-like drive with the pleasure being so ephemeral, the experience was probably like a buck deer at the height of rut enjoying 30 seconds of "slam bam, thank you, maam."

You all probably don't want to read about my libido, but it's worth mentioning because previously, only dopaminergics and alcohol have had any ability to affect my libido.

I've also noticed that the KI has the tendency to make me want to take a nap after I have eaten something. This is kind of a neutral thing, because although I haven't mentioned it yet, I can't nap. Even though I go through most days feeling like I was run over by a septic-pump truck, with all the hallmarks of excessive daytime sleepiness, I can't actually fall asleep if I'm foolish enough to try to take a nap. I can't fall asleep for a nap because I experience bizarre hypnogogic hallucinations, myoclonic jerks and involuntary muscle twitches, and adrenalin surges, without fail, when I become really relaxed - such as in the state of falling asleep for a nap. On the first day of ramping up to 3mg of KI, I was hit with a sleep attack that is like something you read about from a narcoleptic. I just had to lay down and try to fall asleep, but it just wasn't happening. I was extremely physically relaxed, with a leaden paralysis to my limbs and my eyelids feeling like they have been sewn shut, but the hypnogogic hallucinations were too wierd and that all-famlilar electrical zap of adrenaline would shoot through my brain when I was on the verge of passing beyond stage-1 sleep. After 1.5 hours, I gave up, feeling sliightly groggy when I stumbled forth from the couch in a zombie-like shuffle, and stayed up for another 8 hours. Of course, that night culminated in another day of unrefreshing sleep.

I have no clue as to whether of not iodine will proove benefitial to my zombie hell, but it's plain to see I am deficient in iodine seeing as how I consume zero iodized salt, extremely little seafood, and I eat produce from an inland area whose soil if deficient in iodine. If upping the dose shows signs of resurrecting my dick, and makes me want to take a nap when I'm too cognitively useless to do anything else, I'm slightly encouraged by the results.     

Phenibut could be worth a try for sleep here.

I've definitely thought about that one, just as I have thought about pressing my pdoc's offer of benzos, but ultimately, GABAergic drugs are a problematic and incomplete solution to improving sleep quality for me. 

I'm off put by the crude pharmacological nature of phenibut and quite frankly afraid of the addictive potential. I can't use GABAergics, including alcohol, as a daily solution because addiction (even if it is sustainable) is a real concern, and I know that regular use of GABA drugs ultimately leads to reduced dopaminergic functioning and blunting of rewards solvency in my brain.

Edited by Dichotohmy, 22 September 2014 - 06:37 AM.

Phenibut could be worth a try for sleep here.

I think it's a good time to define just what I mean by "zombie hell."

Zombieness, as a symptom, might seem pretty straightforward; I think the collective on these forums can understand the emotional blunting, apathy, and cognitive impact I experience. On the other hand, I can also experience a high degree of psychomotor retardation, including orthostatic intolerance, stiff joints and muscles, pale skin, and dark, sunken in eyes when I'm at the mercy of shitty sleep. I also suffer from a near constant robotic-like gait that kind of makes me physically resemble something you would see on an episode of The Walking Dead. This is especially confusing to me, as when I have the energy to be active, I can run and weightlift just fine. There is a component of partial remission to the physical malaise I experience. 

Being in the mouth of the maddness of chronic illness has also made me redefine my definition of "hell." To me, hell is not a place of physical torment that bad people go to when they die, but instead, hell is alienation and a spiritual void with no way out. These decades of illness have totally dulled my imagination, and my very perception of the intangible realm of a spirit world or a higher power; it all feels like an abstract concept to me - kind of like modern art.

In short, I identify more as a broken animal instead of a human being.

Edited by Dichotohmy, 22 September 2014 - 06:39 AM.

Your symptoms are generally similar to someone who is regularly drinking an excessive amount of alcohol.   

Your symptoms are generally similar to someone who is regularly drinking an excessive amount of alcohol.   

I probably should have explained this more carefully in the OP, but I don't drink reguarly anymore. I've relapsed several times in the last 1.5 years since I first quit, drinking an excessive amount for a few days at a time, but that's far from a regular thing.

My longest sober stretch since quitting was 8 months, towards the end of which, well after PAWs had come and gone, the zombieness symptoms happened to grow worse and worse.

Interestingly, I seem to tolerate alcohol fairly well compared to what CFS/ME or lyme people report, but just a few drinks can definitely make me feel physically sick these days in such a way that I'm not sure can explained by lack of tolerance.

The interesting clue here is that alcohol can consistently improve my sleep QUALITY beyond anything else I've tried, such as melatonin, Trazodone, 5-htp, or Z-drugs, and too many other supplements to list. I've researched the possibility of another GABAergic helping me with sleep, such as lyrica or pregabalin, but the info and anecdotal reports I've found aren't very encourgaging. GHB or GBL looks very interesting to me beyond the quasi-legal trouble of obtaining them. Ideally I would just drink 2-3 shots every night before bed, but I know all too well I don't have the discipline to keep it at that slow pace.

Doctors, and most people I've talked to for that matter, can't seem to understand my sleeping problem is I poor-quality, unrefreshing sleep; yet I don't have a problem with any sort of insomnia or other obvious sleeping disorder (including circadian rhythm disorders). On an average night, I'll sleep my 7-10 hours, maybe waking up 1-2 times and going right back to sleep, and feel like I was run over by a truck when I wake up - always worse than I felt before going to bed. Sleeping for less time than 7 hours, or trying sleep restriction, inevitably makes me feel much worse. Sleeping for longer doesn't help either, and besides, 10-hours seems to be the upper limit for how long I can stand to stay in bed at a time. I've also mentioned that taking naps is impossible for me, so I pretty much have to commit to spending at least 14 hours a day in zombie mode. 

Edited by Dichotohmy, 25 September 2014 - 03:53 AM.

Phenibut or GHB is worth a shot, both tend to induce that deep refreshing sleep for users. Phenibut is weaker but longer-acting and acts on GABA-B receptor while GHB also hits the GHB-receptor but that is excitatory. Alcohol works on GABA-B too I think although GABA-A is more relevant in its mechanism. Both Phenibut and GHB tend to be habit forming though, but I'd say Phenibut is the least evil here and most functional, it's available over-the-counter.

Thoughts, ideas, treatment recommendations?   

It sounds like adrenal fatigue to me. I would advice you to do the hair tissue mineral analysis (including heavy metals) as a must. It will show you whether heavy metals in your body are causing health problems. The most common heavy metal causing adrenal fatigue is aluminium. If this would be the cause, no medication would help, you should just change your diet and start detoxing your body by eating a lot of antioxidants, drinking alkaline water (high in pH), breathing negatively ionised air, etc.

Edited by kenorb, 22 October 2014 - 11:48 AM.

Dichotohmy, on 24 Sept 2014 - 8:42 PM, said:
The interesting clue here is that alcohol can consistently improve my sleep QUALITY beyond anything else I've tried, such as

melatonin, Trazodone, 5-htp, or Z-drugs, and too many other supplements to list. I've researched the possibility of another

GABAergic helping me with sleep, such as lyrica or pregabalin, but the info and anecdotal reports I've found aren't very

encourgaging. GHB or GBL looks very interesting to me beyond the quasi-legal trouble of obtaining them. Ideally I would just

drink 2-3 shots every night before bed, but I know all too well I don't have the discipline to keep it at that slow pace.

Slow wave sleep, delta wave sleep and stage 3 and stage 4 sleep are categories given to phases of sleep that are often most associated with "deep", "quality", "restorative" sleep.

Many of the typical hypnotics do not induce deep sleep, and some even inhibit it. It seems the focus of conventional hypnotics so far has been initiation and prolongation of sleep rather than on increasing depth/quality. But there are some pharmacological agents that can promote deeper sleep, however they are often off label use.

GABAb agonists are one possible option (alcohol may be inducing deeper sleep through GABA mechanisms.)

Sodium oxybate, a slight variant of GHB is available legally. My understanding is that it is extremely expensive and very difficult to obtain.

Baclofen may have promise. It has similarities with GHB, GBL and phenibut, it is a GABAb agonist, and like GHB it has been shown to induce deeper sleep, e.g.: http://www.ncbi.nlm....les/PMC3397788/

Interestingly, baclofen has also been used off-label as a treatment for alcohol addiction. It is cheap and readily available.

There is little to no information about chronic use of baclofen to induce deeper sleep. It's possible that chronic use may cause tolerance, like phenibut, so it may require intermittent use. Based on the studies I've seen, 20mg to 30mg taken roughly an hour or two before bedtime would be the expected dose, but there is minimal info on such use so it may require some experimentation. There is some risk of extremely nasty withdrawal effects from baclofen, though these may be more/only likely if it is taken chronically, multiple times a day, for long durations and/or if administered intrathecally.

Another potential option is 5HT2A antagonists, which can also induce deep sleep.

There are many 5HT2A antagonists, a lot of them are tricyclic antidepressants, but my first choice would be cyproheptadine. It is available over the counter(as a first generation antihistamine for allergies/hives) and has one of the better receptor affinity profiles (e.g. has less anticholinergic effects, minimal serotonin uptake interference etc.) It also has a nice ~6 hour half-life.

Cyproheptadine may be prone to next day hangover at higher doses, and would require dose finding experimentation. I have read anectdotal reports of 2mg-8mg an hour or two before sleep. Tolerance might develop to the sleep effects of cyproheptadine too. Food may substantially delay absorption of cyproheptadine, so it may be best to take it at least three hours after the last meal and not eat until bedtime.

Doxepin is another 5HT2A antagonist, and it has been recently approved for sleep "maintenance" under the name "silenor." It is expensive in this form, but it is also marketed as an antidepressant called "sinequan", "deptran" etc, and this cheaper version can easily be substituted (the larger dose tablet/capsule may have to be divided up though.) Doxepin has an unfortunately long half-life, takes ~4 hours to have full effect on a fasting stomach and can take 6+ hours to reach maximum effect when taken in a non-fasting state - these may make timing and duration difficult to handle.

Amitryptiline is another 5HT2A antagonist and has seen widespread off-label use as a hypnotic. It has a 20+ hour half-life which may make it prone to next day grogginess.

There's some related information on getting deep/refreshing sleep in this thread(including more from me):

http://www.longecity...erent-approach/

Don't know if OP will come back but here are a few safe, easy things that haven't been mentioned yet to try

Curcumin, preferably Longvida or liposomal, for inflammation

Epsom salt baths, not so much for the magnesium as for the sulfate, if you are salicylate sensitive

Lecithin / lipid replacement therapy

The various B1's (thiamin / benfotiamine / allithiamine / sulbutiamine) may help with dysautonomia

Kava kava may upregulate GABA function over time

A real effort to do a serious paleo-autoimmune type diet for a month or more

Resistant starch

Xylitol, lactoferrin, allicin if you think you may have Lyme

Red light or blue blockers for night

I dunno, this probably seems like weak medicine for what ails you, but then again when you find the right piece that fits it can have a profound effect. I'm probably forgetting a few things. If you find some way to improve sleep let me know, I still struggle with insufficient deep sleep.

Edited by StevesPetRat, 21 November 2014 - 08:58 AM.

Roth seems one of the foremost experts on sleep and alcohol and this is a brilliant review of current scientific knowledge of the subject (of particular interest to me is that intermittent small doses of alcohol may be beneficial for sleep which appears to contradict the common advice from medical professionals):

"Sleep, Sleepiness, and Alcohol Use"
http://pubs.niaaa.ni...5-2/101-109.htm

Interesting paper. The good take away is that you need to get the dose right, because too much alcohol actually wrecks my sleep quality.

Don't know if OP will come back but here are a few safe, easy things that haven't been mentioned yet to try

Curcumin, preferably Longvida or liposomal, for inflammation

Epsom salt baths, not so much for the magnesium as for the sulfate, if you are salicylate sensitive

Lecithin / lipid replacement therapy

The various B1's (thiamin / benfotiamine / allithiamine / sulbutiamine) may help with dysautonomia

Kava kava may upregulate GABA function over time

A real effort to do a serious paleo-autoimmune type diet for a month or more

Resistant starch

Xylitol, lactoferrin, allicin if you think you may have Lyme

Red light or blue blockers for night

 

I dunno, this probably seems like weak medicine for what ails you, but then again when you find the right piece that fits it can have a profound effect. I'm probably forgetting a few things. If you find some way to improve sleep let me know, I still struggle with insufficient deep sleep.

Still here, I just don't have anything really encouraging or noteworthy to report in way of progress. Potassium Iodide, which I talked about earlier, amounted to a lot of nothing. Lugol's KI and elemental I tincture, which I'm trying now, isn't amounting to anything either.

I've tried most of the things on your list already and the thing that makes a solid difference for me is a high-fat, high-vegetable (varying protein, so not stereotypical paleo) diet. In particular, animal fats. I have to admit I've never tried B1 supplementation, but the other B-vitamins I've tried individually, such as sublingual Me-cobalamin, sublingal P-5-P, nicotinamide, and 5-MTF either worsen my fatigue, or plain don't help. Stopping my daily Jarrows B-100 complex actually made me feel noticeably better.

Another thing I've been trying is a protocol of cat's claw, knotweed, ascorbic acid, NAC, and vinpocetine. In particular, the cat's claw seems to actually have a noticeable benefit on inflammation, especially that brain swelling, intracranial pressure kind, while the vinpocetine seems to be helping a little with sleep quality but significantly with my OI issues. I've had a few days where I though I might be herxing from some of these supplements, but it's quite possible I was just confusing my normal symptoms as some sort of sign of encouragement.

Edited by Dichotohmy, 25 November 2014 - 10:17 PM.

My symptoms remain unwaning and seem to be slowly growing cumulatively worse amidst the cycle of partial remission and then remittance. I have quit taking vitamin D3, cat's claw, and knotweed, amongst other supplements, because I suspect these things were actually making things worse for me. At best, my body is like an incinerator for quality supplements that are not cheap. Right now, I'm on a really simple regimin of NAC, mag-taurtate, aspirin, and vinpocetine.

I also quit all exercise in the beginning of september, along with trying to limit other forms of physical activity, which I'm suspecting to be misguided and unsustainable. On one hand, my chronic pain and other 80-year-old man like decrepit physical maladies markedly improved, but on the other hand, my metabolism seems to have slowed even more and I miss the tactile sensation of exercise. This is a damned if I do and damned if I don't situation, which I guess means I should err on the side of conservative exercise and the objective health benefits it provides.

In other news, I'm experiencing a troubling degree of diffuse hair loss (head AND body hair), I thought the hair loss may just be related to my methylphenidate use, but it persists even when I abstain from that medication for a week. The sebborheic dermatitis and other conspicuous skin conditions are getting worse. My body temperature remains at a constant 96.4-97.2 (arm pit temperature is a consistent 1-degree lower) which has me wearing 2 or more layers of clothes 24/7 and wearing a blanket more often than not.  My brain fog, depersonalization, anhedonia, and other psychological symptoms persist as a form of bonafied altered consciousness in which real waking life seems less real than dreaming.

I'm going to ask my doctor for detailed thyroid testing this month, and hormone testing as well if I can leverage it.

Edited by Dichotohmy, 03 December 2014 - 09:44 PM.

Another thing I've been pondering is whether a chronic streptococcal infection may be at the root of my issues.

When I was 15, I unexpectedly came down with scarlet fever, complete with a red rash all over my whole body and a 5-day fever that peaked at 104 degrees for around 24 hours. At least the family doctor diagnosed it as scarlet fever and put me on a regimin of anti-biotics that seemingly made me better. That 104 degree fever was similar, as I recall, in some ways to the altered consciousness I reguarly experience. On the other hand, like I mentioned, my body temperature is a consistent 97.0 and below.  

My sister has been sick with MRSA, which my mom, being a long-time hospital nurse, is a carrier of.

The evidence of chronic streptococcal germs being responsible for ME/CFS symptoms is pretty weak and not often mentioned from what my research tells me. On the other hand, maybe I could be lucky and strepococcal bacteria may be implicated in a condition with less of a dreadful prognosis than ME/CFS?

Edited by Dichotohmy, 03 December 2014 - 09:58 PM.

That 104 degree fever was similar, as I recall, in some ways to the altered consciousness I reguarly experience. On the other hand, like I mentioned, my body temperature is a consistent 97.0 and below.

Ok I have a pretty easy answer on this:

1- relief stress by dropping stimulants and quit smoking if you smoke

2 - relief stress by eating more calories and exercising less

3- relief stress by requesting a demote in job environment

4 - relief stress by ditching bad relationships 

5- relief stress by thinking less (you are very intelligent and articulate , it is usually a big trouble when ADHD-C because thinking does not end with a satisfaction (dopamine issue) )

You are soundling like classical case of fibromyalgia composed with sinus infection due to mite or dust allergy or something ...

I have hunch about you tho, like I feel that you set goals higher than you actually need which stresses you a lot without giving any satisfaction.  

Ok I have a pretty easy answer on this:

1- relief stress by dropping stimulants and quit smoking if you smoke

2 - relief stress by eating more calories and exercising less

3- relief stress by requesting a demote in job environment

4 - relief stress by ditching bad relationships 

5- relief stress by thinking less (you are very intelligent and articulate , it is usually a big trouble when ADHD-C because thinking does not end with a satisfaction (dopamine issue) )

You are soundling like classical case of fibromyalgia composed with sinus infection due to mite or dust allergy or something ...

I have hunch about you tho, like I feel that you set goals higher than you actually need which stresses you a lot without giving any satisfaction.  

This is a pretty good post and I've been coincidentally doing all of these things, especially since I really crashed hard around the end of summer and originally made this thread.

I've dropped the methylphenidate to baby doses (2.5mg IR per day) because I'm even worse without it. This doesage is also almost as therapuetic as my previous 18mg of concerta.

I've completely dropped exercise since the beginning of last September. This has helped with joint and muscle pain, but I have to admit, I miss exercising. One shouldn't feel better from not exercising and dramatically reducing low-impact physical activity, and it sure makes me a lot less productive, so I don't want to be this way forever. I've also been eating more, yet don't seem to put on weight in spite of a mostly sedentary activity level. I'm 69" tall and 130lbs, so can certainly afford to put on weight. 

I've destressed to my maximum capacity as far as work and interpersonal relationships. I've been largely incapable of empathy and human connection for a long time (didn't get that way until adulthood), so haven't had issues with other people anyway.

I agree about the importance about thinking less.

I disagree about fibromyalgia being the root/contributer to my problems, mostly because I have a penis, but also because it's a shitcan diagnosis IMO with little to no treatment avenues. I probably have UARS, which contributes to shitty sleep. I know that sinus inflammation can mimic the symptoms of encephalitis, but my sinus issues have really improved nearly 100% since I started using an inhaled corticosteroid 3.5 years ago.

I am a perfectionist, and it is a detriment some times, but I've always been that way and am not interested in psychological theories of the "inner critic." That's also why I haven't bothered replying to this thread for so long - I've just been stuck in an altered consciousness, like a perpetual marijuana high almost, and haven't been lucid enough to write anything intelligent.

Edited by Dichotohmy, 31 January 2015 - 01:30 AM.

In other news, over the last two months, I've been eating more starchy vegetables and supplementing with resistant starch (Bob's Red Mill potato starch), and think it might be having a real effect. By this I mean my IBS and other bowel issues are improved and I've noticed an improvement in circadian rhythm and more REM sleep - perhaps due to increased serotonin and B-vitamin synthesis by the microbiome. It's not a magic bullet by any means, but certainly worth the $3.99 for a month's supply that a 24oz package of unrefuned potato starch costs. I've had more luck with this than 90%+ of other supplementation.

I'm also kind of disillusioned that the placebo effects and other psychosomatic phenomena don't exist for me. That's why I'm like an incinerator for reputable supplements, and CBT, mindfulness, and other psychological approaches are a complete waste of time/money.

Sleep hygene is completely useless for me. I can inexplicably experience a good night of refreshing sleep just as reliably as a shitty night of sleep if I eat a huge meal an hour before bed, or spend time in blue-spectrum light, or go to bed watching engrossing TV.

It's pretty clear to me that I have some sort of physiological ailment that is the root of zombie hell, and that is incredibly discouraging because I don't have the disposable income or mental focus to seek out and find a competent doctor. I have a whole load of wants and clearly defined goals, but I literally don't have the physical health and mental energy to actualize them. That last point is hellish because I'm way too young to be that way. On the other hand, I'd have to say that the altered consciousness and emotional amnesia is a funny kind of silver lining because it keeps me from descending into suck starting a pistol or becoming a homeless, alcoholic drug addict.

Edited by Dichotohmy, 31 January 2015 - 01:49 AM.

I have had staggeringly similar symptoms over the years (including the extremely cracking ankles, coincidence?), however for me they are just periodic. My father is severe bi-polar and I have a lot of depression on both sides of my family. I have only recently been able to fully take control of my symptoms, which also seem to be a bi-polaresque phenomena. Unfortunately, what helped me wasn't just one thing but a combination of clean eating, abstinence from alcohol, smoking and mostly caffiene, supplementation (much as you described), excercise (hiking and light gym work is what I did) and forcing myself to be social (I have some social anxiety). I think for me social interaction is key. My father's manic episodes have always been precipitated by some negative, ego-damaging social event. Many of your symptoms could be caused by the lack of quality sleep and others could be psyco-somatic. I've also found that when in a happy relationship, my sleep improves and that I only really sleep perfectly when I'm with someone I care about. It's as if subconsciously my mind won't let me sleep until I am comfortable with my social status, clearly prioritizing it over anything else. It's a terrible trait in modern society, but at least we have the tools with which to deal with it.

Just as an aside, I recently began taking C60oo and haven't noticed any psychological benefit. Olive oil, fish oil and caprylic acid were already part of my regimen so perhaps the benefit others have seen was due to the oil itself and not the C60. Or maybe it's because I'm in a good place right now. But I have had a couple extremely vivid and lucid dreams (which is rare for me) and I randomly ran 9 miles for the first time in 15 years. So I do believe it's working on some levels. Best of luck.

Edited by Juangalt, 13 February 2015 - 05:17 PM.

In other news, over the last two months, I've been eating more starchy vegetables and supplementing with resistant starch (Bob's Red Mill potato starch), and think it might be having a real effect. By this I mean my IBS and other bowel issues are improved and I've noticed an improvement in circadian rhythm and more REM sleep - perhaps due to increased serotonin and B-vitamin synthesis by the microbiome. It's not a magic bullet by any means, but certainly worth the $3.99 for a month's supply that a 24oz package of unrefuned potato starch costs. I've had more luck with this than 90%+ of other supplementation.

 

I'm also kind of disillusioned that the placebo effects and other psychosomatic phenomena don't exist for me. That's why I'm like an incinerator for reputable supplements, and CBT, mindfulness, and other psychological approaches are a complete waste of time/money.

 

Sleep hygene is completely useless for me. I can inexplicably experience a good night of refreshing sleep just as reliably as a shitty night of sleep if I eat a huge meal an hour before bed, or spend time in blue-spectrum light, or go to bed watching engrossing TV.

 

It's pretty clear to me that I have some sort of physiological ailment that is the root of zombie hell, and that is incredibly discouraging because I don't have the disposable income or mental focus to seek out and find a competent doctor. I have a whole load of wants and clearly defined goals, but I literally don't have the physical health and mental energy to actualize them. That last point is hellish because I'm way too young to be that way. On the other hand, I'd have to say that the altered consciousness and emotional amnesia is a funny kind of silver lining because it keeps me from descending into suck starting a pistol or becoming a homeless, alcoholic drug addict.

Ok then I have some more things to say, 
a) All stimulants and stress relief agents are stretchers of homeostatic boundaries. Maximal bio-capacity comes from good blood circulation , macronutrition balance (glycogen depot) and indigenous antioxidants and morphine systems.
b) Both physical condition and behavioral (includes whole package of emotion - thought - wisdom - knowledge -habits - limiting beliefs etc ...) aptitude improves by accumulation over time. 

thus try to improve your "condition" without any stimulants and not hitting walls of stress and relaxation for example having ankle pains or hypo manic - euphoric reactions.
Non-impact exercises are best biological improvement rituals ie swimming and fitness.  %60 Repetition of max circuit calisthenics is my favorite 5 days a week 10 minutes each day. Running is bad cycling is good etc ...
All stimulants are bad because they are limiting the formation of self-stimulating thoughts and acquisition of its re-enforcing environment.

Ketogenic diet gives %35 less peak performance but it is stable and improves all unstable conditions like epileptic - bipolar - schizophrenic disorders. 
In my case my mental control and performance is very much related to my glycogen depot and blood glucose ...
If your glycogen depot is not full, (probably it is not because of concerta's stimulant effect) then vegetable starch will make wonders since its beta-glucan content populates bacteria which breaks fats into mono-fats in gut. 

If I were you I would immediately switch to ketogenic diet taking help from a professional by going in debt. Because if you risk shit to get candy and lose you things get shittier and it wont make any difference. Shit and shittier  are almost same . This will reduce the symptoms amplitude if any mental biological disorder exists.  Note that you should take a lot of supplements to take care of manganese like earth - alkaline metals. 

And build everything slowly (biology - behaviour - environment) slowly from a stable point then maybe you switch to heavy carb meals.  *** THE WORS THING is fluctuating glycogen depot from 0% to 25% this would make you a zombie for sure ... Vegetable + olive + bread combination would help a lot. My favorite vegetable is tomato and green pepper. 

2g Fish oil (epa,dha unconcentrated) - market grade water soluable multivitamins are must. Piracetam is good but not always it reacts with methilphenidate  and methamphetamine. 

My native language is turkish and first language is german. So dont expect much from my english ... 

take care of yourself. I ve been there, it will pass but slowly, so experiment and be patient. 

In other news, over the last two months, I've been eating more starchy vegetables and supplementing with resistant starch (Bob's Red Mill potato starch), and think it might be having a real effect. By this I mean my IBS and other bowel issues are improved and I've noticed an improvement in circadian rhythm and more REM sleep - perhaps due to increased serotonin and B-vitamin synthesis by the microbiome. It's not a magic bullet by any means, but certainly worth the $3.99 for a month's supply that a 24oz package of unrefuned potato starch costs. I've had more luck with this than 90%+ of other supplementation.

 

I'm also kind of disillusioned that the placebo effects and other psychosomatic phenomena don't exist for me. That's why I'm like an incinerator for reputable supplements, and CBT, mindfulness, and other psychological approaches are a complete waste of time/money.

 

Sleep hygene is completely useless for me. I can inexplicably experience a good night of refreshing sleep just as reliably as a shitty night of sleep if I eat a huge meal an hour before bed, or spend time in blue-spectrum light, or go to bed watching engrossing TV.

 

It's pretty clear to me that I have some sort of physiological ailment that is the root of zombie hell, and that is incredibly discouraging because I don't have the disposable income or mental focus to seek out and find a competent doctor. I have a whole load of wants and clearly defined goals, but I literally don't have the physical health and mental energy to actualize them. That last point is hellish because I'm way too young to be that way. On the other hand, I'd have to say that the altered consciousness and emotional amnesia is a funny kind of silver lining because it keeps me from descending into suck starting a pistol or becoming a homeless, alcoholic drug addict.

Ok then I have some more things to say, 
a) All stimulants and stress relief agents are stretchers of homeostatic boundaries. Maximal bio-capacity comes from good blood circulation , macronutrition balance (glycogen depot) and indigenous antioxidants and morphine systems.
b) Both physical condition and behavioral (includes whole package of emotion - thought - wisdom - knowledge -habits - limiting beliefs etc ...) aptitude improves by accumulation over time. 

thus try to improve your "condition" without any stimulants and not hitting walls of stress and relaxation for example having ankle pains or hypo manic - euphoric reactions.
Non-impact exercises are best biological improvement rituals ie swimming and fitness.  %60 Repetition of max circuit calisthenics is my favorite 5 days a week 10 minutes each day. Running is bad cycling is good etc ...
All stimulants are bad because they are limiting the formation of self-stimulating thoughts and acquisition of its re-enforcing environment.

Ketogenic diet gives %35 less peak performance but it is stable and improves all unstable conditions like epileptic - bipolar - schizophrenic disorders. 
In my case my mental control and performance is very much related to my glycogen depot and blood glucose ...
If your glycogen depot is not full, (probably it is not because of concerta's stimulant effect) then vegetable starch will make wonders since its beta-glucan content populates bacteria which breaks fats into mono-fats in gut. 

If I were you I would immediately switch to ketogenic diet taking help from a professional by going in debt. Because if you risk shit to get candy and lose you things get shittier and it wont make any difference. Shit and shittier  are almost same . This will reduce the symptoms amplitude if any mental biological disorder exists.  Note that you should take a lot of supplements to take care of manganese like earth - alkaline metals. 

And build everything slowly (biology - behaviour - environment) slowly from a stable point then maybe you switch to heavy carb meals.  *** THE WORS THING is fluctuating glycogen depot from 0% to 25% this would make you a zombie for sure ... Vegetable + olive + bread combination would help a lot. My favorite vegetable is tomato and green pepper. 

2g Fish oil (epa,dha unconcentrated) - market grade water soluable multivitamins are must. Piracetam is good but not always it reacts with methilphenidate  and methamphetamine. 

My native language is turkish and first language is german. So dont expect much from my english ... 

take care of yourself. I ve been there, it will pass but slowly, so experiment and be patient. 

I have had staggeringly similar symptoms over the years (including the extremely cracking ankles, coincidence?), however for me they are just periodic. My father is severe bi-polar and I have a lot of depression on both sides of my family. I have only recently been able to fully take control of my symptoms, which also seem to be a bi-polaresque phenomena. Unfortunately, what helped me wasn't just one thing but a combination of clean eating, abstinence from alcohol, smoking and mostly caffiene, supplementation (much as you described), excercise (hiking and light gym work is what I did) and forcing myself to be social (I have some social anxiety).

I only mention Bipolar in passing, not because I believe I have BP2, and certainly not BP1, but because I have some days that are that much better than others for no apparent reason. I agree that an integrative, multi-faceted approach is needed and anything else will fail. At the same time, supplements are nearly always a waste of money for me. Exercise is a really precarious thing as I mentioned, because it's so easy for me to overdo it and I've always recovered slowly, despite good physical conditioning from doing exercising actively for years, and since this latest crash/relapse into full-blown zombie hell, pronounced exercise intolerance is now a thing for me. I'm pretty asocial, but 100% not autistic, schizoid, or socially axious (zero anxiety really, like I mentioned). I think I avoid other people because they genuinely bore me more often than not. I also have extremely blunted emotions, so I have to fake social interaction as a rule, which I don't mind doing if it will benefit me, so give-take, altruistic relationships with other people are pretty alien to me. As I mentioned, I didn't use to be that way.

Many of your symptoms could be caused by the lack of quality sleep and others could be psyco-somatic. I've also found that when in a happy relationship, my sleep improves and that I only really sleep perfectly when I'm with someone I care about. It's as if subconsciously my mind won't let me sleep until I am comfortable with my social status, clearly prioritizing it over anything else. It's a terrible trait in modern society, but at least we have the tools with which to deal with it.

Somatization seems like a strange phenomena to me, in that it seems to be very based on anxiety and emotions. As an aside, I'd also say somatoform disorder is probably way over-diagnosed and over-emphasized in the medical community. I no longer have any anxiety, and my inner monologue is so emotionally neutral it's almost funny. It's like, I mentally consider my worst problems with the same emotional gravity that I would consider in choosing a brand of product at the supermarket.

Just as an aside, I recently began taking C60oo and haven't noticed any psychological benefit. Olive oil, fish oil and caprylic acid were already part of my regimen so perhaps the benefit others have seen was due to the oil itself and not the C60. Or maybe it's because I'm in a good place right now. But I have had a couple extremely vivid and lucid dreams (which is rare for me) and I randomly ran 9 miles for the first time in 15 years. So I do believe it's working on some levels. Best of luck.

The thing is that I do notice psychological benefits, and physical benefits from a rare night of refreshing sleep, and from some anti-inflammatory drugs. Specifically, ibuprofen can have powerful psychological and cognitive effects and really helps me be more active without that body load of zombie-like listlessness. C60 OO didn't do much for me either, and fish oil, avoiding "unhealthy" omega-6 vegetable fats don't help at all for me. I suspect REM sleep is a problem for me, in that I don't get enough of it and frequently awaken during REM. My dreams are pretty vivid and include color, the perception of time, thinking and planning, and emotion. I never have nightmares or almost never have troubling dreams - as a whole, my dreams are mundane and boring, even if they are real and life-like.   
 

Edited by Dichotohmy, 14 February 2015 - 10:18 PM.