u/CeruleanShot

I'm out of rolling PEM and physically better, but mentally just feeling so fucking bad and struggling. I don't know what to do, I feel like I'm drowning. I'm just so fucking alone.

The harder I fight to get moving again the worse I feel but I don't have any choice. Things are pretty bad and I just don't know what to do. I should be grateful for the amount of time I'm able to be upright and moving around, I should be grateful for how much better my sleep has been, how much better I feel. Compared to where I was a couple of months ago I'm so much better. But I can't take care of myself, I have so much stuff to deal with and I'm just, broken. I feel so alone. I feel like I'm drowning.

I just feel so fucking bad, man.

And I can't do them anyway, I just get more foggy headed, plus emotionally upset. It is very weird, it's like my brain turns into an over tired toddler who's wailing and screaming because it doesn't WANT to do the thing.

It's starting to feel like I have a brain injury. Things were so bad for the past year I couldn't see how bad they were, but now that I'm getting some stability, holy shit.

Anyway, just ranting. Don't really have anywhere else to say this.

**Summary:**

I'm recovering from a lengthy crash. Physically I am improved and my baseline is increasing with pacing. Dextromethorphan (DXM) is helping with cognitive symptoms. But I am still really struggling with problem solving and taking care of tasks with cognitive elements. I am desperate to improve this, I have stuff in my life I really need to take care of my brain keeps shutting down.

**Full post:**

After spending half a year in a really scary crash, I've been able to stabilize. I'm still pacing, but by moving really slowly and resting frequently I've been able to get out of bed and leave the house more without triggering PEM. My orthostatic issues also seem to be improved for reasons that I don't understand, other than just, reduced neuroinflammation, I guess.

I've been taking dextromethorphan for months, and it has helped a lot. I was taking 15mg capsules three times a day for most of that time. I see recommendations to take it before activity to help prevent PEM, but it doesn't seem to work immediately like that for me. I have noticed benefits over time from taking it regularly.

I ran out a couple of weeks ago and thought it might be beneficial to take a break for a bit. After a couple of days off of it I *really* noticed a difference.

So I went back on, and I tried increasing the dose. Neuroinflammation researcher Jarred Younger recommends low dose DXM based off of animal studies. But I pulled up some studies on DXM for traumatic brain injuries off of PubMed and found a dosing range of 60mg-120mg/day in divided doses. I am now on 90mg/day.

It's a game changer. Is it working because it's reducing microglial activation and neuroinflammation? Is it helping because it's modulating glutamate? Something to do with acetylcholine? I have no idea, and I don't think the research is very clear on it, either, but this is really helping me a **lot** with cognition.

But I'm still struggling so much to actually take care of stuff and get things done. My brain just shuts down. I try to do things, I try to address a problem, it literally just stops thinking and shuts everything down. I am having such a hard time actually DOING anything.

I downloaded a brain games app and started playing a math game, where you rapidly do mental addition or subtraction with a string of numbers. I was getting 100% on it until it was too much, too fast, and my brain just stopped. It wouldn't do it any more. Tried playing a different math game right after it, without a time limit, and my brain wouldn't add the numbers together.

That is what's happening in general - my brain hits a limit with doing something and just shuts it down.

This is a big, big problem. My life is actually on fire right now and I really need to take care of stuff. I have a lot of stuff that I desperately need to take care of. And I can't get my brain to engage with it, the way it shuts down is really overwhelming.

In some ways my cognition is okay. I am finding it much easier to read, process information, form thoughts, use words. But I have such a hard time doing anything that's "hard."

I don't know, I guess I'm just curious if anyone has any ideas or thoughts.