Months-long episodes of mental confusion during the past 3 years + secondary symptoms

Age: 25

Sex/Gender: Male

Height and weight: 178 cm, 76 kg

Hello everyone,

I apologize in advance for the very long post but I figured it would be better if I included as many relevant details as possible.

For the past 3 years I have been regularly suffering from lengthy intermittent episodes of mental confusion, marked by a noticeable decline in my ability to plan things, to follow/understand conversations, to solve problems (in a context of very little stress/ emotional distress, just to point that out) and other secondary symptoms such as mild fatigue and leg/forearm pain in the absence of any kind of physical straining.

It all started with a 2-3 month-long episode between March-May 2015, marked mostly by these primary symptoms. At the time, these symptoms did not affect my functioning that badly and I still managed to stay on top of things in my last year of university and graduate with high honors. Symptoms then subsided and I just ignored it all, but about a year later through my first job out of university (March 2016), symptoms returned with an increase in severity, to the point where it became difficult for me to do my job properly (couldn't plan my work as well as I did before, made tons of mistakes in my work, and mood and self-confidence started worsening a lot as a consequence). Things became so bad I fell into a severe depressive episode and had to stay off work for about 5 months (I tried coming back to work about 3 months into the episode but couldn't for more than a month in June 2016, I then quit my job).

After a lengthy recovery from the depressive episode, all mental confusion symptoms I had pre-depression disappeared again (towards the end of September 2016). I returned to my normal levels of functioning and started grad school in a new country. I had a very successful semester up until about April 2017 again, where mental confusion symptoms re-appeared again and started to seriously hamper my ability to study effectively and carry my part-time job as a research assistant successfully. I quit my part-time job to focus exclusively on my studies, worked on improving every aspect of my already-quite-healthy lifestyle (diet, sleeping, exercise), and most importantly, changed my mindset to just focus on surviving and doing my best to avoid falling into another depressive episode. Thankfully, I did not and managed to scrap through 5 months (until September 2017) of reduced cognitive functioning, but it was still quite a difficult feat given the demanding academic context where I had to unfortunately be at the top of my mental abilities to perform and succeed. I also started to get (or maybe notice ?) secondary symptoms such as waking up with 1) fatigue and 2) aching forearms and legs with no discernible cause (e.g. no physical straining to explain it), and that for months. I just pushed through and blamed secondary symptom number 2 on my speed-walking habits on my way to catch the daily subway, but even after trying to stick to normal walking I could not feel any change to them up until September when I fully recovered again from everything. In that meantime (i.e. April-September 2017), I also started investigating non-psychological explanations for my ills: I always thought at the beginning that the mental confusion episodes were perhaps 'pre-signals' for the depressive episode I had in 2016, but after not falling into one again despite suffering from the same mental sluggishness problems I had, I realized there might something else behind it all. While doing my best not to fall into the trap of surrealistic self-diagnoses, I started visiting a couple of doctors in the city where I live to seek explanations for what I had. Normal blood-testing results, normal allergy-testing resting, and comments from the GPs I visited left me without any answer and very disappointed. Because of my student insurance and its limitations with regards to waiting times + language barriers, it has been difficult for me to seek medical advice from as many medical specialists I would like to. I then just focused on scraping through until the time my symptoms subsided yet again.

As predicted and in a now very discernible pattern, September/October 2017 came and with it disappeared yet again all suffering. Again, I excelled in school, revived my social life and took back control of my life throughout that period until March 2018, where the same story started to unfold again. I am now interning at a big-shot company, an opportunity I invested a lot of my energy/effort into to secure, and am now again feeling mentally sluggish, fatigued and with limbs aching for about the past 3 months (March before I even started the internship, and carrying on through April-May while working). My work supervisor has already started noticing my current error-proneness and poor planning abilities and is starting to grow impatient with them. I know I will survive the fog again, but I am starting to feel that this would be now my last chance to uncover and address whatever condition I have at the moment, before graduating and having to plunge back into the engineering workforce, which is not really tolerant of sluggish thinking, poor planning abilities and inattention mistakes.

Maybe sleep apnea ? Or something neurological ? What could explain my ills and/or their pattern/seasonality ? If it's not allergies (2 tests gave back normal results), not seasonal affective depression (given that these episodes never happened to me in winter + the absence of any significant emotional stresses throughout the 3 episodes and the different environments (didn't matter whether I was studying vs. working, or in my home-country vs. abroad) I lived through.

Apologies again for the lengthy post. I have done a home sleep study a couple of weeks ago and am eager to know about its results (my doctor appointment is in about a week), but I would still welcome any alternative suggestions with open arms. This has been really destroying my life !

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