Multiple mental health and cognition issues, brain hypometabolism, how to get back on track?

Hi, I'll try to explain my problems to the best of my ability, looking for some advice on how to proceed and get my mental health on track, since my everyday as well as professional life are suffering.

Reason I'm asking this question is because at this point in time I'm not sure anymore what is causing all of my problems right now, if it's anxiety, stress, brain damage, but probably a bit of everything.

I'm 26 and have multiple mental health and cognitive issues, most have been diagnosed at one point, including brain hypometabolism due to excessive binge drinking. I would also self-diagnose ADHD, due to suspicions the doctor had when I was conducting neuropsychological tests. but also due to just noticing my own pattern of behaviour.

This will probably be a long post, so I'll put a tl;dr at the end.

I'm currently 26, and a bit too young to have all of these problems, at least compared to my peers. I have been diagnosed with depression and anxiety before, and not too long ago also with hypometabolism of the cerebellum, which basically means decreased glucose consumption in the part of the brain responsible for fine motor control, alongside other things.

I'm not gonna go into too much detail, because that would take to long, but in short, I have a history of depression, weed and alcohol abuse. I have been smoking weed on and off since 2015, and have had pauses of various duration, ranging from weeks to months, during the first few years I smoked probably a few times a month, then had periods of smoking for a month or two in a row, once or twice daily. During that time, from 2015 till now I began drinking socially and had a lot of binge sessions, so I wasn't an alcoholic, but what I was doing wasn't healthy. Didn't think too much into it, most of my peers were doing it. Started noticing my issues getting worse around 2017, and I began taking various antidepressants around that time, and have been on and off until recently, with various durations.

Fast forward to late 2020, just before the covid breakout, I broke up with my first girl, and had a really tough time handling that, since it was my first girl, and the only way I knew how to deal with it was with alcohol and weed, so that's when I smoked weed for 4 months in a row, and decided to finally stop in March 2021. But after I was finally done with weed, I had a binge drinking period of about 3 weeks, where I drank about a liter of wine every day in a row. I didn't think much of it, but at the last day I had about 3 liters, and the next day I woke up I was super hungover, so hungover in fact that it lasted for a few days until I figured something was really off and went to the ER. They gave me an IV, and I felt better the next day, but I had already done too much damage, ended up with permanent dysarthria which still bothers me today. Of course I was told to never drink again by the doctor who gave me IV.

Now for the weird part: I was recovering for about 7 months, and during this period of recovery(obv. no weed or alcohol consumption), I felt like I was slow, couldn't think straight, had brain fog, cognitive issues, memory issues, couldn't recall words, had grammar and vocabulary issues in my primary language, and felt like I forgot a huge portion of my second and third language. I also had multiple check-ups with a neuro, and had done brain screens during that time. I was diagnosed with encephalitis, which is brain inflammation. I was really scared for my life, and felt like it was going to stay like that for life.

So I started eating healthy, taking Essential oils, B-vitamins and working out, all of that paired with brain neuroplasticity helped me to recover a lot, so much in fact that when I went for a check-up with my neuro in October 2021, I told her that I've never felt better in my life mentally, because that's how I really felt. I haven't had a puff or a sip of alcohol, and I felt that my memory had really recovered, I could recall every word I wanted, I had no cognitive issues, no short or long term memory problems. She even complimented me on how my memory seemed to be better than hers. I was still left with dysarthria, which means I have problems with controlling my speech muscles, so I have to sort of exaggerate certain movements, but that was whatever. Basically this is when I felt the best ever mentally since my issues began in 2015, had no stress, no anxiety, no memory issues. Felt effin normal again finally.

My happiness didn't last for too long, I decided to go for a single(!) drink with my friend a few days after the good news from my neuro, and the next day I felt sluggish again, word recall problems, etc. What I believe happened is I was so worried that I damaged my brain again with this single drink that I started to worry so much subconsciously over it, I was stressed and anxious again. That was October 2021, and it has remained that way ever since. Since then I haven't had a sip of alcohol for many many months, maybe a single drink every few months just to satisfy my buddies. I did get drunk like one time, and that was off of a few drinks, so nothing close to getting blackout drunk. During March 2022, I started taking Eglonyl(sulpiride), I was taking that for anxiety for a few months, and I started feeling well again starting summer 2022, no cognitive issues. At one point during the end of summer I just stopped taking it for a few weeks, not sure why, I probably forgot about it since I was feeling well mentally, then started taking it again, but my problems returned. I started the pills again but they weren't doing as much this time. I quit taking them a few weeks after. At one point I felt good again, cognitive issues were gone mostly, except for my constant stress over health, which is ever present, and probably caused word recall problems. But mostly I felt like I was going in the right direction.

Then one day my friend got drunk and bought weed, and invited me out. I didn't know he was drunk nor that he bought weed, so when we met up he just handed me a gram. Talk about giving drugs to a recovering addict. I was contemplating smoking it, and in the end I did, because what is one gram going to do to me, I recovered from much worse. Well, long story short, this is where my impulsiveness comes in, hence why I suspect I have ADHD. I did feel just fine the next day, and decided to buy more. So I smoked a few joints daily for a month, AGAIN. This was October/November 2022. After barely quitting thanks to my other sensible friend, after being addicted for a straight month, I now have once again multiple issues, brain fog, word recall, memory and cognitive issues.

What's making everything worse besides having this brain fog which will probably last for months is that I'm also writing my final thesis, and I have to start working in about a month or two, so the stress due to that is just making everything that much worse. This has been my life from November 2022 till now, just brain fog, cognitive issues, language issues again, word recall and grammar, can barely write in my third language(which I got really proficient at, having studied it for 6 years, and even spent time living in that country, managed to reach C1 level, but right now my current proficiency feels like a B1), and just being really stressed and anxious.

What I forgot to mention is that I have done a brain spect f-18 screening or whatever, and the result said that my brain is mostly fine, except the cerebellum part which I mentioned having hypometabolism. So my thinking is, if we don't take into account the brain fog from binge smoking weed for a month, since that's responsible for much of my issues now, my brain is mostly fine according to the brain screen. So my question is I guess, what should be my next step, aside from never smoking again obviously?

I figure I am impulsive, that's probably why I binge, since I have low self-control. This to me indicates some symptoms of ADHD. I have difficulties concentrating on my thesis now, because of the brain fog. I am also stressing out constantly, and I'm anxious. Sorry for writing so much, you can tell this text is all over the place, scattered, just like my mind currently.

How should I proceed, what should my first priority be? I'm supposed to start a job as a programmer in two months, but I'm still studying and have trouble memorizing and following everything, which is why I'm stressed over starting work. I'm fairly certain most of my issues are actually caused by stress and anxiety(if we ignore the acute brain fog for now). I think the reason I felt so well after my 7 month binge drinking recovery is because I was so happy making progress every single day. I wasn't stressed, or anxious, I was just happy to be seeing minor daily improvements over what seemed like permanent brain damage at that time. Do you have any recommendations on meds, which I could talk to my psychologist about? I would appreciate and words of advice, I need some guidance right now because I have issues putting everything into perspective.

Much appreciate, and a happy new year!

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