[44F] Experiencing brain fuzziness and head pressure

Patient Description

A 44-year-old female has been experiencing persistent brain fuzziness and a feeling of disconnection for about a month. The patient suspects that these symptoms may be related to anxiety and the medication hydroxyzine, which she is currently taking. The symptoms have led to feelings of disconnection from those around her, which she finds frightening. In addition to these symptoms, she reports experiencing anxiety, constant pressure in the front of her head (rated 5/10 in severity), occasional blurriness in vision, dizziness, and depression. The patient notes that methocarbamol sometimes helps relieve the head pressure, and hydroxyzine aids in sleep. She suspects she might be experiencing derealization. The patient plans to discuss these symptoms with her healthcare provider. Her medical history includes anxiety, depressive disorder, sleep apnea, irritable bowel syndrome, and psoriasis. She has allergies to penicillin, sulfa, and fentanyl. Current medications include Taltz, rosuvastatin, and vitamin D.

Arora's Assessment

What might be happening

Based on the symptoms you've described, there are a few possibilities to consider:

Medication Side Effects: Hydroxyzine, which is often used to manage anxiety and help with sleep, can sometimes cause side effects like dizziness, blurred vision, and a feeling of disconnection or brain fog. It's possible that your symptoms are related to this medication.
Anxiety and Depression: Both anxiety and depression can contribute to feelings of derealization, brain fog, and head pressure. These conditions can also affect your sleep and overall sense of well-being.
Derealization: This is a dissociative symptom where you might feel disconnected from your surroundings or yourself. It can be associated with anxiety, stress, or certain medications.
Sleep Apnea: Given your history of sleep apnea, poor sleep quality can contribute to daytime symptoms like brain fog, dizziness, and mood changes.

It's important to discuss these symptoms with your healthcare provider, as they can help determine the underlying cause and adjust your treatment plan if necessary.

What you can do

Medication Side Effects:

Discuss with your healthcare provider about the possibility of adjusting your hydroxyzine dosage or exploring alternative medications that might have fewer side effects.

Anxiety and Depression:

Continue any prescribed treatments for anxiety and depression, such as therapy or medication.
Practice relaxation techniques like deep breathing, meditation, or yoga to help manage anxiety.

Derealization:

Grounding techniques, such as focusing on your surroundings or engaging your senses, can help manage feelings of derealization.
Keep a journal of your symptoms using MDandMe to track patterns and share with your healthcare provider.

Sleep Apnea:

Ensure you are using any prescribed CPAP machine or other treatments for sleep apnea consistently.
Maintain a regular sleep schedule and create a calming bedtime routine.

What you should look out for

While your symptoms are concerning, they are not immediately life-threatening. However, you should seek medical attention if you experience:

Worsening dizziness or balance issues
Severe or sudden changes in vision
Intense feelings of disconnection or confusion
Any new or worsening symptoms

Remember, it's important to consult with your healthcare provider to receive a formal diagnosis and appropriate treatment. They can help you navigate these symptoms and find the best approach for your situation.

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2 mo ago

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