I am not a doctor. The biggest thing for me in the last couple of years has been physical health. Exercise, eating correctly, and proper sleep have resulted in a huge improvement in my mental acuity, and relieved a sense of I had of "I'm not operating at my actual capacity."
This advice can feel trite, or it can feel overwhelming. Changing physical habits when you're already depressed is a huge undertaking, and I don't want to minimize it. However, my revelation has been the mind truly is not separate from the body, and taking care of myself by running, lifting weights, falling asleep at the same time has had largely outsized benefits vs any medication or therapy I've tried in the past.
I had a biology professor say something to the effect of "when you have energy that's because you're burning energy." You workout, you get your heart rate up, your metabolism is going, you feel energized and you think better.
Another way to put it is laying around on the coach, eating and sleeping a lot will not make you feel more energized even though you filled up your tank
I share this perspective. I don't have acute trauma behind my anxiety and depression, but I have been through periods of poor self-care wrapped up with those states, and I relate to OP. Exercise, sleep, nutrition, and spending time with even just one person who likes you are pillars of (mental) health, and without them, all the other tools (meditation, psychedelics, therapy) don't seem to have much leverage.
Agreed on mind and body as one. I'm working to address physical health, but it often feels my brain has been irreparably damaged over the course of 2 decades to where no amount of physical health will rewire the necessary circuits to achieve normal function.
That's hard, I'm sorry you have that struggle. I am about as far away from an expert on the brain as it gets, so I don't want to pretend to have wisdom there. The only thing I can say for myself is around Duḥkha, or that life is suffering.
Navigating the balance between self improvement, and being okay with the idea you may never improve to the point you want is hard. I know as much as I wish I could run a 5 minute mile, I was incredibly sedentary in my teens and 20's. It bothers me that I may never become "elite" in fitness because of my past, and that's just a fundamental barrier for me now.
My current thought is trying to find my personal worth in the journey of attempting self improvement, and not having an absolute goal of "I must be this smart" or "I must be this fit" to consider myself valuable. That mindset is easier said than done, though.
Yep, I've found that accepting a new value framework at an intellectual level is far easier than getting your emotional brain to accept it. I've found that having deep conversations with people where you talk about your new value system helps. There's something about the process of sharing your new value system with your friends & acquaintances that hastens the re-wiring of your emotional brain.
This is not meant as a criticism, hopefully more of an inquiry if you so choose. Is it possible that your 'feeling' of your brain being irreparably damaged is actually factually incorrect? And that your assumptions/model of the plasticity of the brain may be wrong and skew a bit negative?
Is it possible that these negative thought patterns are holding you back? Awhile back, I became aware of some irrational negative thought patterns I had myself, and worked on reframing them, and it helped immensely w/ confidence.
This is what therapists have told me, but when my mind totally blanks when asked a question in a meeting, or when I can't vocalize a coherent thought without stumbling over myself, or when I have to read a paragraph 20 times over for the information to stick, I have a hard time believing it's just a negative self-perception.
On examining the negative thought patterns, I think there's at least a couple parts to it:
1. If you very much believe no amount of physical health interventions will have any cognitive effects, then it seems like the probability of you sticking with any sort of health/fitness routine is very low. If in fact, health/diet/fitness DOES have positive cognitive effects (it's been proven scientifically and there are tons of anecdotes), you may end up depriving yourself of a really great thing for improving quality of life and cognition. So examining the possibility that your cognition is not doomed and immune to physical health interventions could greatly increase the odds of improvement.
2. In 2 of your examples, they were social situations. In my experience, negative thought patterns can definitely impact that. I'm saying this somewhat loosely, as I'm not an expert, but have done research in the past on this: Thoughts can trigger bio/physiological responses in the body/brain that can definitely impact cognition.
medicine has been a big factor for me, but I noticed when I started the meds especially (wellbutrin was added to my vyvanse regimen in June), that I was going to bed at the same time and waking up at 8am, I'm a night owl so this is real weird, but since then I've drifted back to old habits, and the meds seem to be less effective, but I guess in retrospect maybe it's just having a better structured day has a lot more bearing than I give it credit for.
This advice can feel trite, or it can feel overwhelming. Changing physical habits when you're already depressed is a huge undertaking, and I don't want to minimize it. However, my revelation has been the mind truly is not separate from the body, and taking care of myself by running, lifting weights, falling asleep at the same time has had largely outsized benefits vs any medication or therapy I've tried in the past.