[sneak]

> “Burning out all of the glucose and dopamine in your brain” isn’t a thing.

This sort of narrative-based grandstanding is something the author is previously known for.

His "lol oops I hacked too much" doesn't hold up to scrutiny, otherwise this would be an extremely common thing in overworked knowledge workers. It's not.

[Robotbeat]

I’ve had similar things happen. It’s not uncommon.

It is a physical thing. I’m not sure it’s caused by burning out all the glucose or whatever (as that is short term addressable). Dopamine, that’s possible.

In my case, it was caused I think by not getting enough sleep combined with cognitive load, perhaps exasperated by high sodium, and poor nutrition. Stimulants (such as caffeine, but also Ritalin, adderall, etc) if not carefully moderated both cause you to continue to work beyond the point your brain physically needs rest while also causing a kind of dopamine resistance where you need more stimulant for the same effect.

And you get migraines. In my case, optical migraines (expanding noise/patterns... in your visual cortex, not in your eyeball... that is me with somewhat foggy thinking and a bit of a head ache). A little like seizures but limited to certain parts of the brain. A little like micro-strokes as well as there’s evidence that migraines like that are somewhat vascular in nature in that similar damage is seen (in folks with lots of migraines) as in small strokes. And they seem to happen when combined with high sodium, low water intake, combined with lack of sleep and high cognitive load.

But I wouldn’t be too certain about the causes. It’s hard to tell with these things.

I suspect it has something to do with the glymphatic system (as drinking enough water seems to help as does getting enough sleep).

I’m more careful with my sleep schedule and generally don’t push myself overly hard like in grad school and try not to have too much sodium (eating Ramen—with the packet—triggered one of my episodes) and I really have them only extremely rarely—less than once a year—instead of multiple times a week like in grad school.

Recognizing limits on yourself is important. I think hard work is really wonderful and feels amazing, but you should be careful to sleep enough (7-8, maybe more if you’re recovering from something... I aggressively try to get at least 7 hours every single night), drink enough water, don’t over do it on stimulants, and make sure to eat enough.

[PragmaticPulp]

Burnout and stress related disorders are very real, but trying to explain them away as purely physical illnesses isn’t accurate, nor does it help with finding a resolution.

> It is a physical thing. I’m not sure it’s caused by burning out all the glucose or whatever (as that is short term addressable). Dopamine, that’s possible.

No, you don’t simply run out of dopamine, nor can you use it up by thinking too hard. The body is extremely good at keeping the brain fed and stocked with neurotransmitters, even between meals.

This pop-science concept of running out of dopamine isn’t real.

The real problem here is that mental illness still carries too much stigma. Some people are so resistant to accepting a mental health diagnosis and treatment that they will go to great lengths to reframe their problems in physical terms, thereby dodging what they feel (incorrectly) would be an admission of mental weakness.

Even this Tweet author’s doctor diagnosed him with a mental illness, and he even cites the diagnosis from the DSM. However, for some reason he still tries to reframe it as what he calls a “physical” thing.

[csnover]

> The real problem here is that mental illness still carries too much stigma. Some people are so resistant to accepting a mental health diagnosis and treatment that they will go to great lengths to reframe their problems in physical terms, thereby dodging what they feel (incorrectly) would be an admission of mental weakness.

I feel like suggesting that someone would try to ‘reframe’ their condition to avoid stigma inadvertently perpetuates stigmas by reinforcing the false dichotomy of mental vs physical illness.

Cognition is an extremely complex and poorly understood physical system, but a physical system nonetheless. There’s no separate ethereal plane where consciousness lives, no great uniqueness to its dysfunction. It’s not surprising to me that some people would introduce their own worse pseudoscience when physicians claim their problems are not physical problems, and I think that can happen regardless of stigma.

I believe we would do well to stop cleaving ‘mental illness’ (and, you know, ‘dentistry’) into a separate category from any other physical health problem. These conditions are physical conditions, just with such complexity that we’re not currently able to measure, understand, or treat them with the same level of precision as others. This sucks, but at least it’s honest.

[posthiatal1]

I don't agree with the OP's interpretation of the organic causes, but:

The PTSD seems quite plausible, as either a consequence of the original phenomenon or, yes, even a factor in it.

For an organic component, if any, I prefer hypoperfusion & ischemia.

I wonder if circulation can be impaired by chronic high levels of stress (and the inflammation caused by stress).

If so, I wonder if this can happen selectively, affecting most strongly the areas used most intensively during stressful times (and receiving the most exposure to high-cortisol blood).

I wonder if narcolepsy and/or something like this may work to protect the brain (from whatever mechanisms) during periods of high stress.

If ketogenic diet helps with narcolepsy, I wonder if one mechanism is that burning glucose is a source of oxidative stress...

[sneak]

There's nothing in your comment to suggest that your constellation of symptoms is in any way related to the constellation of symptoms (or purported underlying cause(s)) in TFA.

[Robotbeat]

He mentions seizures and micro stroke. This isn’t too far off. Qualitatively different effects, so the underlying physical cause could be different, but I wasn’t intending to imply that mine and his effects were identical.