Your inconsistency isn't a character flaw or willpower problem. The pattern — episodes that start and stop on their own, don't respond to behavioral intervention, and lift randomly — is the signature of a brain regulation problem, not a motivation problem.

Three systems explain almost everything:

• HPA axis (stress switch). After head trauma, the cortisol switch commonly fires without cause and won't reset. That's the random on/off you can't control. Exercise and willpower can't reset a stuck hormonal thermostat.
• Dopamine system. TBI damages dopamine-producing regions and creates a chronic low-dopamine state over months. That's the motivation collapse during lows — depleted drive circuit, not laziness. It also explains why serotonin-first meds kept failing: the targets were wrong.
• Sleep / body clock. TBI damages the brain's master clock. Non-restorative sleep keeps cortisol high, which wrecks sleep further — a self-sustaining loop that burns out on its own schedule.

The hopeful part: every node is measurable and at least partly treatable. Calming any one node tends to settle the whole loop. Sleep is the highest leverage.

Bipolar-spectrum flags worth a proper evaluation: onset before 25, many lifetime episodes, family history, antidepressants backfiring, easy elevation. Not a verdict — a reason for an evaluation that apparently hasn't happened yet.

Informational only — not a diagnosis. Full sourced document: root-cause-framework.md

The core idea: a quarterback + specialists. Help has been fragmented and no one has held the whole picture. The team has two layers: one provider who owns the whole picture, plus specialists who fix one node of the loop at a time.

Priority 1 — Neuropsychiatrist / TBI-informed psychiatrist. Unlike a general psychiatrist, the TBI connection is their home turf. They'll take your football history as central (not noise), run a proper bipolar-spectrum evaluation, and understand why serotonin-first meds kept failing. This one hire changes everything downstream. Track where you are in My Team.

Priority 2 — The right bloodwork + sleep study. Before another psychiatric medication, get the cheap tests: hormone panel (IGF-1, testosterone, TSH), sleep study (apnea alone can cause your entire symptom list), pharmacogenomics (why meds backfired). Any thorough MD can order these.

Sleep medicine specialist. Non-restorative sleep plus needing 10–12 hours but waking exhausted demands a real look. Sleep is the master switch.

Already on your team: Dr. Ken Cook / BrainCore (keep going) and C3 Wellness / Dr. Chirumbolo (keep in the loop on anything that changes).

The app's role: Every specialist works better with data they can't get in a 30-minute appointment. Your daily check-ins and episode log are that data. The Export section turns it into something you can hand a new provider.

Informational only — not a diagnosis. Full sourced document: dream-team-blueprint.md