Fixes I've attempted: Trying in singleplayer, reinstalling windows, reinstalling game, verifying integrity of game cache.

This issue usually starts by a muting of all sounds associated with player actions or in game happenings EXCEPT for environmental sounds like birds chirping and wind. Every once in a while all the other sounds will then "catch up" and you'll hear a bunch of explosions and gun shots that I guess have happened since it was muted.

Then various issues pop up and the game starts to become unplayable. For instance the inventory items won't load and buildings will disappear, or they will appear with only the furniture floating in the air. Here's some screenshots attached as it degrades. Also, it usually crashes after I escape to main menu and I see the refoger loading screen.

Also this only started happening about two months ago