Yeesh
Not a big deal to see that from a lot of players, but for a guy like Vasek to be acting like this is definitely concerning. I would say he should shut it down for a month or two and really considering hanging it up if he can't get himself right.
I would imagine it has been a very trying year or two with very few ATP main draw matches. Travelling all over to play at low end tournaments and not being able to get up and play at your best against opposition that you know you should be beating has got to be draining when you're at his age.