Memory is becoming horrible!

[Dedle]

  I am a 41 yr old woman.  I have noticed a gradual, but progressive, decline in my cognitive function and memory over the last couple of years.  I do have a complex medical history, including hypothyroidism, managed effectively for 14 yrs with Synthroid and checked twice yearly, some kind of connective tissue disorder with lupus like symptoms and ANA pattern more significant for CREST or possible Sjogrens but impossible to identify at this point the specific illness.  I also have had in the past a history that included 2 major instances of depression, once when my father died when I was 18, and in my early 30s when my marriage fell apart.  I also have problems with frequent bouts of bronchitis and asthma.  Occasionally I do feel a little depressed, mostly because I get so sick and tired of hurting and being ill and it seems the docs have been unable to get my symptoms under control.  Besides being sick I am a single mother and work full time so I do have stress in my life, especially surrounding time management....but I generally feel happy at work and at home.  The problem is my brain does not seem to work as well as it used to.  I have difficulty concentrating.  I have difficulty understanding complex mathematical or verbal problems which has impacted on my ability to help with my kids' homework.  I have difficulty remembering names, and numbers.  Once I forgot my address.  I routinely forget my SS#, phone #, etc.  I forget to turn off the stove, lock the front door, or sometimes to remove the keys from the lock!  I touch something, and within minutes it is lost.  I forget deadlines for my job.  I forget to pay the bills, and the ones I remember to pay, I lose.  I often get my words mixed up, substituting wrong words...usually I will recognize when I do this.  Often I can't think of the word I want to say.  Recognizing and being aware of these errors makes me even more scared.  I have tried to take Ginko Balboa, which does seem to help a little bit, but at the expense of giving me daily headaches.  My doctor thought I was probably depressed and explained it was normal to be depressed when dealing with chronic, difficult to treat illness...she tried me on prozac but I saw little difference.  It doesn't "feel" like the depression I have had in the past....I am usually not unhappy, I can usually find humor in the situation, I have no problems with thinking of suicide...  rather I am tired to the bone all the time, I have difficulty sleeping, and I am having these memory/thinking problems.  Does this sound more like a physical or mental problem to you?  It seems easy for the docs to jump on my history of depression, but I am concerned it may be more physical than that.  I did try a fairly long term trial of St. John's Wort, which did not seem to have any effect either.  My children, now teenagers, are accusing me of either not caring about them because I can't remember anything they say to me, or telling me I have Alzeimer's.  I did have what appeared at first to be a neurological event a few months ago, I lost use of my right arm for a short period followed by weeks of numbness and weakness....however a CT scan proved the problem was not neurological and they called it neuropathy....the CT scan showed the brain to be completely normal.  My reflexes were also hyperactive on the right side, but that was never followed up on.  What should I do next?  Could these be normal signs of aging.... again it doesn't really seem to be so for me.... I see people much older than I functioning much better than me.  I cannot go back to my psychiatrist that treated me a decade ago, he retired and I lost track of him, and have no idea even what happened to my records.
  I am on Plaquenil and Prednisone as well as typical asthma meds...can't take NSAIDS any more due to several occurences of gastric ulcers and colitis.  I try to take my meds consistently, but often forget to take doses...or I just can't remember if I took them or not and am scared to double dose.  So I know I probably skip some doses.
  I love to learn and had wanted to investigate going back to school for my doctoral degree, but am feeling like I am losing the ability to succeed in this area.
  Please let me know what I should do, what I should expect?
  Deedle

[HFHSM.D. - DE]

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Dear Deedle;
You have described a very complicated medical history which makes it difficult to ascertain which could be causing your cognitive problems.  Many conditions impair cognition aside from old age: brain injuries and tumors, medications, infections, chronic lung diseases, alcohol, AIDS, and inflammatory diseases.  Depression could also cause cognitive impairment and this could easily be confused with true dementia.  This is called psudodementia and it occurs in 15% of depressed elderly patients.  Although you mentioned that what you are feeling now is different from the last two episodes of depression, I would still recommend that you get an appointment with a mental health professional for a good evaluation of your depression.  There is a very good chance that cognitive problems resolve with appropriate treatment of depression.  Having said that, I also recommend that you and a psychiatrist re-evaluate the memory problem by means of a neuropsychological evaluation if the symptoms do not improve.
Henry Ford Behavioral Services has a Memory Clinic and you could call [phone] for an appointment.
I hope this information was helpful to you. It is however for general education purposes only and is not intended to be a substitute for professional medical advice.
Keywords: Horrible memory/pseudodementia