LilMargie's Journal

I promised to write something about the program that I went to last week, "Cognition & MS", which was presented by Dr. Darcy Cox, formerly of the University of San Francisco (she is moving to a position in Canada - go figure!).  I thought that I would put it in the form of notes, if that's okay.  If you have any questions or it's not clear, ask me on your comment, I'll go back to the pamphlet and check to see if there is a more informative point that I can develop for you.

Depression (Dr. Cox spoke about this first, so will pass it on)

-Autoimmune disease = increased risk of depression (neurochemistry findings)

-20% of people w/MS suffer from depression

-50% of people w/MS will suffer from depression in their lifetime

-depression may worsen if not treated, but is also one of the more treatable symptoms of MS.

-term for a symptom of depression: anhedonia = lack of enjoyment

-depression vs. grief = grief hurts, depression disconnects, grief can be worked through, depression cannot.

-most recent research finds no relationship between interferon meds & new onset depression (interferon gamma for Hepatitus-C does increase risk)

Cognition and MS:

Areas of neuropsycological functions impacted by MS:

-speed of processing

-attention & concentration

-language

-memory (recall, taking longer to memorize things)

-visual/spatial processing & memory (getting lost driving; right-left confusion; problems assembling things from diagram/instructions; difficulty in understanding how machines work, i.e., cell phone, microwave, VCR,; trouble judging differences between objects like when parking a car;trouble visualizing an object from a verbal description of it) 

-executive functioning (this means multi-tasking, decision-making, organizing & communicating information)

From the pamphlet: "Only a few decades ago cognitive impairment was considered rare in MS.  We now know that 50-65% of people w/MS have some cognitive problems.  While most symptoms are mild to moderate, they can have a significant impact on a person's ability to function comfortably."

-presentation for Alzheimers & MS are VERY different

-cognitive impairment "waxes and wanes"

-steroids can cause cognitive impairment

Factors that impact cognitive function:

-Sleep

-Depression

-Fatigue

-MS

Brain atrophy (shrinking): all brains experience atrophy, the rate of shrinkage is faster w/MS sufferers.  CRABs protect against atrophy.

Do you think you are having cognitive problems?  It is important to determine what is causing the cognitive impairment; is it fatigue?  Is it sleep disorder?  Is it depression?

To determine whether you are experiencing cognitive problems, you can have a neuropsychological testing assessment.  Problem: expensive, time consuming (takes approx. 8 hrs), emotional.

CBT = Cognitive Behavioral Therapy

This therapy helps you manage your anxiety and adaptive coping skills, for example:

Appraising the problem --> controllable?-->problem focused strategy--> less stress

Appraising the problem -->not controllable?-->emotional focused strategy--> less stress

The important aspect of CBT is that it reduces the stress you feel when experiencing a cognitive issue.  The more you notice your cognitive problems, the more it happens-- because stress aggravates the symptoms.

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That's all of my notes, but as I mentioned, I have a booklet that they provided so I would be happy to elaborate on any of the points if you are interested.

Hope you are well, my friends.  Whew!  I feel like I just finished my homework!

Love, M