Cognitive problems in psychosis

Ok I'm being brave and creating a new thread

I've read about cognitive problems in mental illness, but I don't really understand what milder manifestations look like. I've seen examples of thought disorder on wikipedia, but they seem to be severe examples of disordered thoughts/speech. Obviously I imagine that these problems don't just suddenly appear, there must be a gradual appearance.

I'm curious because I never, before yesterday, thought any of my cognitive problems were to do with the schiz aspect of my problem.

Anyway here is what I posted yesterday:

So what cognitive issues do people here have? I'm especially curious if anyone can notice the milder manifestations before they become more severe? And are any cognitive problems specifically psychosis-related?

*Willow*

its hard to notice mine to me but i can tell u what my dad and pdoc told me mine are.

Willow, I have a cognitive impairment. I underwent a full evaluation by a cognitive neurologist to determine it. The doctors said the impairment could be due to my illness or a side effect of meds. There is no way to tell for sure. One thing I do know is that if I go off my meds my impairment seems to worsen.That makes me think its the schizo part of me. I have problems with basic problem solving, face regonition, picking up on patterns,recall of things like numbers and objects...word association...etc......D.

i frgt to put what.

but i become indecisive. my doc said thats schizo. because its part of being unmotivated.

i cant understand the simplest stuff.
problem solving.
forgetfulness.

more stuff i forgot right now

also all this made worse by meds. and i mean WORSE WORSE WORSE than it already is.

My dis-organised thoughts basically arose because i had different 'beings' inside of me all projecting their ideas into my mind. They would project thoughts and ideas as if they were my own. It made it very difficult to keep my thoughts together as they would overlap and sometimes overpower my own mental process'. Since treatment has been successful i see no other problems with my cognitive process'.

Ok here are some examples of the things I struggle with:

Concentration,

Memory (dunno if that's linked to concentration though i.e. I'm not concentrating enough to absorb new info so can't recall it later on),

Motivation,

Ability to do mental maths (never my strong suit but has definitely gotten worse to the point that it's embarrassing that I can't do such simple sums in my head)

Ability to read (I get overwhelmed by large amounts of text cos it's so hard and I used to be an avid reader, which is a MAJOR PROBLEM for Uni when I'm supposed to read lots of journal articles.)

I misunderstand meaning so if a word has more than one meaning or sounds like another word, I'll hear or read the wrong meaning. This especially happens with positives and negatives eg so I'll understand 'does/doesn't' the wrong way around which confuses me. This makes reading very hard because I keep thinking sentences contradict each other until I read it several times.

My visual processing ability has decreased so it makes me much slower reading and copying things off the board in Uni and working out problems.

I struggle sequencing tasks, and sentences and paragraphs when writing (which makes writing essays so hard).

I can't think of any others off the top of my head... I had my IQ tested though just over a year ago and it had dropped 11 points so I know these problems are real and not all in my head.

I know it's worse when the voices are loudest because I just can't concentrate on anything else. I haven't noticed if it's worse on/off meds because when I was off meds I wasn't studying at the same time. I know the reading ability gets better and worse, but I haven't noticed if that's linked to psychotic stuff or depression or both (I think it's both but I'm not certain cos I can't remember what my reading ability was like back in the spring when the psychotic stuff was bad and the depression was less)

Anyway that's just me rambling to give others some examples to jog their memory...

*Willow*

I'd love to have a full cognitive/neuropsychological examination but I'd never get one on the NHS and I don't even know if they do it privately, but I bet it would cost a bomb.

I suffer with indecisiveness too Newtus, but that was always put down to depression cos that affects motivation. How do you distinguish between negative symptoms and depression?

*Willow*

i was supposed to get one but never did. long story.

how do i? well they are so alike for me. difference for me is i cant find a reason for no motivation in psychosis. in depression its cause im feeling sad\down. its easy to say that and think its still either/or but its kinda clear with motivation.

everything else not so clear. except not looking in peoples eyes has always been there for me and its not related to mood at all. i frgt some other negative symptoms

Here are some negative symptoms from: NIMH · Schizophrenia

I remember reading a page that listed them but I can't find it now...drat!

There's also this one that links negative symptoms with cognitive difficulties in sz:

The negative symptoms of schizophrenia

*Willow*

i dont think i have flat affect. with meds yes. without - no.

i have extreme problem with hygiene i know that much. shower 1-2x month.

and i tend to talk very little. contrary to maybe what u see here.

everyone notices all this with me

I feel sad when depressed to a certain point when I'm crying all the time at silly things, then I get worse and feel completely numb and cannot cry. So it's not always easy for me to say "oh, I feel sad so that's why I have no motivation."

Interesting. I have the same problem with eye contact and was going to blame this completely on depression, but thinking about WHY I don't make eye contact...it's because I worry that people can read my thoughts and see deep inside me to my blackness/darkness...which I guess is a psychotic symptom?

Anhedonia (lack of interest) is also a depression symptom and I've had this since before the psychotic stuff. Speaking little, for me, is depression-related, as is my flat affect. I struggle with hygiene and that's due to both depression and psychotic stuff.

I don't understand what it means when it says "Lack of ability to begin and sustain planned activities" - is it motivation, or sequencing activities, or something else?

Anyway I'm rambling

*Willow*

i understand. motivation tends to be an easy one for me to figure out. others harder.

mine has been pointed out as schiz by my docs/past therapists/family. first thing everyone notices i guess. therapists say "i notice you dont make eye contact" and docs and other people. but is seen as i guess almost autistic-like inability to make eye contact. i used to talk to people when i was young and look the other way and people thought i was deaf. but im not. and im not autistic. im not aware of it either. it just happens.

forgive me anyone who has autism. i dont understand it well and can only explain my experiences my best.

Okay here are mine:

Memory - sudden black holes in my memory, often so deep and dark I can't even remember what I'm forgetting. Lose my keys, my words, my purse, my shoes. Forget what people are saying to me, who told me things, I repeat myself to others.

Focus - hard to stay on task. Hard to do one thing at once. Easily distracted. Even on things I really love doing, can't focus on them for long. But also a terrible multitasker (see memory, LOL.)

Processing - I am getting slower and slower and now it's even obvious to me. Takes me forever to read. Takes me forever to respond. Takes me forever to find things on a page. Takes time for my emotions to come out and react. Yup... Murtle Turtle should be my name.

Indecisiveness - Any decision takes me forever. (See slow processing. )

I really believe cognition is a major issue for all mental illness, and it's totally ignored.

It is really important to our ability to function normally, but it's so hard to find information about it. I'm lucky that my pdoc doesn't ignore it though cos he knows how important it is to me to be able to function well at Uni.

I'm sorry that so many of us struggle with cognitive crap :/

*Willow*

I struggle with a lot of these too. Concentration and organization seem to be my biggest issues. Before I got ill, I was able to concentrate for hours. Now I tend to wonder off and get restless.

Reading is another major issue for me. I have trouble understanding language especially if it is vague and illustrative. My tendencies towards literal thought has also worsened. I read small segments at a time rather than all at once. I also take notes as I read. This has helped with comprehension.

I have auditory processing disorder so I have trouble recalling lectures. I record them and write my notes at home where it is quiet. Having poor concentration doesn't help this either.

My IQ seemed to drop too. It takes a lot more effort to solve problems and even find creative ways to approach them. I don't feel mentally sharp as I once did. My mind seems to have gotten dull.

Assistive technologies has helped me work around these issues and succeed in university.

I've was not diagnosed with schizophrenia but I had 4 episodes of psychosis and have been fine ever since but I take a medication for people that have that. It is a mood stabilizer and ever since I've took it I have no energy no motivation and I don't care about nothing .and now I am depressed. I've been on it for 4 yrs and my family doctor tried to cut it back to 80 mg and after one week I could not take it. My scicitist who I quit seeing cause he would not help me . So now I looking for a new scicitrist. But that is how I feel every day. And it is fustrating.

Yeah I relate to all this. Can hear perfectly what is being said but can't process it so that it makes sense.

Also I have to reread things because on first take I read it incorrectly.

Didgee, J1968 and Paulycoll Sorry you all struggle too

I know we spoke about this a little bit in another thread, but could you describe what technologies you have that help? I'm interested if there is anything that could help me organise my thoughts for planning and writing essays. I have mind map software, but that isn't helping as much anymore.

I also record my lectures and record my revision notes and listen to them on my iPod, because I find it easier to remember auditory information.

I had speech-to-text software but didn't get on with that at all.

I also have text-to-speech software which I find massively helpful for proofreading my written work and reading aloud text. Though I usually just quickly scan journal articles to find the info I need, and so don't use the text-to-speech software because it reads the entire thing and I just want certain sections or even certain sentences, but maybe I need to go back to using the text-to-speech software properly cos I may understand things better. Several times I think a sentence backs up what I want to say only to realise later that it doesn't or vice versa (my reading problem with positives and negatives again).

I'm still trying to find ways around these problems; making it up as I go along!

*Willow*

There isn't much I can suggest right now. You have tried everything that I have.

I listen to my lectures at home and take notes at the same time. This fills in all the gaps in my notes and improves my understanding.

Can your text to speech software read text files? If so, you can copy and paste the journal articles in a text document so you can edit out text you don't want the software to read. Or you could copy and paste it into a Word document, edit it and then save it as a pdf.

Me too. If I discover something new I'll let you know.

Thanks for replying Didgee!

Yes my text-to-speech software can read any text that I highlight, so will read websites and PDFs etc. I just have to use it more I guess (I keep thinking that I *should* be able to read stuff on my own and so don't use it as much as I could).

*Willow*

One cognitive problem I've noticed is that it is hard to sustain or initiate conversationl. I just cant find the words to say, am lacking in words. Typing up responses takes long, because I can't seem to express myself well.

Nosanctuary

I have similar problems thinking of things to say at times. It's very frustrating!

*Willow*

This is such an important topic, thank you for starting it Willow!

These are some of mine, though this list is definitely not exhaustive because trust me I always forget something(obviously, hahaha):

-Memory, my short term and long term memory have suffered hugely. I can't tell you what I did this morning, I honestly don't remember. I didn't dissociate either, my mind is just on the fritz and I just don't retain information like I should. And long term..? Forget it, as it were. I get a lot of weird looks when people find out how bad my memory actually is, especially because I'm really young to be having problems like this!

-Concentration, a lot of things I do just end up not getting done because my mind gets side-tracked so easily it's ridiculous. I've had this problem posting here for example, I'll be writing my post and then something will distract me and the unfinished post will just be sitting here and I'll be like, "oops".

-Loose associations, my mind connects things that aren't connected to "normal" people. In its milder form it mostly comes off as me being a bit "weird" or "off", but full-blown it turns into complete incoherence.

-Motivation, I could write a disorganized novel about this one. I need to clean my bathroom at the moment, I've needed to clean it for over two months now. It's gross, I know it needs to be cleaned. But it still hasn't gotten done because I just... I don't know how to explain why I can't just get up and do it. There's something missing in my logical thinking, I can't see things through to their natural conclusions like non-sz people do. When I have something to do I can't think of what steps to take and what order to take them in so that things get done. This has caused me a lot of long term issues. I've tried a lot of things to fix this, but I haven't had much success.

-I can't retain information all that well, like if you guys pay attention I just about always quote posts I'm directly replying to because otherwise I'm going to forget what I'm replying to and just go off on some random tangent that's not related to the topic whatsoever.

This kind of stuff happens to me a lot too.

-Indecisiveness, me making a decision about anything big or small can take forever and a day sometimes. It sucks.

I have serious issues with thought disorganization in general, and it's hard to really articulate what it all looks like. It's like this fog inside my mind, constantly. It's like... let's say normal people's brains are like a room full of files and they can just pull out the ones they need whenever, they're all in their space like they're supposed to be.. but in mine? They're all over the place, like someone came in and just trashed the place and now the files are scattered everywhere and I don't remember where anything used to be or where it was supposed to be. It confuses me at best, and at worst I end up incoherent.