Living with Memory Problems To the WORLD, YOU may be ONE person; but to ONE person, YOU may be the WORLD! Sometimes physicians can't cure memory problems. Sometimes subclinical memory problems or a learning disability, which was well compensated for, may be aggravated by stress, medical conditions or environmental factors such as pollution or toxins. These aggravating factors may weaken the parts of the brain that was weak to begin with. The effected parts of the brain does not communicate as effectively so the cognitive problems become more noticeable and troublesome. However stronger parts of the brain shows no signs of problems or decline. This is what apparently is the case with my brain. This may be the case with many people who begin showing cognitive and memory problems after developing Hashimoto's, Hypothyroidism, Chronic Fatigue Syndrome or any other chronic medical conditions. I will include links to sites pertaining to learning disabilities, memory and other useful sites as I search this out. LD Online Site includes a lot of info on LD. "Learning disabilities are defined as disorders that impair the ability to acquire and use skills in listening, speaking, reading, writing or math. These difficulties occur at the level of the central nervous system and involve peculiarities or idiosyncrasies in perceiving, understanding and using verbal or nonverbal information. Diagnosing learning and attentional problems in adults involves understanding the individual's delayed history, observing current performance, and testing cognitive functioning. Specific error patterns in attentional capacity, reading, writing, speaking or math helps to differentiated a disability from a normal low strength area. Adults with learning problems often have suspected that something was wrong for years. They say they had to work harder than others in specific area to get the same information, took longer to finish assignments, and sometimes had to retake classes or get extra help. Many found the educational process so frustrating that they left school early, even though others often felt they were intelligent enough to succeed. Adults struggling with a learning disability face many challenges in life. Adjustments must be made in work, education, daily routines and social interactions. They also often have to deal with secondary emotional issues such as frustration and low self-esteem." Characteristics of Adults with Specific Learning Disabilities "it is important to note that, by definition, an adult who has learning disabilities is of average or above average intelligence. This wide span of ability means that it is possible for IQs to be low average to high or even gifted. What is noteworthy about those who have learning disabilities is that ability does not match achievement -- whether in academic areas, in functional behaviors, or in employment outcomes. There seems to be a significant gap between what would be expected, given the individual's ability, and what is actually accomplished (Reiff, Gerber, & Ginsberg, 1993). Critical Characteristics Adults with LD show a wide array of critical characteristics that are problematic for them in their daily lives (Gerber & Reiff, 1990; Gerber & Reiff, 1994; Johnson & Blablock, 1990). First, academic skills that were not mastered during the school-age years remain difficult. Problems arise in such areas as reading, math, spelling, and writing. In each case, there can be a wide variety of reasons for lack of attainment of academic skills. In reading, for example, the reason might be poor comprehension enhancement strategies. Related to mathematics, problems evidence themselves in using math concepts and thinking in mathematical ways (either for daily use or for more sophisticated applications). Finally, in writing, whether the problem is spelling, handwriting, or written expression, there can be many reasons for apparent difficulties. In each case, there is a high probability that the source of the problem(s) is the underlying dynamics of the learning disability: the psychological processes that have a bearing on the presenting problem. These psychological processes include cognition, perception, language, attention, motoric abilities, and social skills. These processes, individually or collectively, have a bearing on academic skills, but they have equal impact on all areas of adult functioning -- whether at home, at work, or in the community. Secondary Characteristics There also are numerous secondary characteristics relevant to the adult learning disabled experience. These characteristics can be viewed as the "next layer" of manifestations of learning disabilities, which emerge as a collection of coping mechanisms or a set of thoughts and feelings evidenced in either positive or negative ways. Because of the complex nature of learning disabilities in adulthood, generalization about secondary characteristics must be viewed with a "discriminating eye"; that is, the characteristics discussed below may present themselves in various forms and exist around a multitude of themes. An understanding of the secondary characteristics of adults with LD, therefore, must be based on the perspectives of the individual as an adult, the learning disability, and the context of lifespan issues. Social and emotional characteristics are most notable in adults with LD. An overall feeling of lack of self-worth, low self-esteem, and a poor self-concept can be pervasive (Barton & Fuhrmann, 1994). A number of writers in the area of adults with LD have commented that this area typically is where this otherwise heterogeneous population shares a great deal of similarity. Many adults with LD have had particularly painful experiences during their school-age years, both in and out of the classroom. And it seems that they carry their pain each day of their lives, whether they are successful or unsuccessful in their adult lives. Consequently, it is not uncommon for them to feel dumb, stupid, and incompetent (Gerber, Ginsberg, & Reiff, 1992). Many have carried self-attributions into adulthood, stemming from the notion, "I am a person who cannot," as opposed to "I am a person who can," and they often take on the attitudes and behaviors of learned helplessness (Groteluschen, Barkowski, & Hale, 1990). As a result, many adults with LD see themselves as incapable or as losers. In essence, they feel that if they get something right, they are lucky, and if they get it wrong, then they are dumb! Even adults who have experienced mostly successful lives have reported that they sometimes feel as if they are "impostors." Their impostor syndrome (Clance, 1985) always make them feel that, despite past accomplishments, they still are not worthy of achievement, and that someone "will find out" that they are not qualified or capable. For these reasons, it is understandable that adults with LD often experience a sense of frustration and exasperation. The cost is a set of "emotional baggage" that is carried into most social and learning experiences and daily living tasks (Barton & Fuhrmann, 1994). Confronted with myriad challenging tasks every day combined with a history of self-doubt lays the seeds of emotional liability (Gerber & Reiff, 1991). Moreover, stress and anxiety become part of the mix, often leading to an uncontrollable feeling of being overwhelmed by what has to be accomplished. When, in some cases, everything becomes too overwhelming, more intense and protracted emotional reactions become likely, leading to a wide array of mental health problems, including depression. Within the social and emotional realm, it is particularly difficult to generalize about positive or negative motivation, which in so many cases is situation-specific. For example, some describe adults with LD as having little motivation because of the accumulation of failure experiences over the span of their lives. Unfortunately, this often can be the case. Others are highly motivated at times during their adult years for a variety of reasons. Motivation can be heightened, for instance, when a parent wants to learn to read so he/she can read bedtime stories to his/her children, or when he/she wants to learn a new skill for job advancement or for retraining purposes. In addition, when adults with LD want to take control of their lives, motivation that fuels initial success, and that begets further success, can create an awesome set of dynamics and become a source of lasting intrinsic motivation. Certain secondary characteristics have been found to be effective for taking control of one's life, which, in turn leads to greater possibilities of successful adaptation to adult life. One characteristic is the capacity of some adults with LD to be resilient despite past failure. In many cases, the lives of individuals with LD are punctuated with successes and failures. Those who been able to move forward undeterred by failure (and sometimes strengthened by it) have a greater sense of inner strength and self-confidence. In essence, in tough times, they know that there are good times ahead, if they are able to stick with it (Gerber, et al., 1994). Resilience is a set of dynamics that affects different segments of the population of adults with LD in different ways. Whereas all individuals with LD have the capacity to be resilient in some cases (e.g., those who typically attend literacy centers), resilience may be more of an exception than a rule. Another positive characteristic is the unconventional way in which some adults with LD devise learning strategies or adaptive methods to master a task or learn a new routine. They have unique ways in which they approach tasks, and, when given the time and opportunity, they are able to problem solve in their own style. This process has been termed "learned creativity" and is credited with adaptive techniques used in employment, daily living tasks, and social situations (Gerber, et al., 1992; Reiff, et al., 1997)." Dual Exceptionalities Gifted Students with Learning Disabilities This may be what I call "One smart brain cell & one MR brain cell". Anyone who feels more intelligent than most people in one area but dumber in another area than most people. Characteristics of Gifted Students with Learning Disabilities. High abstract reasoning ability Good mathematical reasoning ability Keen visual memory, spatial skills Advanced vocabulary Sophisticated sense of humor Imaginative and creative Insightful Exceptional ability in geometry, science, arts, music Good problem- finding and - solving skills Difficulty with memorization, computation, phonics, and/or spelling Distractibility and/or disorganization Supersensitivity Perfectionism Grasp of metaphors, analogies, satire Comprehension of complex systems Unreasonable self expectations Often, failure to complete assignments Difficulties with sequential tasks Wide variety of interests (Baum, Owen, & Dixon, 1991; Silverman, 1989) Healing ADD: Identifying and Treating 6 Types of ADD "Here is a summary of the six ADD types, detailed in my new book, Healing ADD (Putnam). All types have the primary ADD symptoms, which separate these problems from other conditions, such as depression, bipolar disorder, or anxiety disorders. Type 1: Classic ADD – hyperactive, restless, impulsive, disorganized, distractible and inattentive. SPECT shows marked decreased activity in the prefrontal cortex during concentration. Usually diagnosed early and effectively treated with stimulant medications (such as Adderall, Concerta, Ritalin), aerobic exercise, and a higher protein, lower carbohydrate diet. Type 2: Inattentive ADD – primary ADD symptoms plus low energy, poor motivation, frequently daydreams or appears spacey. SPECT shows more focal decreased activity in the prefrontal cortex during concentration. Diagnosed later, if at all, more common in girls. These are quiet kids and adults. People with Type 2 are often labeled lazy, unmotivated, not that smart. Also, effectively treated with stimulant medications (such as Adderall, Concerta or Ritalin), aerobic exercise, and a higher protein, lower carbohydrate diet. Type 3: Overfocused ADD – primary ADD symptoms plus cognitive inflexibility, trouble shifting attention, stuck on negative thoughts or behaviors, worrying, holds grudges, argumentative, oppositional, trouble with change, need for sameness. SPECT shows increased activity in the anterior cingulate gyrus (the brain’s gear shifter) and prefrontal cortex. Often seen in families with addiction problems or obsessive-compulsive tendencies. Stimulants, by themselves, usually make this type worse, people become more focused on the things that bother them. Effectively treated with Effexor, or a combination of an SSRI, like Prozac, and a stimulant, aerobic exercise is also helpful, and a higher carbohydrate diet. Type 4: Temporal Lobe ADD – primary ADD symptoms plus learning and memory difficulties, temper problems, dark thoughts, frequent headaches or upset stomach, mood instability, periods of anxiety for little to no reason. SPECT shows decreased activity in the prefrontal cortex and temporal lobes. Often seen in families with learning or temper problems. Stimulants, by themselves, usually make people with this type more irritable. I have seen a number of children with Type 4 hallucinate on stimulants. Effectively treated with a combination of anticonvulsants (such as Neurontin) and stimulants, and a higher protein, lower carbohydrate diet. Type 5: Limbic ADD – primary ADD symptoms plus chronic mild sadness, socially withdrawn, poor appetite and sleep patterns, and a high ANT (automatic negative thoughts) population. SPECT shows decreased prefrontal cortex activity and increased limbic (emotional part of the brain) activity. Stimulants, by themselves, usually cause problems with rebound or cause depressive symptoms. Effectively treated with stimulating antidepressants (such as Wellbutrin), intense aerobic exercise and a higher protein, lower carbohydrate diet. Type 6: Ring of Fire ADD – primary ADD symptoms plus very oppositional, aggressive, up and down moods, very sensitive to the environment ADD symptoms plus extreme moodiness, anger outbursts, opposition, periods of expansive or grandiose thoughts, inflexibility, racing thoughts, excessive talking, excessive motor movements, difficulties with empathy and listening, these symptoms are often made much worse with stimulant medication. Contrary to everything we assumed, ADD is not a single entity that responds to one treatment. It is a complex spectrum disorder and these differences are essential to proper diagnosis and treatment." The Complete Neurological Examination Info on nuerological examin including memory, attention & other aspects of the exam. Includes information on various details. "Vigilance and focussed attention. Attention comprises at least two related functions: the ability to focus limited attentional capacity upon some stimuli to the exclusion of others, called focussed attention, and the ability to be distracted by significant stimuli outside of focussed attention, called vigilance. During focussed attention, the brain continues to process all incoming stimuli; stimuli that activate a sufficiently large network of neurons capture attention. For example, when you are at a social gathering and you are attending to a conversation (focussed attention), you will probably be distracted if someone outside your group mentions your name. Maintaining an appropriate balance among many competing stimuli and response alternatives requires exquisite coordination among many regions of the brain, most importantly brain stem and basal forebrain arousal systems, thalamic relay and gating systems, and higher-order cortical association systems capable of determining stimulus significance. Metabolic disorders that partially compromise neuronal function are usually first manifested by disorders of attention. The converse is an important clinical rule: patients presenting with general disorders of attention (called delirium or confusional states should first be suspected of having a metabolic disorder such as drug intoxication, electrolyte imbalance, or a systemic infection. Such attentional disorders are usually entirely reversible with correction of the metabolic disorder. Spatial attention Attention has an important spatial component. The left and right hemispheres appear to have different attentional capacities. The left hemisphere is adept at focussing attention, particularly to the contralateral (right) hemispace. The right hemisphere, in contrast, is better at maintaining vigilance in both right and left hemispace. Right hemisphere lesions will therefore often result in a very abnormal distribution of attention, since the remaining intact left hemisphere will focus attention in right hemispace, and left hemispace will be neglected. Left hemisphere lesions, on the other hand, will produce much less of an attentional bias, since the right hemisphere can attend to stimuli in both halves of space. Patients with unilateral neglect from right hemisphere lesions may fail to respond to visual, auditory, or tactile stimuli in left hemispace, and they may direct gaze preferentially to the right. They may neglect to cancel lines (or letters) on the left side of the page, and this deficit will be greater if the page is placed in left hemispace. They may also bisect lines far to the right of midline. Intentional attention: the frontal lobes We become aware of stimuli that are able to activate strong neuronal networks by virtue of previous inborn or learned associations. Thus, our nervous system is wired to respond rapidly to moving stimuli in the periphery of the visual field, loud noises, or signs of aggression in others. We learn to respond selectively to other stimuli, such as the sound of our names. Brainstem, collicular, and parietal systems are important in mediating these "automatic" attentional responses. But we can also will ourselves ("intend") to attend to stimuli of less obvious salience, for example, to reading about brain mechanisms of attention. Frontal cortical networks contribute importantly to setting goals, and directing attention to stimuli that are goal-relevant. They help suppress responses to stimuli that are not relevant to the task." National Center for Learning Disabilities "Lifelong LD: Learning disabilities do not go away as a person matures. You do not grow out of having a learning disability when you become an adult. You're also likely to face new challenges in fulfilling your role as a family member, employee, spouse, or citizen. This section was designed especially for adults like yourself. Use it as a guide to help manage your LD in different areas of your life. It will help you appreciate the risks as well as the positive consequences of living with LD as an adult. There's also advice on relationships and parenting along with tips about building your own success story." The positive traits of LD "Creative Problem-Solving Adults with learning disabilities must learn to work around their disabilities. This experience allows them to think "outside the box," often leading to more creative solutions and imaginative answers to problems. Outgoing Personality Many adults with learning disabilities develop outgoing personalities in an attempt to compensate for their learning problems. Strong Compensatory Skills To make up for their learning disabilities, many people develop strong skills in other areas. Persistence Often, people with LD do not give up when attempting a difficult task. Despite frustrations, they keep trying until they meet with success. Empathy Persons with learning disabilities often provide support and understanding for others. Because they themselves have experienced the frustration that can result from having a learning disability, they can be that much more supportive of others." Successful People with LD and AD/HD "Did you know that many successful and famous people grew up with learning disabilities and attention problems? Whoopi Goldberg, Charles Schwab, and Greg Louganis, to name a few, are all inspirations. They show us how people with learning differences can use their strengths to become highly successful in their field." Learning Disabilities Links Attention Deficit Disorder Association This national membership organization focuses on adults and families, provides referrals to local support groups, and offers materials on AD/HD and related issues. About.com Attention Deficit Disorder Lots of info on ADHD as well as support groups & articals. ADHD in Adults "ADHD can be absolutely overwhelming for an active adult with a want and need for a career, healthy relationships, and a low-stress lifestyle. This section helps adults with tips to regain control of things in their lives that ADHD may have drastically affected." SUMMARY OF THE PRACTICE PARAMETERS FOR THE ASSESSMENT AND TREATMENT OF CHILDREN, ADOLESCENTS, AND ADULTS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER "This summary of the practice parameters describes the assessment, differential diagnosis, and treatment of children, adolescents, and adults who present with symptoms of attention-deficit/hyperactivity disorder. ADDvance "Created by Patricia Quinn, M.D. and Kathleen Nadeau, Ph.D., leaders in the field of AD/HD. The ADDvance website provides information and support to women and girls." The National Center for Gender Issues and ADHD "For girls and women, ADHD is often a hidden disorder, ignored or misdiagnosed by the educational and medical communities causing these girls and women to suffer in silence." AADult Support of Washington for Adults with Attention Deficit Disorder Site includes a collection of articles by the national ADD authorities as well as adults with ADD. The International Dyslexia Association Information on Dyslexia. "Dyslexia is one of several distinct learning disabilities. It is a specific language-based disorder of constitutional origin characterized by difficulties in single word decoding, usually reflecting insufficient phonological processing abilities. These difficulties in single word decoding are often unexpected in relation to age and other cognitive and academic abilities; they are not the result of generalized developmental disability or sensory impairment. Dyslexia is manifest by variable difficulty with different forms of language, often including, in addition to problems reading, a conspicuous problem with acquiring proficiency in writing and spelling." Social and Emotional Problems Related to Dyslexia "The dyslexic frequently has problems with social relationships. These can be traced to several causes: Dyslexic children may be physically and socially immature in comparison to their peers. This can lead to a poor self-image and less peer acceptance. Dyslexics' social immaturity may make them awkward in social situations. Many dyslexics have difficulty reading social cues. They may be oblivious to the amount of personal distance necessary in social interactions or insensitive to other people's body language. Dyslexia often affects oral language functioning. Affected persons may have trouble finding the right words, may stammer, or may pause before answering direct questions. This puts them at a disadvantage as they enter adolescence, when language becomes more central to their relationships with peers."