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Interview

What to Remember to Do When You Can't Remember What You Should Be Doing

August 30, 2017

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Credit: Ingram Publishing via Thinkstock


Since the election, I keep forgetting things and am deeply distracted. It reminds me of when I was going through health struggles at the same time as a devastating break-up: My memory seemed shot. I took the opportunity to chat about this with David Fawcett, Ph.D., L.C.S.W., our wonderful mental health expert here at TheBody.com. He helped me to think about what might be going on and gave me some simple suggestions that can make a difference.

JD Davids: I've noticed that at times in my life when there's been an excess of stress, or even more than the usual day-to-day stress, it does seem to affect my memory. Is that something that is a thing?

David Fawcett, Ph.D., L.C.S.W.: Yes. In our normal lives, we have a certain amount of bandwidth to deal with stuff. When we get stressed, that gets chipped away at; it gets narrowed. I think it's more distraction than a memory issue. We get disconnected from some of the memory. It gets harder to recall quickly, that fast-switching that we have to do to recall proper nouns, or names, or appointments, and that kind of thing.

It's pretty normal that any kind of stress, including political stress, can really distract us. People have a lot of accidents around the home. They have car accidents. They miss appointments. They can hurt themselves, just because they're distracted. It's all a package.

JD Davids

JD Davids

JD: It's all a package, indeed. And have you seen since, for example, since the U.S. presidential election, more people expressing that this is going on with them?

DF: I haven't seen any studies. It's too soon -- it's all anecdotal. But every one of my clients has expressed an uptick in these kinds of symptoms, along with post-traumatic stress reactions and more emotional reactions. But certainly in terms of day-to-day functioning, and functioning comfortably, in terms of being on their game -- there's been a marked decrease in people's ability to focus, for sure.

JD: If someone is having memory or distraction problems, are there certain red flags or markers that indicate they should be assessed by a professional?

DF: Yes, if it starts to impair or impact daily functioning somehow -- and that's a very subjective thing. I think that with serious memory issues, we quickly learn how to cover, because there's a little bit of shame and embarrassment to think about them. So, many won't accept it if they see it's happening. It's hard to detect.

But, sometimes, we know best what's going on in our heads, even if all our partners or friends think that this isn't really a problem. You left the teakettle on, or you left the door unlocked, and you forgot to pick up your kid at school, or whatever. I think if it starts to impact daily function, then it's important to kick it up a notch and have somebody else do a status assessment, just to see.

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JD: And is that something a primary care provider would be equipped to do? Or would it be a mental health professional?

DF: There are some standard screening assessments that any medical personnel should be trained to do. It's called a mini mental status exam. And it's simple stuff: There are five questions they can ask, or they can tell you three words and asking you to remember them, give you a mathematical problem to solve, and then come back to see if you remember the three words. It's little teensy tasks that, when combined, can communicate whether it's an issue or not.

If that screening shows some sort of problem, it's probably best to then get a referral to a mental health provider. Ultimately, the people trained to do that are in the field called neuropsychiatric. There are psychologists that do it, and it's a meaningful assessment, sometimes a two-day exam. But it's very expensive and very few people ever can go through with it, just because it's so formidable to get it paid for, and to go through it.

Even then, the results are often questionable. And that's the issue with a lot of these memory things. The best control we have is on the front end. Once we start having memory issues like that, we can try to relieve the stressors, improve coping skills. But, ultimately, it's really hard to determine what's actually going on, if it exists. Is it organic? Is it a situational thing? Is it broad neurocognitive stuff? Is it old age? Is it HIV, for those who have HIV? And, if so, is it the meds or the virus? We often don't know.

But, ultimately, it kind of doesn't matter. Because often the only interventions we have (besides maybe a medication shift, with HIV), are to do things we talked about before. The lifestyle changes and tools that can assist us are really the best we can do right now.

JD: So, what can we actually do to remember the things that distraction can cause us to forget?

DF: In my own case, I have started shamelessly using Post-it notes and technology just to remind myself. I will send myself an email because I'm in one of those periods when I've got a lot going on, and I have random thoughts. So, at night, just before sleep, I'll think, "Oh, my God, I've got to do this tomorrow." I'll just send myself an email.

And that also provides a record of it that I can search.

It can depend on how you process. I'm a kinetic and visual person. By writing -- handwriting or typing -- I can internalize stuff better. So, I tend to write down steps, or a process, and internalize it that way. That seems to be more effective for me than just trying to remember it by itself.

So, if you're a visual person, maybe write it down -- or record it and listen to it; but use some way to really internalize it at a deeper level than just, "I have got to remember that."

JD: Right.

DF: Because what happens in our memory is that we have two kinds of memory systems. One is a temporary memory bank that only really has five or six thoughts. They have to get converted into a permanent bank, where we can access them later, or they'll get bumped aside and forgotten. If they're not actively processed, not moved into permanent memory, or there are so many distractions, they can get bumped off and disappear.

So, that's something to think about: We can only really hold five or six things in our mind at one time until we consciously try to move those over into a permanent memory space.

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