One Brain's journey

About five years ago I was diagnosed with social anxiety. I already knew from my reading that ADHD almost always comes with coexisting disorders known as co-morbitities and I was pretty sure I had it from reading the symptoms. So it was no great surprise, but now it was confirmed. I also knew that social anxiety does not equate to shyness neither in the intensity nor in the range of fears. Social Anxiety is usually described as fear of scrutiny and, in my case at least, scrutiny resulting in judgment. I have no fear of public speaking. Well maybe a little, as in the old adage, “If you ain’t scared, you ain’t paying attention.” Mine comes into play around the telephone and with authority figures. I also have trouble in social situations where I don’t know people. I would rather rather walk a plank over a pool of sharks than step into a room full of people. In a lot of ways social anxiety had caused more damage in my life than ADHD and following the diagnosis there was another period of adjustment to that fact. Not long after though, I had the opportunity to participate in group therapy employing Cognitive Behavioral Therapy (CBT) at the Centre for Addiction and Mental Health (CAMH). We met once a week over some two months or so. An early impression of my fellow participants was that they were all articulate, intelligent and if you met them under favorable social conditions you would never guess they had any kind of anxiety. I found the application of CBT somewhat strenuous mentally, although the one time outside the group that I did apply the mechanisms I was taught, I had quite positive results. But it was difficult and I came to the conclusion that if I had been in my twenties, I would have made the effort but at the age I was I wasn’t sure that the benefits equated to the effort of doing it and in my mind that effort was substantial and I couldn’t imagine having to go through it in every social encounter in which I would experience anxiety. However, I came across some research about what happens in the brain with CBT and realize now that I had missed an important aspect of the training. I discovered that it wasn’t just tricking my brain out of the fears. I was actually changing the structure of my brain. In other words, I would not have to go through the CBT process forever, every time I was faced with a social anxiety trigger. Eventually, I just wouldn’t react to the triggers at all because the structure of my brain would have been changed. I think I still have the worksheets I was given in those CBT sessions. I’m going to look for them now…

I was returning home from having lunch with a friend recently and saw a billboard for something called VIVIMIND™. One line read, “Test your memory at VIVIMIND™.com.”   Since I am past 60 and also because I have the obvious interest in this field, when I got home I logged on to the website which said VIVIMIND™ is “a patented product based on the naturally occurring ingredient homotaurine, which binds to A-beta proteins and reduces the deposition and toxic effects of these proteins in the brain.”  The site claims the product is supported by over 15 years of combined rigorous scientific research including clinical testing with over 2,000 individuals. The site also claims VIVIMIND™ helps prevent memory loss due to aging and that it is sold in drugstores and supermarkets as well as online.  You take two tablets daily and a month’s supply costs $90.  One of the drug store chains listed that stock the product was Shoppers’ Drug Mart and there is a store not five minutes away from where I live. I was going to walk there to check it out but then I got to thinking.  To me, more than anything, this product is a sign of three trends. One is that this current crop of seniors will not be content to just make a long, slow slide into senility as previous generations might have. Another point is about the importance now of having a product backed by solid scientific research. Don’t get me wrong though, I have no idea whether VIVIMIND™ is backed by solid scientific research other than what they claim. Finally, the website says VIVIMIND™ is a “natural health product”. I am a recent convert to natural health products. I was diagnosed recently with high blood pressure. It was inevitable. My father had it from his mid-forties. I tried medication after medication and had side effects with every one of them. About the time that my doctor, in frustration, was about to prescribe what he referred to as “water pills”, a medication that my father would have been prescribed half a century ago, I tried omega-3 fatty acids at the suggestion of a friend. My blood pressure is now normal. Even so, given a choice between taking a supplement for the rest of my life versus the change brought about by a natural regulation of cognitive function as with Cogmed Working Memory Training…well you know where this is going. Just for the record again, I have a relationship with Cogmed Working Memory Training (which I described in my first post) but I have not done the training.  Finally, consider VIVIMIND™ at $90 a month versus a one-time fee of $1,500 for the Cogmed Training? Well it seems a bit of a no-brainer unless you don’t plan on living very long.

Working memory was first explained to me by a psychologist friend as memory in which words, numbers or visual images and spatial relationships are stored for just a few seconds to be manipulated or recalled. I know from an neuro-psychological assessment I had in 2004 that I have a problem as described in the report as “Immediate and delayed recall of visual and non-verbal information.”

I was also tested in these three key areas by Dr. Atilla Turgay during a consultation in his office last summer. He does this test in just a few minutes asking you to remember and repeat back seven digit numbers, sentences forward and backward and then, the one I did terribly at, the positioning of his fingers, hands and legs which I had to replicate.

Lately I have come across references to working memory as fluid intelligence and the I started to get confused. This confusion increased just a few weeks ago when I was reading a blog that referred to a relationship between schizophrenia and problems in working memory. It would seem this is getting pretty far from remembering someone’s phone number or a street address. I accept that my knowledge in this area is limited. In addition, new knowledge in the area of neuroscience seems to be increasing daily.

I will come back to this subject when my own understanding has grown enough to explore it further…

When I was diagnosed with Attention Deficit Disorder (ADD) in the summer of 2000 well into middle age,  I was told to educate myself about ADD. I took this advice quite seriously and over the course of the next few years I read almost 40 books on the subject. Looking back on this effort at this point in time I realize that most of the content of those books is now obsolete.

Off the top, let me declare that I sometimes do marketing work in Canada for a Swedish company known as Cogmed.  They have created an on-line training program that improves working memory, a key component of ADD.  Improve working memory and you will improve focus and attention.

I first made contact with Cogmed because a friend told me he had come across their program and that, not only did it appear to work but that it was backed by solid scientific research. My friend works in the psychological services department of a large Canadian school board and spends a large portion of his work time assessing kids who have this disorder. He suggested that he and I together might try to acquire a license to use Cogmed Working Memory Training, and we set about to do that.   The discussions had just begun when I realized that we did not qualify to be a Cogmed practice a license but was asked by Cogmed’s CEO, Jonas Jendi, if I would provide support in Canada for marketing Cogmed.  At the present moment I am not engaged in doing this and have no financial relationship with Cogmed but I still view their organization and their primary service, Cogmed Working Memory Training, with a great deal of respect.

I was intrigued with how and why Cogmed worked.  I learned that Cogmed improves the brain function known as working memory but how does this happen?  I am no expert in medicine but I had thought that if a part of your brain wasn’t functioning properly, you were pretty well stuck with it.  Then I remembered a lecture I had attended at the University of Toronto Faculty of Medicine in a series known as Mini-Med School, a course designed for the public to explain various aspects of modern medical practice.  The lecture I recalled was on stoke rehabilitation and the physician who spoke began by asking the class of more than 200 people, “When was the last time you saw a stroke victim on the street?”

The class seemed a bit confused and so he curled his arm up and limped across the stage the way I had seen lots of stroke victims do in the past but for the life of me, and for that matter most of the people in the lecture hall, I couldn’t remember the last time I had seen someone who looked that way.  A few people raised their hands and then the lecturer asked, “Do you know why you don’t see people like that anymore?’  No one answered and he began his lecture.

He worked at Baycrest Geriatric Hospital in Toronto and headed up the stroke rehabilitation program there.  He said that with a stroke the last function to go is motor control.  The reason stroke victims used to end up apparently paralyzed is not because they couldn’t move their limbs but because the part of the brains that makes them aware of the arm or leg that might be affected is not working.  If you could make them aware of a limb, according to him, they will be able to move it.  This concept is what guides the most advanced stroke rehabilitation today.  This meant that stroke rehabilitation where medical practitioners are painfully moving an arm, or a leg, back and forth hoping to engender some muscle control was a total waste of time.  Instead practitioners, at least those at Baycrest, were doing things like supplying patients with special glasses that shifted a patient’s vision to one side or the other and then after the brain had adjusted, removing the glasses and behold, the patient was aware of the limb and, more importantly, could move the it.

I realized, after some more research, that the concept of neuroplasticity is quite new and absolutely groundbreaking in the world of medicine.  In his bestselling book, The Brain That Changes Itself, Norman Doidge said, “The discovery that thoughts can change the structure and function of our brains—even in old age—is the most important breakthrough in neuroscience in 400 years.”

And so began my journey…