On executive dysfunction and concentration issues

[Hubris]

So, I tried to organize something - won't go into detail but you can assume it's documents. The effort I put into this, gargantuan and I feel like I'm dying. Never again.

The person I'm working with asked if I take drugs because the way I organized things is beyond terrible. He is a friend, didn't mean anything bad was just being honest.

So this person, who has ADHD and is not currently taking stimulants, has substantial executive dysfunction and concentration issues. They are not able to be very productive. And this has been proven scientifically, yeah? No doctor or scientist would argue ADHD people don't have objective deficits in these areas.

Even they are incredulous at how much worse those issues of executive dysfunction are for me. I basically have zero working memory.

And yet, even if I have it 100 times worse, Every neurologist in the world (except a very small contrarian minority) will tell me I have no cognitive or executive dysfunction.

Neurology is literally a scam profession.
Virtually every neurologist (except maybe a small contrarian minority) is a fraud. This is such a controversial statement, 10 years ago I would have assumed you were a nut if I heard you say this. But it is literally true. Everything I have seen in the last 10 years confirms this. I stand by this and you will not convince me otherwise.

And I hate that there is no official system for me to report this scam. If I invest in something and lose my money, there are people I can contact who will handle it.
If a neurologist scams me, and 99% of them will, completely annihilating my life in the process, there is nothing I can do. Nobody will ever listen to me. And worse, that 1% can't help me because the 99% will prevent them from doing so.

rant over, I guess.

 

[Hubris]

I will add this thought:

I don't think that psychiatrists are to blame for my problems. They will not deal with my illness simply because it's not mental so it's beyond their expertise. Yes, there are a few evil psychs claiming that it is mental and they can cure it with magical words but I don't think they are taken all that seriously by most.

The issue is neurologists. They are supposed to be dealing with my problem but will ignore it NO MATTER WHAT ANYONE (psychiatrists included!) Says.

I could get 100 letters from 100 different psychiatrists stating my problem is neurological and not mental, and the neurologists will simply ignore them.

Even if you had a literal army of tanks and nuclear artillery threatening world war 3 if the neurologists don't start studying it, THEY STILL WON'T DO IT. They will just pretend to be doing it with the most half assed uninspired research possible.

This is such a fucking absurd situation and nobody outside of super niche communities will ever believe it.

 

[Hubris]

I will add a second thought:

I tried studying my own problem out of desperation and I came to the belief that it was related to the anterior cingulate cortex, which coincidentally showed the greatest abnormalities in Younger's RMS study.

I set out to try this on myself. Of course, every neurologist in every hospital department kept telling me with absolute arrogance that there was no reason to do RMS (especially because you can't do whole brain you have to pick regions).

Through sheer luck, I found (while I was hospitalized in a rheumatology department, a patient there) someone who worked in an MRI department and gave me contacts of a place to attempt this.

Where I live, you can't do this tests like this one by paying. You have to 1) get a prescription (which I got from a sympathetic psychiatrist, ironically, who believed me and wanted to help) and 2) find someone willing to bend a few rules to do it (use clinical care funds to do a research test).

So I did the MRS, and my Cho/Cr ratio in the anterior cingulate is 6 SD above controls. The highest patient in Younger's study is 3 SD. In my case, the difference is so high that it could be a biomarker because it's statistically significant. Of course, I can't replicate this with more controls etc I was lucky to even do this.

Guess what, even armed with this finding, every neurologist I showed it to completely ignored it. Nobody will ever help me research this. And even if they did, with this attitude, how could they possibly figure out the problem? ZERO curiosity, rationality or scientific thinking of any kind.

You can't win, no matter how hard you try.

 

[livinglighter]

@Hubris, if you can get a neurologist to order a neuropsychological evaluation carried out by a neuropsychologist, then everything cognitive, including executive functioning, working memory and concentration, will be assessed to see if it's a structural brain problem, mental health problem or if you are making it up. The results are then forwarded back to the neurologist for diagnosis.

Neuropsychological assessments are used in neurology as screening tools to ascertain if cognition abnormalities are organic or not. I'm not sure why pwME are not regularly given this test except that neurology won't deal with them as a patient.

 

[Hubris]

if you can get a neurologist to order a neuropsychological evaluation carried out by a neuropsychologist, then everything cognitive, including executive functioning, working memory and concentration, will be assessed to see if it's a structural brain problem, mental health problem or if you are making it up

That's not how it works. I was administered those tests many times and they are not capable of seeing my problem. They are like doing a standard MRI - completely useless for an illness like this one.

 

[livinglighter]

That's not how it works. I was administered those tests many times and they are not capable of seeing my problem. They are like doing a standard MRI - completely useless for an illness like this one.

I know it's frustrating explaining something you know already, but did both the neuropsychologist and neurologist that were working together inform you that testing revealed no abnormalities?

I'm asking because I've done the test which revealed abnormalities.

 

[Hutan]

So I did the MRS, and my Cho/Cr ratio in the anterior cingulate is 6 SD above controls. The highest patient in Younger's study is 3 SD. In my case, the difference is so high that it could be a biomarker because it's statistically significant. Of course, I can't replicate this with more controls etc I was lucky to even do this.

Hubris, I suspect the reason the neurologists dismiss the finding is because they don't know where to begin to understand it. I'm sorry that I don't have the capacity to try. Maybe you can find a researcher expert on the topic by searching for people who have published about it? They might be interested to help you, or might be able to recommend a neurologist who understands what you are talking about. Doing that sounds quite difficult, especially with cognitive difficulties, but it sounds as though getting the MRS was very difficult, and you managed that.

 

[Hubris]

I know it's frustrating explaining something you know already, but did both the neuropsychologist and neurologist that were working together inform you that testing revealed no abnormalities?

Depending on day or battery of tests, either no abnormalities or minor ones. Nothing comes out of it either way.

Hubris, I suspect the reason the neurologists dismiss the finding is because they don't know where to begin to understand it. I'm sorry that I don't have the capacity to try. Maybe you can find a researcher expert on the topic by searching for people who have published about it? They might be interested to help you, or might be able to recommend a neurologist who understands what you are talking about. Doing that sounds quite difficult, especially with cognitive difficulties, but it sounds as though getting the MRS was very difficult, and you managed that.

That was many years ago, definitely not possible now. Researchers give you the shaft 99% of the time, after many years I have to say not worth it.

Neurologists don't know where to start because they never even started thinking that they should start.

 

[Sid]

I hear you. My EF is shot and I have no working memory. My digit span is like zero.

 

[bobbler]

So, I tried to organize something - won't go into detail but you can assume it's documents. The effort I put into this, gargantuan and I feel like I'm dying. Never again.

The person I'm working with asked if I take drugs because the way I organized things is beyond terrible. He is a friend, didn't mean anything bad was just being honest.

So this person, who has ADHD and is not currently taking stimulants, has substantial executive dysfunction and concentration issues. They are not able to be very productive. And this has been proven scientifically, yeah? No doctor or scientist would argue ADHD people don't have objective deficits in these areas.

Even they are incredulous at how much worse those issues of executive dysfunction are for me. I basically have zero working memory.

And yet, even if I have it 100 times worse, Every neurologist in the world (except a very small contrarian minority) will tell me I have no cognitive or executive dysfunction.

Neurology is literally a scam profession.
Virtually every neurologist (except maybe a small contrarian minority) is a fraud. This is such a controversial statement, 10 years ago I would have assumed you were a nut if I heard you say this. But it is literally true. Everything I have seen in the last 10 years confirms this. I stand by this and you will not convince me otherwise.

And I hate that there is no official system for me to report this scam. If I invest in something and lose my money, there are people I can contact who will handle it.
If a neurologist scams me, and 99% of them will, completely annihilating my life in the process, there is nothing I can do. Nobody will ever listen to me. And worse, that 1% can't help me because the 99% will prevent them from doing so.

rant over, I guess.

I don’t actually know what ‘neurologist’ covers on the basis of what they do and the niches they can avoid certain things with vs generalist bits they absolutely must cover.

I sort of assume they begin with the looking at scans - even though anyone with proper osychology will tell you the first thing we learn is that the issue with studying the brain is tgat it’s not like studying body parts - it’s just lumps of matter until you combine it with understand what ‘actions’ are going on at the time. Because someone has to breath at the same time as all the components involved in eg reading so it will always be needing to be being mapped and looked intelligently for the individual layering of ‘scenarios’ given bad eyes could make a difference to how hard it the way other parts of the brain work and other illness could mean that the breathing is harder impacting the sun total what you are seeing as someone hold a book in bad light and tries to read and so on.

and without time for the subject to develop and good methods to genuinely understand all these bits then scans are useless.

the issue with executive function of course is that as you say it’s the ‘battery’ or working memory in the middle if it all. So if a subject decides it won’t understand the bit around it then how on earth can it see the power source issues coming off it to know what they are looking at?

yes it probably is a fraud but in the sense of being deluded into thinking it knows stuff based on having sn entities background and the hubris fallacy if ‘i needed to get good grades in something fir this job title’ but with no wisdom to realise whether it got good grades in tests of nonsense and is unaware of massive unknown unknowns snd worse unknown knowns and due to its misogyny shoves patients off to ‘therapy’ and ‘just the clinical that doesn’t answer back and acts like psychiatry’ rather than respecting and sponsoring the proper scientific side of scientific osychology that would look at cognitive oattens and loads AND their scans and push the subject forward.

so j sense it’s massive misunderstanding iv it’s own subject matter and it’s unwillingness to hand over mist of what it claims as it’s territory but it isn’t prepared to use the correct methods or science fif to thise sybjdcts that would mean it’s more like a filibuster it bottleneck.
However I do think there are some cross-over roles, sad thing is as it only uses half the name in order the subjects seen forty words long then differentiating someone taking psychiatry or clinical psych therapy old school git nowhere in 60yrs and didn’t try with new treatments. ‘Subject’ masquerades under the sane ‘psych’ as the ones bring the science

I think it might be worthwhile for us all to try snd find people who might explain and confirm the terms of those who could do the useful areas that are majorly missing - because then at least we could start lobbying fir having more if them and those subjects growing over the ones who are red herring the issues (because of inherent misogyny and Freud delusion preferences in their areas meaning they just write off unknowns to shady manifesto-based beliefs and forgive tgrnselves for a lack of wisdom tgat shouldn’t be forgiven or something the subject guards cuddling it’s ignorance like it’s acceptable) etc.