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June 8, 2012 1:48 PM   Subscribe

Help with memory loss please! I am taking lithium for my mental illness, and although I've tried numerous other medications, it does the best at managing my symptoms with minimal side effects except this major one: I think I'm having a LOT of memory loss. I'm looking for coping strategies, techniques, etc that might help mitigate this.

Relavant details, I'm 28, female, don't drink or smoke marijuana, and have always had a very, very good memory. I've been trying to switch to a different mood stabilizer but I've had poor reactions to EVERYTHING but lithium. I'm currently on Pristiq, which seems to work great for my depression, and I'm taking a low dose of sapphris, which makes me exhausted so we're going really slow.
I've learned to deal with the stomach issues lithium causes, I just really want some help with feeling like I'm forgetting things I used to remember. I don't even know how to keep track of it, how to get organized. I don't know what to do. Someone recommended I try Coque10, but given how expensive it is I'm hesitant to try unless I hear more than one anecdotal recommendation.

I'm in good health, I'm a full time employee and a graduate student, I have an active social life, I feel like I can't afford to just lose patches of time and events. Plus, my notes are so disorganized because I used to rely on my brain to remember where I put things. As my job becomes increasingly complex I feel like I'm drowning.

I'm looking for supplements, food, techniques, exercises, books, anything at all that you found helpful. I am NOT looking for suggestions for different meds (I'm trying....and I'm working with my doctor, and I've tried the homeopathic route before under doc's supervision, it's not an option for me right now). Thank you all so much, you never know how much you miss something until it's gone!!
posted by thankyouforyourconsideration to Health & Fitness (11 answers total) 9 users marked this as a favorite
Previously. The best thing to do is make sure you get enough sleep, but obviously your medication and illness will impact that.

Random stream-of-consciousness thoughts: Make copious notes in a Moleskine; you're not Clive Wearing, but it's still a good technique. Get a good to-do list, calendar and contact list, for your phone if you have a smartphone. Lots of alerts. Organize as much as possible, even trivial stuff. Relate things to each other: associative memory/cued recall is much stronger than free recall. Practice and testing help retention. In other words, if you want to remember things for a long time, test yourself periodically: "What was that guy's name again? Oh yeah, Bob." Even when you don't need to.
posted by supercres at 1:58 PM on June 8, 2012 [1 favorite]

I appear to be having the same problem. Something I'm taking, very likely Lithium, is causing my working memory to fail badly. I have 'memory holes', events which I cannot recall and a general inability to focus.

As far as assistance goes, all of the things supercres describes are good suggestions. I have my daily work set up in an excel sheet for me to work through and I find MS, OneNote works well as a combined memory aide and to do list, but you'll find what works for you.

In general terms I don't have an answer, I've have had to talk to my manager and explain what's going on just in order to stay employed. I have had to materially change my life to deal with constant memory failure. I can only suggest that you keep the doses low let your doc know what's happening and learn to compensate somehow.

Good luck, I feel for you.
posted by fingerbang at 2:18 PM on June 8, 2012

I have been there. The antiseizure medications are really nasty this way. Calcium is fundamental to memory function, and drugs like lithium and anticonvulsants really mess with your brain calcium homeostasis.

Though I have some opinions about which medications to try, that's not what you asked and so I'm going make a wide detour around that question.

Here are some things I can suggest that have worked for me.

Thiamine pyrophosphate is an essential cofactor in cellular energy production and thiamine is highly conserved in the hippocampus, the seat of most all memory. You can try large dose sustained release thiamine (that helped me), or even some of the synthetic analogs, like sulbutiamine, which may be available by prescription in your area.

(In general, getting enough B-vitamins is important. Have you tried taking a B-complex supplement?)

Some people like coenzyme Q10, as you point out, but it didn't do much for me. There is, however, no harm in trying it.

Magnesium is another big one. It is essential for ATP synthesis and most people don't get enough. It also uses some of the same metabolic pathways that calcium and lithium do, so if you are taking lithium, it may mean you are not moving it around in the brain properly.

I have also been on a "paleo"-style diet since January and I am an absolute convert. The impact on my mood and mental function has been unparalleled. I was introduced to it by Emily Deans.
posted by rhombus at 4:23 PM on June 8, 2012 [2 favorites]

Thigs that helped me: Celtic sea salt, glyonutrients, and coconut oil. Plus co-q-10 and B vitamins.
posted by Michele in California at 4:41 PM on June 8, 2012

One thing to consider, if you are a sufferer of manic periods, is that when you are manic, your memory is over-charged. So it's possible you are expecting a "normal" that isn't.
posted by gjc at 6:50 PM on June 8, 2012 [1 favorite]

I have a fairly poor memory for no real medical reason that I know of, and I've had plenty of medical exams. I find it helps to make myself little notes on index cards about important items and then refer back to them a few days later to see if I'm forgetting anything and to gauge how well I'm getting things done. I find it's important to put dates on things (including the year) otherwise I'm liable to find an ancient note card that got lost and not immediately know if it was from last month or two years ago last month. To-Do lists are awesome, as are ongoing shopping lists for things I'll need next time I'm at the store. The notes don't even have to be organizational, they can sometimes just be something I want to look up on the internet but will forget within hours if I don't write it down. Keeping a journal, when I can remember to do it, really cuts out that feeling like I'm losing days of my life to my poor memory. Having a separate document for quotes, ideas, and little snippets of things is nice too.

I'm not what you'd call an organized person, but having specific places where I put vital everyday items like keys and my cellphone really staves off the disaster of trying to leave the house and then being unable to go on time because you don't know where your stuff is. I check my work schedule daily, even on days I don't work (to make sure that I really don't need to be at work), and double check the times I have to be at places because my memory is unreliable about things like the difference between 12:15 and 12:45. Having a weekly event, say going out every Wednesday night at the same time with friends, is a wonderful way to keep track of the passage of time and the days of the week by giving you a happy metric that exists independent of things like school and work. Driving to new places based off the memory of looking up the route on google maps is treacherous and has gotten me lost more than a few times, so a GPS for the car is really not a bad idea. I keep a word document on a flash drive with account names and passwords for everything I do online because the rarely used ones will often have either, or sometimes both, pieces of information be forgotten. I update my resume promptly upon leaving any job because trying to fix that stuff later is a nightmare, and doing that as I go along would probably be even better when it comes to items like starting date and starting pay.

I freely admit to people that I have a bad memory, and if I think I'm not remembering something about them I just go ahead and ask it again and hope it sticks this time. I warn people that I'm not going to remember their name at first so they don't get offended when I don't know it the next time I see them. If I ever lost my phone I would be socially stranded without my contact list, and I might just have to back that up in a word document soon. If someone leaves a voicemail on my phone I keep re-saving it until I'm 100% sure I won't need any information from it anymore. I enjoy talking with my friends and family about old events we've shared together because hearing their narrative about how things happened can sometimes help to iron out the fuzzy spots in my own internal narrative of whatever it was, or else add some extra depth and detail that my mind didn't save on its own, plus these conversations can surprise me with incidents that I'd completely forgotten existed.

Something that has occurred to me to do but I haven't tried yet is to write a brief individual paragraph about people I know who are acquaintances, starting with their full name, so I won't forget we've known each other if I don't see them for six months. That happens to me semi-frequently for people who don't leave a strong impression, like old co-workers. I end up seeing people and recognizing them, but not having any context for who they are even after they've given me their name, unless they realize what's up and clue me in with a few more details.

Finally, a quirky thing, but I take my medications in the morning and then immediately eat two gummy vitamins afterward. The desire for the gummies makes me remember to take my meds, and the strong impression they make upon eating them lets me verify in my memory whether I've taken them or not for the day. It helps that I have a sweet tooth. Before that I would accidentally double up on doses or skip my medicine entirely because the mere thought of needing to take them could blend into my brain as a false memory of having taken them, simply because the act in and of itself leaves little impression on me. You could easily alter this by taking them with a flavorful drink, or any other ritual act like that which triggers multiple senses.

Writing this all out, um, I hadn't really realized how bad my memory was or how many coping skills I'd developed to deal with that. Go figure I guess.
posted by CheshireCat at 6:52 PM on June 8, 2012 [2 favorites]

I've found a lot of the tricks designed for people with ADHD are pretty useful for depression-related memory loss/cognitive dysfunction; you may want to take at some of the books designed for that market.

I live for timers, reminder notes to myself (get pretty Post-It notes; they are less "I am sick and have to prod myself to do the simplest crap" than plain 3x5 cards.) I personally forget what I'm supposed to be doing right now a LOT, so timers and sticky notes and To-Do lists help. There's a sign by my bathroom clock that reminds me what time I have to be out of the shower to make it to work on time - I drew a clock face with the hands pointed to the right time, so it's super easy to tell whether I'm late or not.

There's a big board in my office that's full of things I'm supposed to keep track of - it says things like "the last time I did any filing was June 4th" and "don't forget to input this information using this form on this date" and "I have X hours of vacation I can use" and "I still need to know when Big Important Event is scheduled, and I need to tell Important Person about it once I know." When my boss asked me to remember to remind her about a specific made-up holiday (think "Cat Lovers Appreciation Day") exactly two days in advance, I put "Remind Boss About Made-Up Holiday On This Date." This way all I have to remember is that I have to look at the board, and since I walk by the board on the way to my desk, this isn't all that difficult. This significantly reduces my anxiety about forgetting to take care of something at work, BTW.

I keep lists of things I need to know about certain people - and I try to be fairly religious about copying the information into at least two places, so that if I goof up and don't remember to do it in one spot, it's still in the other. Same with appointments - they go into my phone, they go into my office calendar, the reminder card is affixed to a particular filing cabinet, I enter it on a list of "upcoming appointments where Fee will mysteriously not be in the office" that I print out for my boss each week (she forgets, too.) I can think of at least five places where my therapist's phone number can be found, right this instant. I let my phone sync the contact list to Facebook, so there's a bit of backup there - I'm still trying to figure out the best long-term personal contact management system. For work I rely heavily on Outlook, which gives me LOTS of space for notes about people. I put in a description of their office, who their neighbors are, and sometimes (if they're in a confusing part of the building) the path to get to them. For a few personal contacts I've got physical descriptions of their house, so that when I'm driving down the street I can be looking for "the door with the extra-large knocker; there's probably a butter-yellow minivan in the driveway" instead of a number. I always put mistakes that are easy to make in the comments, too - "don't turn until after you go over the hill" and "yes, you really do need to take the first left, even though it looks like that's a private road, it isn't."

I keep trying to get into using the full-fledged notetaking software, but I haven't gotten the habit yet. I am fanatical about the Outlook "notes" feature, though, and at home I use various note-like desktop applications.

You must have KeepPass or something similar for your passwords. The alternative is to have unsafe passwords. If you do nothing else I advise, please do this today.

Telling people I probably won't remember their name later on, when I first meet them, helps. I tell them "next time you see me, you need to tell me your name again." This gives me the confidence to ask them their name a second time. I usually include a humorous tale about horrifying times I've forgotten someone's name, particularly if they are someone I'm going to need to remember. I also disclose this to people who've known me for a while, so that they'll help me remember the names of people - there's a lady at church who very helpfully says "you met this person at this other event, and she has two kids" whenever she talks about someone else (I also have social anxiety, and she's part of the Coalition To Get Fee To Be Comfortable Enough To Come To Events.)

When I remember something, I have to write it down. Today I emailed myself - "Buy Toto's 'Africa' On MP3 When You Get Home." I can't trust myself to remember, so I choose not to trust myself to remember. I don't have a spot my shopping list pad sits in, waiting for me to sit down and put the list together - the list is a note in my phone, which constantly gets updated. I'll be in line at Subway and realize I need to buy mustard, and I pull out my phone right then and add mustard. This has greatly reduced the number of days where I don't have something basic in my pantry.

I have hooks that are for my work ID, my car keys, and my house keys, affixed to my front door. Whenever I walk by that door, if I don't see my work ID, my car keys, and my house keys, I stop and fix it right then. I still lose things about ten or fifteen times a day, but they no longer fall into the "must stop everything and fly around in a blind panic because I literally have no other choice" category. I'm still trying to find a fixed spot for my cell phone - I may need to wear a holster. Pens, hair clips, and socks were sort-of solved by just buying a lot of them. I own maybe eight or nine tweezers, but I only know where two of them are right now. I can think of at least forty or fifty hair clips that are in my car, apartment, or office, but I only know where two of them are. It's sometimes a matter of figuring out how many you need to own so that it's basically impossible to have all of them be lost at the same time. You usually figure this out when the moment arrives that it's been, e.g., many months since the last time you had to buy pens due to not being able to find any working pens.

I have a handful of things that are on my "yes, go ahead and check it" list. For example, cooking oil, shampoo, sanitary napkins, pencil leads, AA batteries, and toothpaste. Whenever I happen to find myself worrying whether or not I have them, I am allowed to go check them (I have OCD so it's important that this is not a list that's infinitely long.) I actually have a really high awareness of what I have in my house - of the stuff that's on the list, anyway - as a result. I check the cooking oil every other day; the AA batteries sit with the shampoo and toothpaste and sanitary napkins, so that I can check them all at once.

For remembering to take meds, they sit right by my alarm clock. When I shut off the first alarm of the morning, I immediately take my morning pills. When I am setting my alarm at night, I immediately take my evening pills. My glasses sit next to the alarm clock and the pills, and except when I'm in the shower, there are two places on earth they're allowed to be - that spot next to my alarm clock, or my face. Oh, and my pills are kept in one-day-only boxes with giant letters AM and PM. A lot of the stuff that's oriented toward early-stage dementia patients is really freaking useful. (You can get those boxes much cheaper at Meijer, etc.; if I have to start taking anything in the middle of the day I'll probably upgrade to one of these.)

AUTOMATIC EVERYTHING. Auto payments for bills, auto refills for pills, sign up for every reminder service offered (by car repair shops and doctors and such.) Outsource as much executive functioning as you possibly can - I haven't had to lift a finger to pay almost any of my bills in probably two years. When I schedule with my therapist, I schedule out a whole year if I can. The less you need to interfere in a process after the initial set-up, the more likely it is to run smoothly.

(I still have a lot of issues and am always looking for more tips & tricks. I think this is one of those never-ending battle deals.)
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 7:50 PM on June 8, 2012 [4 favorites]

I regularly remind my SO to pleeeeease do the introduction thing for anyone whose name I have not independently mentioned within six or so months. And importantly, that sometimes it's a bit of theater -- SO should say "oh, [friendname], you've met my wife desuetude, right?" And then friend and I are going to cluck at SO and say "pfft, OF COURSE, hi!" But confidential to SO: Thank you, ZOMG, I had no fucking clue what her name was even though we totally know each other.
posted by desuetude at 9:50 PM on June 8, 2012

WRT remembering to take medications I got a black permanent marker and labelled each pill in the blister package with the day when I have to take it. So if I can't remember if I took the meds I can see straightaway if Saturday's are already gone or not. My phone tells me what day it is (cos I will never remember that!!) and I have reminders popping up to tell me when to take the pills.

Other memory saving tricks that I use:
Stick a post-it note on my computer screen at work for things I have to remember after I come back from lunchbreak
Write plenty of notes during meetings and then highlight things I have to do and add them to a big to-do list
Send an email to myself with instructions of something I need to do so I'll see it when I open my mailbox in the morning.
Take time to file my papers - 10 mins at the end of every day - so they are organised and I can find stuff when I need it
Use facebook, email, text message if its an option when making arrangements - then when I forget I can go back to the inbox/sent box - rather than phone conversations or in person.
Keep a pencil and paper in the kitchen so I write indgredients down when I run out of them and don't forget to put them on my shopping list
Always carry spares of things (pills, sanitary napkins, painkillers, pen, plastic bag etc) in my handbag.
posted by EatMyHat at 6:23 AM on June 9, 2012

I take a boatload of Lithium, plus a few other mood stablizers and I have these giant holes in my brain. The only thing that helps me is to use my iphone and iPad and computer as an ever present, wide-reaching exomemory. Being able to update my google calendar wherever I am and have it update everywhere else is a godsend. I actually will set up a series of phone calls I need to make as say, 3 different events, so after I make the first call the alarm for the next one goes off.

I also agree that my memory seems much better when I am manic, because I feel like I am firing on all cylinders. Interestingly, the things I do or say while manic will be some of the first things I forget when I cycle back down again.
posted by Biblio at 6:09 PM on June 9, 2012

Thanks everyone for your answers! I decided to start taking CoQ10 and calcium, I will later try adding something like thiamin to see if that is helpful.

I utilize my phone and computer for reminders regularly...the most difficult place for me is at work, because I do not have good systems, and I am in a new position so I can not fall back on prior knowledge. I'm working on finding ways to better organize my own notes so things are easier to reference. My goal, of course, is to get away from lithium or any anticonvulsant, but as I mentioned before, it has not been possible so far.

Also, as far as I can tell, it is not necessarily that I have heightened brain functioning in my manic periods. I've spent most of my life closer to a depressed state than anything else, and even in that state my memory was pretty awesome. People I barely knew were often surprised at conversations and details I could recall.

Thanks again, and I'll try to update as I find particular techniques mentioned that were useful. Thanks!
posted by thankyouforyourconsideration at 9:58 AM on June 12, 2012

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