Psychologist

[BM]

Hot on the heels of my oral thrush, I've been referred to a psychologist to address some mental problems I think many will be able to identify with. For a long time I've had a mental sluggishness, which is getting worse. In addition I've been losing words (i.e. without warning, I can't remember the word I wanted to say and I can't think of another word to replace it - very embarrassing in interviews!). Other problems include typing completely the wrong words to communicate what I want to say (when I read back what I've written, it's a mystery as to where these words have come from); having difficulty in *noticing* things: when I go into a room to find something, it could be right in front of me but I don't 'click' that I'm looking at it; total inability to read aloud from text; general difficulty in learning new things. The severity of these problems vary from day-to-day (expect for the reading aloud, which never improves).

I suppose I'd just like to know what I can expect during my appointment, if anyone's been to a psychologist for similar problems.

[GSOgymrat]

I'm a mental health counselor and, although I don't know all the details of your health history, I think a psychiatrist or neurologist would be more helpful in addressing the problems you describe.

[Hellraiser]

I'm dealing with the exact same thing.  I haven't thought about seeing someone over this.  Am I just making light of something that I should be concerned about?

In particular...

I will type something, and when I reread it it will be missing words.
When I speak I will be unable to think of the correct word I want, no matter how obvious.
I'm just nowhere near as eloquent as I once was.

I chalked it up to getting older, but I keep reading threads where people are saying similar things.  These things began happening before I was diagnosed and before I began meds although I'm fairly sure I'd been positive for quite some time before being diagnosed.

Do other people have these same issues?

[mecch]

I'm a mental health counselor and, although I don't know all the details of your health history, I think a psychiatrist or neurologist would be more helpful in addressing the problems you describe.

You need a psychiatrist or a neurologist who will work with your HIV doc to identify medical rather than psychological issues.  I think you should ask the pyschologist for his/her opinion about the best specialist to address your concerns.

[Matty the Damned]

I'd think a neurologist or perhaps a psychiatrist would be a better option for the OP too. That said a good psychologist will be able to determine if that's the case and make an appropriate referral.

MtD

[BM]

Thanks for the suggestions, guys. I'll keep you posted, however my appointment isn't until the beginning of May.

[BM]

What kinds of assessment/tests might the psychologist perform?

[alliance]

I haven't seen anyone about this, nor do I plan to because it seems to be getting better for me. I noticed a gradual, subtle decline in things like you mentioned, word recollection, train of thought, understanding things - general cognition. I seem to be getting better steadily, now that I'm on meds, I'm functioning quite better now, I dont seem to be struggling for words etc. anymore.

[tednlou2]

I've noticed I will type words incorrectly.  I will type "hear" for "here," "their" for "there," and so on.  I wonder whether this is HIV related or just getting older.  Or, whether I'm just typing more since joining this forum and would just make those mistakes regardless.  I never wrote much online before--just used internet to read email, read news, or look at store websites. 

I've also noticed when reading questions to docs on thebody or Dr. Gallant, many of the questioners misspell so many words where it hard to understand them.  Not sure if those people speak English as their first language or if something more is going on.

It sounds like you are having more issues than just typing "hear" for "here."  I hope you can figure out what is causing it. 

[BM]

I was seen by a psychiatrist today. I've to have a CT scan of my brain in a month and am being referred to a psychologist. I have "definite short-term memory problems". 

[MarkB]

I have been experiencing similar symptoms, particularly (it seems) since going on medication. Mentally, I am sluggish in a way I have never been before. Is there any research to suggest whether the problem is simply one of age, or is it HIV / meds related?

[Billy B]

 All of my friends of a certain age are complaining of this. They are St8, Gay, +, - , men, women and of all races. Some do/or have smoked weed or never touched the stuff. Older brains don't work as well.
We have learned to laugh at these moments and not make a big deal out of it.
Peace,
Billy

[BT65]

Older brains don't work as well.
We have learned to laugh at these moments and not make a big deal out of it.
Peace,
Billy

There you have it.  I feel the same.

[peteb]

Hi I know just what you are going through I have the same problem
what medication are you on
Pete

[BM]

I started on Kivexa (Epzicom) and nevirapine, before switching to raltegravir, tenofovir and boosted atazanavir, because of resistance.

I wouldn't have thought my problems were as a result of age: they've come on relatively quickly and I've just turned thirty. Also, I have a handy twin brother (or as I affectionally call him, my bag of donor organs/control experiment) with which to compare my symptoms, and he is still fully compos mentis.

[Zohar]

This is interesting as I\'ve been experiencing very similar problems over the last few months. I never used to be absent minded, but now I often find myself forgetting what I was doing in the middle of a task, and having difficulty with recall of words and information.  I think now I might raise this issue when I next see my doctor in a couple of weeks.

[BM]

I thought I should post an update.

After seeing a psychiatrist and being sent for the wrong brain scan, I was then sent for the right brain scan and sent to a different (better) psychiatrist. The results were that my brain looks normal (i.e. no obvious HIV-related damage), and I was referred to a neuro-psychologist. We've been doing a series of tests including the WAIS-III (Wechsler Adult Intelligence Scale-III), the BADS (Behavioural Assessment of the Dysecutive Syndrome), and will soon complete the WMS-III (Wechsler Memory Scale-III). It has all been very interesting, although trying to mentally reverse an orally-presented string of eight digits is a form of cruel and unusual punishment.

More when I get the results back.

[Joe K]

I have seen psychiatrists and psychologists, mainly to address my mental health issues, but also when I noticed a decline in my mental acuity. For me, the solution involved changing some medications to slow acting and the addition of Methylphendiate (Ritalin). The Ritalin acts as a mental stimulant for me, it does not give me any speed-like feeling, but it does provide me with clarity. I am always careful to monitor my own performance and my husband will comment if he finds my behavior somewhat changed. I mention this to encourage anyone, who feels they are experiencing declining performance, to see someone about it.

There are many reasons that may cause a mental decline and proper diagnosis is imperative. I know some of my decline is due to my age and years living with HIV, but in this case, my confusion was caused by my depression medication and with a little adjustment, I seem to be somewhat back to normal. Each of us is very different and often the best gauge of your health is you and if something bothers your performance enough, you need to look into it.

edited to correct a drug naming error that EM pointed out below.

[BM]

Hi killfoile. Thanks very much for posting: you've just reminded me of a documentary I saw in which a psychiatrist carried out an experiment using methylphendiate in students without brain compalints and discovered their brains turned into information sponges. It's something I'd meant to run by the psychiatrist when I started seeing him but I had forgotten about it till now.

It's also encouraging just to know I'm not alone and that something can be done.

[emeraldize]

Using the spelling Ritalin - in case anyone wants to search it - will help you Google info.

[tednlou2]

I was with several family members this weekend and noticed all of them when telling stories had at least one incident where they couldn't think of the word they were trying to say.  One began telling a story and then forgot the rest of what they wanted to say.  So maybe it just happens to everyone.  Maybe we are more tuned in to our bodies and notice things more.  Maybe it is due to having a lot on our minds, anxiety, and depression.  I've mainly only noticed issues when typing.  But like I said earlier, I've never communicated by computer as much as I do now.  I have also noticed I will read things incorrectly.  I will see the word "president", for example, and read it as "precedent".  However, I read this article how we don't actually read every letter in a word.  It said people look at the first letter and the last and how long the word is, and that's how the brain reads words.     

Having said this, if someone is having constant issues, then that is obviously something different than the occasional forgotten word or thought.  And what I just said is not meant to discount what are very real problems for many of us.   

[PeteNYNJ]

Losing words does happen to everyone, especially as you get older.  My mother has been doing it for years...forget about getting peoples names right 

BM, you are on the right path with the tests you outlined below - you should be able to determine what is going on.

A bit of advice though, don't think too much about it.  I find in situations like the ones you present, the more you think about it, the more you worry, the more the symptoms seem to appear.  You are actually overworking your brain

[laslopaka]

I have a lot of memory problems. I was diagnosed with HIV Encephalopathy. I had a brain MRI and they found I had extensive Gliosis In my brain. My memory is a little better now that I have been on Meds. Not falling down as much and gained most of my weight back.
 But still feel exhausted. Sorry for the spellings. Glad for the spell check.

I'm dealing with the exact same thing.  I haven't thought about seeing someone over this.  Am I just making light of something that I should be concerned about?

In particular...

I will type something, and when I reread it it will be missing words.
When I speak I will be unable to think of the correct word I want, no matter how obvious.
I'm just nowhere near as eloquent as I once was.

I chalked it up to getting older, but I keep reading threads where people are saying similar things.  These things began happening before I was diagnosed and before I began meds although I'm fairly sure I'd been positive for quite some time before being diagnosed.

Do other people have these same issues?

[Hoover]

I have been suffering from loss of works for a couple of years now.
My mother was the same way and could never recall the names of any of her 7 kids.
I noticed her lack of words when she was my age and now I have the same issue.
Our poor dogs even realize I don't get their names right!
Actually I had thought since I now live in a Spanish speaking country I was just loosing my English words to Spanish. Presently I am not on any meds, this predated the HIV so I am guessing it is genetics.
It is hell getting old!

Hoover

[wolfter]

This is one of the main issues I was dealing with when I decided to join this forum.  I always used the term "brain fog" when trying to describe it to my doctor.  It's kinda refreshing that it's a common occurence.  Mine didn't start out gradually, it was like "BOOM", here i am.  I'm starting to just laugh about it now.  My family and friends even notice.  Lately, I've taken to hiding things and totally forgetting why and where.  Nothing like hearing your cell phone ringing in the crisper bin, or finding your dirty mags in the bathroom.  Oh wait, that one's ok. 

But seriously, I don't know if it's related to age, hiv, or medication, it's just another hurdle to deal with.  Certainly better than the alternative.

[littleprince]

I noticed that straight after my CD4 count bottomed out, I had PCP and then went on meds that I had terrible memory problems. for a few months I had real problems with remembering meoples names but that got better. sometimes i also couldn't think of a simple work  in a sentence.

I still find typiny  is terribly effected. My typing was never the best but I'm alyways using the incorrect letters in words. It's not just typos, my fingers sem to deliberately press the wrong keys. Sometimes there are words in a sentence that I typed that I wasn't even think ing of. I have no idea where they come from.

It takes me twice as long to type anything now as I spend half the time going back and fixing things. By the way, I left my mistakes inthe aboves sentences so you see what I mean.

[Breezy19635]

I am really glad and sad to read this string. I know that I will be thinking a word and I type something totally different. I am a very good typist and speller, but lately I have been really having a problem with it. I told my doc about it and she didn't seem concerned, as long as I could remember who was president and repeat numbers after her. But seeing that others are having the same problem, I am really glad I got to read this. It tells me that I am not alone, so even though I still experience it, to know that it isn't just me makes me feel like I am not losing my mind.

[Granny60]

Hubby has this same problem. CD4 gets below say 250 he forgets EVERYTHING, gets lost,  can't spell, can spend 2 hours typing and editing an email till it makes sense,  but when his numbers edge up  most things get clearer.  sleepless night do the same thing to him.  He had MRI'S  showed no lesions,  saw a shrink ( wasted time and nobody knows why he was sent there).  Flippin shrink just asked him who was president, what the date was,  what his birthdate was and told him he wasn't insane and sent him on his way.  WTF was that???

[jjbearphx]

Nuroligist, psycholigist may be to get you to deal with it ain't gonna get better.
This is Neuro Cognitive disorder, I have it as well along with Epilepsy. There dose not seam to be much avalible treatment wise, except they do anti seizure meds with me. AVR dose a great job slowing our pet virus, Yes I call it a pet thats better than trying to live with monster pets you can controle sometimes.
 where was I oh yes Phoenix.... seriously avr controlls well but not well past blood brain barrier, where the virus is at work pick and shuvel undermineing our inner self. Best we can do is keep as on top of it as we can, use tools post it notes are great, reduce distractions and live each day as best we can.
Bear

[jjbearphx]

This may cause a blow out but those of us on rategravir (Isentress) and are perception scrambled speak up. Aids Meds staff take note we may have stumbled on a newside effect not listed. Bear

[BM]

I was warned at the start that psychological testing might identify a problem for which nothing can be done. I'd rather know either way. At yesterday's session, the psychologist hinted that my memory performance is short of what my intellgence test result predicts it should be. I'll get the full results either next week or the week after.

[koderkev]

I have a lot of memory problems. I was diagnosed with HIV Encephalopathy. I had a brain MRI and they found I had extensive Gliosis In my brain. My memory is a little better now that I have been on Meds. Not falling down as much and gained most of my weight back.
 But still feel exhausted. Sorry for the spellings. Glad for the spell check.

Not to be scary or anything, but encephalopathy is what killed my first husband. I'm curious to know what kind of meds they're giving you to combat it. Are they giving you antibiotics?

My first husband was an English scholar, who wrote a novel that he was never able to publish. He also wrote lots of poetry, some of it specifically to me. I watched this man who was a genius with words reduced to only being able to say “yes” and “no.”

Given all of that, your post scared me somewhat for you. I'm glad to hear that you're feeling better!

Kevin

[laslopaka]

Sorry to hear about your husband.
I am currently on sulfameth and Atripla. I took my blood draw yesterday and waiting to find out my results in a couple of weeks. I'm feeling a little better I'm still woozy and off balance sometimes.. I switched ID Doctors  and currently under his care. He stated that I would be off of the bactrim as soon as my cd count goes up. I heard that encephalopathy could be fatal???  Did your husband take antibiotics for it?  How far along was he? was he progresseing? Thanks for the info

Not to be scary or anything, but encephalopathy is what killed my first husband. I'm curious to know what kind of meds they're giving you to combat it. Are they giving you antibiotics?

My first husband was an English scholar, who wrote a novel that he was never able to publish. He also wrote lots of poetry, some of it specifically to me. I watched this man who was a genius with words reduced to only being able to say “yes” and “no.”

Given all of that, your post scared me somewhat for you. I'm glad to hear that you're feeling better!

Kevin

[koderkev]

Sorry to hear about your husband.
I am currently on sulfameth and Atripla. I took my blood draw yesterday and waiting to find out my results in a couple of weeks. I'm feeling a little better I'm still woozy and off balance sometimes.. I switched ID Doctors  and currently under his care. He stated that I would be off of the bactrim as soon as my cd count goes up. I heard that encephalopathy could be fatal???  Did your husband take antibiotics for it?  How far along was he? was he progresseing? Thanks for the info

This was back in the early 90's, when there was no effective HAART therapy. They tried to halt the progress of the infection, but he was too far along and his own system wasn't able to fight back.  Today, I'm sure your doctor has a lot more effective treatments available to him.

At the time, Bobby had the best AIDS doctor in Kansas City, and even he threw up his hands. There wasn't anything he could offer.

[BM]

Here's a clip from the documentary I mentioned (effect of ritalin on normal brains):

http://news.bbc.co.uk/1/hi/health/8468338.stm

[laslopaka]

Thanks for the info.
My previous doctor did not seem to be to concerned. She even told be aids was not a disability. My CD$ count was 84. Hah. Needless to say I did not stay long with her. My current doctor even told me to follow up on my claim for SSDI even said to try and get a rating from the V.A. Still waitting to find out about both of them. Although I got denied for the SSDI but am appealing.??

This was back in the early 90's, when there was no effective HAART therapy. They tried to halt the progress of the infection, but he was too far along and his own system wasn't able to fight back.  Today, I'm sure your doctor has a lot more effective treatments available to him.

At the time, Bobby had the best AIDS doctor in Kansas City, and even he threw up his hands. There wasn't anything he could offer.

[BM]

The psychologist's intital thoughts are that I have anxiety and depression, but I'll have to wait a month for her to score the tests and formulate a diagnosis.

[MitchMiller]

I also am a member of the group.  Had exactly same symptoms... searching for the right word, typing emails missing entire words.  Before meds, I had a couple bouts of vertigo where I almost fell flat on my butt.  I am absolutely certain Sustiva contributes to my issues, although it is not entirely to blame.  I recognized the few times over the past 7.5 years that I missed a dose by realizing I could think clearly. 
I've found that vigorous exercise helps... like running, aerobics.  Gets the blood pumping to the brain.  Stimulants can help temporarily and sometimes aspirin as well.  It may be my imagination, but I also think that my brain clears after drinking black walnut extract (which is supposed to activate latent HIV so I would have thought it would make it worse).

[BM]

Just thought I'd rescue this thread from oblivion. Getting my results on Thursday.

[wolfter]

I'm also going to question my ID doctor about the Isentress connection.  My brain fog seemed to have started around the time I switched to it.

[BM]

I typed a long, detailed reply only to discover that a spell check makes your text disappear if you're using Firefox, so here's the abbreviated version, which I can expand if you're interested:

My memory test results were variable, with visual memory lower than auditory memory but all within the normal range. My psychologist went nuts over my "astronomical IQ". I have intact executive function. She doesn't think there's any evidence of organic brain damage (backed-up by scans) but that my problems are due to severe depression, for which she feels cognitive behavioural therapy would be a good next step. She doesn't want to land me with "more tablets to take", but isn't ruling out antidepressants. All in all I'm quite relieved.

[GSOgymrat]

That is good news. Depression is something that can be treated much more easily than organic neurologic problems.

[tednlou2]

That is good news--not that depression isn't bad.  Depression can cause so many mental and physical problems.  Since depression has been around since the beginning of time, I'm surprised we don't know more about it and a way to just fix it.  When you watch commercials for depression meds, they'll say "it is believed" the meds work by increasing serotonin, etc, etc.  It seems like they aren't totally sure how they work.  Thousands, if not millions, of people have depression due to something going on in the brain(lack of serotonin, other chemicals, or neurons not connecting properly) and not from something bad that happened to them.   

Besides a cure for HIV, I hope for a cure for depression.  I can pinpoint the time I started having depression in my teens.  I was fine and then like a switch something was different.  It didn't come on over time.  When I've told this to people, they've said I just thought it happened that way and I'm not remembering it right.  I had reasons to be depressed.  Maybe it all just built up and came on at once.  But, I think some chemical thing happened in my brain.  Right before this happened, I had smoked pot with a friend.  I've wondered whether the pot was tainted with something or it just didn't agree with me.  When I've told that to people, they think I'm against pot.  I'm not.  There are so many people who've been through hell and don't have depression.  So, it is seems those of us who have it are genetically prone to have it or something occurred in our brains that didn't in their's.   

[gregftl]

I have the same problems from time to time. I have anxiety/panic disorder. I take xanax for it and i think the xanax has that affect on my memory.

[BM]

She seemed to think a lot of it stems from the fact I'm unemployed. Low mood means low energy which means no patience for the delicate dance of nonsense required to interact with the HR tossers of the companies applied to (who wants to talk about a time they displayed "leadership in a team scenario" at the best of times?!). It's a bit of a vicious circle.