COGNITIVE DEFICITS and TIPS ON ENHANCING YOUR COGNITIVE FUNCTION FOR DAILY LIVING

Cognition means knowing or perceiving. No matter what you are doing, your nervous system is always trying to provide you with the most complete and accurate picture of reality. Your cognitive processes create and refine this picture, and make it possible for you to use it. Your adjustment in every area of your life depends upon your cognitive abilities because they are what enables you to recognize and understand what is going on around you. You use these adjustments to come up with plans for dealing with changes, and you can come up with ways to put your plans into effect. Judging whether or not your approaches and adaptations worked, remembering them if they did, and then modifying them if they didn’t are all cognitive processes. Every aspect of dealing with MS (as with everything else in your daily life!) is based upon the use of your cognitive abilities, therefore it can benefit you to be aware of them.

There is another important benefit to becoming familiar with your cognitive symptoms. These symptoms tend to be extremely sensitive to changes in your level of stress, so they may serve as effective warning signals. Changes in the ways that your cognitive abilities are working may provide some useful clues that you are approaching your limits. Subtle changes in aspects of your cognitive functioning can alert you that you’re in danger of exceeding your capacities. Armed with these warning signals, you may be able to slow down and re-adjust, before your established symptoms begin to appear and/or intensify.

The most common cognitive difficulty in people with MS is mild to moderate impairment of short-term and working memory. People who usually have good memories may find themselves forgetting things, such as appointments. Their attention span and ability to concentrate may be diminished. Sometimes they find it hard to keep track of what they were doing before they were interrupted. For example, they may have difficulty getting back on track if the phone rings while they were sorting mail. While these problems can be quite subtle, they can be extremely frustrating and upsetting.

Some people with MS experience more serious cognitive problems. They have difficulty with planning and problem-solving and tend to become overwhelmed and inflexible when a task is too complex. They may lack the flexibility to generate alternative solutions. They may even be unaware of their difficulties and have problems monitoring their own behavior. 

Comprehension of the impact of their behavior on others may also be overlooked.

Difficulties with the self-regulation of behavior can create problems in many different ways. Some people with MS may be unable to plan and organize purposeful activity. Sometimes the problem is in the area of initiating action. Difficulties with “getting started” may appear to others as depression or lack of motivation. Other people who have MS may have the opposite problem of being unable to stop themselves. They may be very talkative and uninhibited, blurting out comments they would have kept to themselves in the past. Because they are unresponsive to the normal social clues that let them know their behavior is inappropriate, they seem very impulsive and oblivious to the reactions of others. Furthermore, they may have a “short fuse” and experience unpredictable angry outbursts.

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