I took a break from my ‘day’ job, and the re-deployment effort for this blog for a while there.  Why?  Because for a while there, it wasn’t coming as easily and the white noise was overwhelming.

What wasn’t coming easily? ; My ability to get things done from a cognitive point of view.  Huh?  What does that mean?

Here’s a somewhat snooty answer to the question “What wasn’t coming easily?”:

• Responding to complicated instructions with a sense of comfort, and in a demonstrably confident, repeatable, concise, clean manner was becoming clumsy;
• Holding up my end of a detailed conversation, assimilating multiple viewpoints and responding appropriately, with the ability to recall the details of the discussions was becoming a lot of work;
• The ability to learn something new like figuring out a new piece of technology became an increasingly frustrating exercise with many starts and stops usually while I tried to second guess the intention of the designers and technical writers.

It’s not that I couldn’t do any of it, it’s just that it all felt somewhat rough and choppy. It seemed to be taking more effort and took a bit longer than any of it should have.

There also seemed to be so many self-generated distractions popping up to get in the way of my being able to sustain the processing of a given thought through to a logical conclusion.  Those pop-up distractions were even inhibiting the follow through on an activity, not just a thought.

Okay, so what kind of distractions are we talking about?

• A low level sense of paranoia; too quick to take offense, and too easily irritated
• Questioning my own capabilities with completing both simple and complex tasks
• Ruminating; running conversations, thoughts, ideas over and over in my head
• Fixation on and distraction by visuals often resolving into accelerated self-talk
• Becoming really chatty or alternately , being rudely antisocial

My cognitive processes needed a lube job.  I’m referring to some of those often overlooked cognitive bits and pieces which act as the dollops of grease on the friction points in your life, the tiny dabs of lubricant that help move you through each day.  Short term and cognitive memory, problem solving capabilities, and that kind of thing, are at the core of your mind’s work day.

There can be a lot of different influencers that affect those little things your mind does to keep everything in sync.

I found for a while there that for me it was emotional stressors which had a big impact.

When emotional impact begins to screw with your cognitive functions and you then start to question your own abilities, effectiveness and place in the world you know that you are in some serious trouble.

You need to recognize the impact and then deal with it.

There is always going to be some sort of indicator to alert you that you are sliding ‘off centre’ and that some sort of adjustment is necessary.

I’m not sure how other people recognize them.  Try looking online.

You may find that you’ve got your own internal, personal, and perhaps ‘physical’ cues that you should be paying attention to that don’t show up in the mental health guides. Not everyone has the partner who will share and speak with brutal honesty, and not everyone has the friend who can step into that gap.  You may not have a strong enough relationship with your doctor for them to be able to recognize or validate the ‘cues’. You’re the one who is going to have to discover how to recognize your indicators.  You may end up having to do it on your own.  That’s tough.  That level of self-awareness is really tough.

For me, the one indisputable indicator is when my brain feels like it’s congested, as if my my brain has a cold giving new meaning to the term ‘head cold’.  Someone, I can’t remember who, described the sensation as being like trying to think your way through the porridge in your head.  Maintaining any usual level of activity and interaction when this starts to happen is absolutely exhausting, not unlike the tired you get fighting back from the initial impact of a stroke or brain injury.

When all the factors aligned and I found myself in that odd place where I was trying to work through the porridge in my mind I began questioning my own capabilities to do the work I truly enjoy.  So, on the advice of my doctor with whom I do have a strong relationship, I took a step back and availed myself of a short term medical leave in order to rest my stressed brain.   That short term leave turned into a long term disability insurance claim which offered me the opportunity to get some cognitive testing done with a view to comparing where I was at the end of my structured stroke rehab period and where I am today.

After several missteps we finally got the testing and assessment done.

Something that plays to my vanity is that one of the doctors who evaluated the test results suggests that I have had and still do have a huge cognitive reserve.

Cognitive Reserve.  That’s another one of those nebulous terms that no-one really explains or even uses in conversation outside of a doctor’s office.  I’ve come to think of cognitive reserve similarly to the way I think of physical energy and stamina reserves and ‘getting in shape’.  Runners get out and train for a marathon so that when they actually run it, their body has the ability to cope with the stressors associated with that much sustained effort.  The runner creates enhanced heart and lung function, builds energy and stamina reserves that aren’t needed to just walk down the street.  Because of the training effort the reserves and capacity are there when needed. to fuel the body’s sustained efforts.  Cognitive reserve is what your brain draws on for a cognitive boost when you are working through a mental marathon, under stress or in crisis and your cognitive processing power needs some help.  Cognitive reserve is your brain’s ability to demonstrate resilience and stamina, coming up with different and even unexpected connections to get the cognitive job done.

What I am beginning to understand about cognitive reserve is that it is built up over a lifetime of activity and living, and is strengthened by education, complexity of skills training, and targeted experiences with things like puzzles, mathematics,  music, and the arts.    All the arts; the literary arts, visual arts and the lively arts enhance cognitive reserves.  Living your life and participating in it fully builds the framework for a strong cognitive reserve.

No one really thinks about or considers the building of cognitive reserve when we should be building it, but instead we wait until there’s a brain injury, stroke,  decline in memory or  other significant indicators before we consider the need for strong cognitive reserves..

It seems to be part of the ‘human condition’ not to pay attention to the building of the reserves we’ll need later in life, or in case of injury.  A marathon runner trains because they know what’s coming.  We generally know how most of us will age, and we do generally understand what it takes to recover from injury so why aren’t we all training for it?.  Why do we wait for the red flags on everything from vision and hearing loss, to heart health, to muscular deterioration and even arthritis before we do much about it?  In context of this oversight or willful neglect  I now laugh at the number of times I hear one of my contemporaries say they’re out of shape and need to get to the gym, or regret the loud rock ‘ roll of their youth, or wonder why they didn’t form a close bond with a dentist when they had the chance.

We may indeed have a more informed generation coming up behind us, but that doesn’t make them any healthier or prepared for aging.

I have been reasonably fit and body aware all my adult life. The two items are not mutually inclusive according to friends and acquaintances.

If I have one more person, especially a medical professional, tell me that the challenges I’ve been addressing   are just because I’m getting older, I am definitely going to say something, loudly.  It’s bad enough that recent brushes with paranoia tell me that some of the folks  I work with are ageists, I certainly don’t need to hear that same level of condescension from doctors, nurses and medical receptionists.

In the spirit of full disclosure I will mention that I was cautioned by my family doctor some time ago that all the drama and trauma associated with my cancer treatments would add ten years to my relative physical age.  I do have to remind myself of that occasionally.

Wait a minute!  We were supposed to be talking about the why’s and wherefores of my medical leave.  I’ve gotten a bit off track.

I’ve written briefly about behaviour amplifications as a by-product of the hemorrhagic stroke I experienced.  Lately I had found that more and more of the amplified behaviours I thought were under control were pushing me off my centre.  There was a significant event in my family which may have been a trigger that accounted for some of it. This turned it all into a ricochet of self-doubt. The question was becoming about whether or not the amplified behaviours were affecting my ability to do my job.

As the tensions in my personal life built towards some sort of crescendo and the stressors at work got worse, or shall I at least say stronger, I found myself questioning my own abilities and capabilities.

Can I do this job anymore?

What is happening to my cognitive reserves?

How much of the performance of my job over the past couple of years was propped up by my team and my immediate supervisor(s)?

When I lost my team in the near constant shuffle of personnel and job responsibilities which characterized the last couple of years I lost that anchor and support.  I seriously started to question, as I’m sure did my supervisors, my effectiveness and my ability to do the job.  I felt the stress, and the almost overwhelming anxiety associated with ‘letting people down’, and the associate low-level paranoia that goes with it.

I will admit that I’ve never felt as ill at ease as I have the last few months.  If this is depression, I definitely feel bad for the folks who are knocked to their knees by it on a regular basis.  This is not a great feeling.

It was, as my doctor suggested, time to take a break,   so I did.

Next posts will be more about the wherefores and then the climb back to a graduated return to work.