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I went to a new tdoc yesterday. He seemed very knowledgeable and asked in-depth questions. Overall, I was happy with the visit.

 

I described to him my memory loss, inability to initiate activities (cleaning, brushing my teeth, sex, etc.),math trouble, "flat" feeling... things like that. These things have been getting worse over the past few years. This is mainly what we talked about yesterday, although I mentioned my other problems.

 

When we got to the end of the session, he asked if I had any questions for him. I asked if he had an opinion of what's going on with me. He said the things I am describing probably are caused by a problem with the frontal cortex and that it sounds like I have "dysexecutive syndrome". He went into more detail but I couldn't follow him. Then I went home and tried to google it, but I still can't understand it.

 

I will ask him next week, but until then... Does anyone know anything about this and is there a cure or help for it? Thanks.

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Well, if I break the word down I come up with dys meaning bad and executive meaning one who gives orders, plans and executes initiatives  so I guess it means you have a tough time initiating and planning ? Ask him next week like you state.  And tell him to explain it to you in plain English. 

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I did some quick googling and found the Wiki page easiest to understand. http://en.wikipedia.org/wiki/Dysexecutive_syndrome

 

It says that it happens in those with schizophrenia, I am assuming it would also happen in those with other schizophrenia spectrum disorders. 

 

Basically, it explains that damage has occurred to the frontal lobe of the brain, where executive functions are managed. Executive functions are things like planning ahead, organizing, abstract thinking and emotional/behavioural control. So, this area has been damaged, resulting in problems in all those areas. 

 

The article explains that people in the acute phase of illness (schizophrenia) have more problems with this than people in the chronic phase. I would guess that you are in the acute phase of illness, based on what I've been reading in your blog. You have been struggling with psychotic symptoms quite a lot lately, right? Psychosis is hard on the brain. 

 

I also have probably suffered from dysexecutive syndrome when I am acutely psychotic, and many others probably have as well. When I am psychotic, I often have the same problems, like not being able to brush my teeth, get out of bed, plan and start activities basically. Then, when I am in the more residual phase of my psychosis (after the acute phase), I tend to have strong negative symptoms, which sounds a lot like what you are describing. 

 

There is no cure for it, according to the Wiki article. But, there is hope. It tends to lessen when you are well. For example, I am very well right now, and I have no negative symptoms or symptoms of dysexecutive syndrome (assuming I ever did, I'm just guessing, I don't have a diagnosis). So, there is hope that one day when you are well, these symptoms may ease up a bit. 

 

The article explains that goal-focused therapy can help with dysexecutive syndrome. So, helping you to plan and initiate activities, one little step at a time. Maybe since your tdoc has identified this, they will be able to help you with small goal planning. 

 

Did that make any sense? I hope that helps. 

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I have pretty poor executive function, which kind of drives my pdoc nuts. The problem is so does DH, so we have to break everything in our lives into tiny bites. Keeping a household together is a real challenge. I've never heard it called dysexecutive, either. But I am fairly sure that in BP, the damage to executive function is in the pre-frontal cortex. I swear I have also seen parietal lobes are damaged, but I couldn't find search terms specific enough to find the paper, there were hundreds of hits.

 

AHA: Here's a paper that dances around the edges of the topic we are discussing, but nonetheless is interesting, and discusses the pre-frontal cortex, and parietal lobes. Pictures of fMRIs, too, which I always love. I just scanned it, so I can't say it is the most definitive paper ever.

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Dysexecutive Syndrome is mainly a diagnosis of brain damage or lesions, with a pretty large executive dysfunction group of symptoms. It seems to be a very controversial diagnosis in the MI world. Mainly because it is thought to be actual damage by a physical trauma like a stroke; and mental illnesses are suggested to not cause brain damage. If you have had a physical trauma, to which can be seen on certain tests (MRI, CAT, Etc.), it would be more likely diagnosed. If that is not the case, the diagnosis would most likely be between you and your psychiatric team, unfortunately.

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  • 2 weeks later...

Dysexecutive Syndrome is mainly a diagnosis of brain damage or lesions, with a pretty large executive dysfunction group of symptoms. It seems to be a very controversial diagnosis in the MI world. Mainly because it is thought to be actual damage by a physical trauma like a stroke; and mental illnesses are suggested to not cause brain damage. If you have had a physical trauma, to which can be seen on certain tests (MRI, CAT, Etc.), it would be more likely diagnosed. If that is not the case, the diagnosis would most likely be between you and your psychiatric team, unfortunately.

Actually, my pdoc and many sources confirm that Psychosis causes brain damage and that people with schizophrenia show changes in the structure of the brain, such as the well-documented ventricle enlargement.

 

So, dysexecutive syndrome matches well with Schizophrenia.

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Dysexecutive Syndrome is mainly a diagnosis of brain damage or lesions, with a pretty large executive dysfunction group of symptoms. It seems to be a very controversial diagnosis in the MI world. Mainly because it is thought to be actual damage by a physical trauma like a stroke; and mental illnesses are suggested to not cause brain damage. If you have had a physical trauma, to which can be seen on certain tests (MRI, CAT, Etc.), it would be more likely diagnosed. If that is not the case, the diagnosis would most likely be between you and your psychiatric team, unfortunately.

Actually, my pdoc and many sources confirm that Psychosis causes brain damage and that people with schizophrenia show changes in the structure of the brain, such as the well-documented ventricle enlargement.

 

So, dysexecutive syndrome matches well with Schizophrenia.

 

 

Correct. And I wholeheartedly agree. However insurance companies & other types of professionals who dedicate their lives to medicine (outside of the psychological field) have not caught up and do not agree. Thus actually getting the medical treatment (which is accepted or denied by insurance unless you can pay for it yourself) is very slim unless you have the proof and documentation of the injury or lesion caused by that mental illness.

 

Sucks, I know. But atm that is the way it is.

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