On May 28th I took an on-line test for memory function. This memory test is reputed to be well validated as an accurate indicator of problems associated with a variety of causes including brain trauma. The test may be found here: Link to the on-line memory test.
I took the memory test at eleven o’clock in the morning, and scored poorly. As the day progressed I noted that I had lost enthusiasm for my activities, that I sought to engage in avoidance sleep, and that I was devoting time to recognized compensatory activity (made soup stock) rather than continuing with scheduled tasks. At around six o’clock I made the short post Very Little has Changed. I then forced myself to engage in development of a draft blog post concerned with prior employment activity. Later in the evening, I ate the remainder of a frozen food dish which I had first consumed in response to a depressive trigger earlier in the week. I ate this item despite it being a suspect cause of tummy trouble.
When I recognized that I was engaged in a behavioural response associated with depressive events, I commenced taking detailed notes in an attempt to identify the trigger event. This post is based on that series of notes.
When I took the memory test, I was forced to take it twice. At the finish of the first test, I requested the final report but was instead provided with an error message stating I had not answered each item in the question bank and the test could not be processed due to this error. I then proceeded to take the test a second time.
My subjective impression of the second memory test was that I performed better, and faster, than on the first attempt. My understanding of the requirements for each test item was improved and I therefore anticipated this increased knowledge would result in a high score. I was not expecting the low score delivered on the second assessment.
Memory Test – Section 1 Shapes & Tiles
The memory test had a number of discrete sections. The first section concerned a set of shapes hidden beneath blue coloured tiles. The subject needed to click on a tile to reveal the underlying shape, and then click on a tile location which concealed the identical matching shape. The hidden shapes were different on each test attempt.
I found this difficult. I could not remember the revealed location of the shapes. I employed a logical process to methodically identify matching blocks. On the first attempt, I failed to notice that I was trying to locate a match for a shape which had already been found and matched. On the second attempt, I appeared to do better at locating hidden shapes by intuitive selection. On both occasions I attempted to remember the location of revealed shapes but this stored information generally proved incorrect.
Memory Test – Section 2 Numeric Input
The second section required the subject to input a numeric keypad response equal to the number of words displayed on screen. If the example was ONE ONE ONE then the subject was to input the number 3 in response. In a number of cases, but not all, there was a conflict between the word content and the number of times that word was displayed. In the prior example, I would read the word “one” and keyboard the number 1 in response. This was incorrect; the instructions required a keyboard response of “3” if the identical word was displayed three times. I don’t know why this gave me trouble, but it did.
I believe Dr L utilized a similar form of test. I believe I was able to master Dr L’s test through verbalizing what I observed onscreen. If I saw the number ONE three times I would state “three” out loud and verbally reinforce the correct response. My sense is that this made task performance easier to achieve. I forgot this workaround, and forgot the connection with Dr L’s testing, until I commenced entering notes after completing the test.
Memory Test – Section 3 Connect the Dots
The third test section required connecting a sequence of dots while following a pattern of alternating letters and numbers. The correct sequence was 1, A, 2, B, 3, C, 4, D etc. I was slow at this. I had to go back and verify the next letter, or number, in the sequence. It was relatively easy for the first set of sequence events (I appeared to have no trouble going 1, A, 2, B ) but this facility seemed to disappear later in the sequence.
Memory Test – Section 4 Faces and Names
The fourth test section involved the display of lots and lots and lots of faces together with their names. This display of faces and names was then repeated a second time but in a different sequence. On the third display of faces and names, the subject was required to view the random presentation of a face name pair and indicate if this was a true match of face and name, or a false paring of the two items.
This test was very difficult for me. It looked easy at first but I felt my confidence ebbing away as the large number of face name pairs became apparent. I worked hard to remember face name pairs but as the number of items increased I became increasingly uncomfortable. My discomfort was due to a recognition of the impossibility of my holding this many face name pairs in memory.
I attempted to “fix” details of each image as a memory aid but this became impossible beyond one or two faces. One image of a woman had a distinctive broach, or rosette. I remembered the rosette and matched that to the name, not to the face. Another name, Deirdre, was matched to her zebra stripe shirt material rather than to her face. Apart from these two individuals, I had very low confidence in all the subsequent matches.
Despite this, I was not anticipating the low score I achieved. I didn’t expect to be top of the class but felt I would rank somewhere in the middle of the lowest quartile. My final score was off the map on the low end of a normal range that extended from 7 to 100. This was very discomforting to me. This unwelcome information formed the key trigger to the subsequent depressive event.
I was further disconcerted by the discovery I had inadvertently interrupted the string of consecutive blog posts. The last post carried a date of May 26th and it was now May 28th. I do not know how I managed this outcome. I thought I had scheduled a post to run on May 27th, but clearly this was not the case.
I suspect this missing post formed a secondary trigger. I had pushed hard on the blog in the expectation that if I exerted myself, and mustered significant effort, I would somehow manage to advance my recovery. That I might somehow climb out of this problem and achieve a return to the uninjured me. That I might somehow recover the capacities that I no longer seem to enjoy.
From May 7th through to May 26th I worked diligently and completed 20 posts. I was assisted in this by a series of events which seemed to throw up new subject matter on a regular basis, and by the fact one overly long post was broken into three parts with each part scheduled to be run over a three day period.
In retrospect, I believe that the 100th blog post also formed a trigger. When I realized I had reached the century milestone, I felt a quiet sense of achievement. There was a burst of confidence that I could do more, that I was making progress. This awareness, coupled with the realization that I had started a consecutive string of daily posts, motivated me to continue with the objective of running consecutive daily posts until the end of the month.
I also suspect that one of the key aspects of this trigger, and perhaps all of the other triggers, has to do with a sense of agency. When I completed the 100th post, this involved recognition of personal agency, the blog serving as evidence of a measure of credible performance. I was exhibiting a positive capability and this augured well for further improvement. The memory test outcome punctured this balloon of growing self confidence. I went into a tailspin when I was forced to acknowledge that very little has changed.