Clients get life ‘sorted’ at memory clinic

Cognite is the brainchild of Dr Himani Kashyap and Dr Rajkumari P Reddy of the Department of Clinical Psychology at NIMHANS.

BENGALURU:Are you feeling very forgetful these days? You wish you could perform better at work and reach your full potential? Having a hard time focusing?  For people experiencing the above, ‘Cognite’, a memory clinic started at NIMHANS Centre for Wellbeing, is proving to be the useful.

Cognite is the brainchild of Dr Himani Kashyap and Dr Rajkumari P Reddy of the Department of Clinical Psychology at NIMHANS. The two doctors, who received referrals for a number of people whose only difficulty was memory, concentration, being productive at work and such, but had no diagnosable psychiatric disorder, realised that such a clinic is a necessity. Today, at least 70 per cent of the people visiting this clinic are those with no psychiatric or neurological disorders.

“It begins on a small scale, and then snowballs. It starts with being unable to complete assignments, keep up with deadlines, difficulty in organisation and compromised efficiency at the cost of the self.  Then it gradually pervades to the other spheres, including interpersonal relationships, eventually making one feel dysregulated emotionally (referring to an emotional response that is poorly modulated, and does not fall within the conventionally accepted range of emotive response) emotionally, so this clinic is for them,” says Dr Reddy, associate professor, Department of Clinical Psychology, NIMHANS.

Explaining that symptom control is no longer the only goal for clients or mental health professionals, Dr Kashyap, assistant professor, Department of Clinical Psychology, NIMHANS, says, “We saw that there were many people who came to us with cognitive complaints, but had no psychiatric illness in the past. Also, we realised people would like to live their lives as fully as possible, despite having a psychiatric illness. As clinical psychologists, we support this goal for clients. Therefore, this clinic focuses on helping clients become fully functional.”

This special clinic, devoted to assess and intervene with cognitive complaints, started in June, and three months into being operational, it has seen a good number of clients. Most clients who come in are students, marketing professionals, software engineers and new parents.  The referrals, which happen from NIMHANS and from other private clinics, are mostly clients complaining of problems such as, “I used to be a topper at school, but now I can’t read two lines”; “I forget things people say to me”; “My husband and I end up having a lot of arguments because I keep forgetting what he said to me... Important things,” explains Dr Kashyap.

The clinic mostly sees a lot of young professionals — both men and women. With both genders, doctors claim to see a lot of anxiety, striving for perfectionism, poor organisation on everyday efficiency.
Day to day forgetfulness can also be worked on, says Dr Kashyap. Recently, there was a client who had lost her earrings, which made her realise that she had been losing many things of late. “She told us that she is forgetful, she misplaced her gold earrings, some money given to her for safe-keeping, and only after searching for many days, she realised she had kept it in the house and forgotten where she had kept it. In such cases, we realise that it is just a cognitive problem she is going through after being treated for depression,” says Dr Kashyap.

It is believed that episodes of depression or trauma bring about forgetfulness or memory loss, and that once the depression is cured, these side-effects will also vanish. But doctors say that’s not true. “With disorders like depression or anxiety, the traditional understanding is that cognition will improve once the symptoms disappear. This is what clients are often told — ‘Don’t worry, you will get better, no need to do anything’. But that doesn’t help. More recent research shows that even after the symptoms remit, thinking and productivity remain a problem,” says Dr Reddy.

Meanwhile, there are clients who come to just ‘organise’ or get their lives ‘sorted’. The treatment for clients is done after a systematic assessment, which includes an understanding of emotional, cognitive and interpersonal factors. We then recommend interventions, which include psychoeducation, cognitive exercises, strategy training and lifestyle changes, the doctors say.

The clinic, as of now, is for people in the 18 to 60 age bracket, and operates on Fridays between 9.30 am and 1pm. However, those suffering with dementia are sent to NIMHANS, as a different kind of intervention is required.

“Our set up provides services, primarily preventive in nature, to cater to subclinical conditions using brief, scientifically proven methods. If the condition warrants extensive and long-term therapeutic need, we make appropriate referral to NIMHANS,” says Dr Reddy.

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