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llw26
llw26, Mental Health Professional
Category: Mental Health
Satisfied Customers: 54
Experience:  LPC-September 2011. I am in the process of obtaining my doctorate in psychology. Forensic, Neuropsychology, Adult.
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In the middle of a conversation, for no apparent reason, and

Resolved Question:

In the middle of a conversation, for no apparent reason, and especially when we're just making small talk, I can suddenly become disengaged and say words without being truly connected to them. I also feel like my hearing becomes less at those moments, and I can't fully emotionally comprehend. Any ideas?
Submitted: 2 years ago.
Category: Mental Health
Expert:  llw26 replied 2 years ago.

llw26 :

Hello -- I know it says you've spoken with some specialists, has a neuropsychologist been one of those specialists?

Customer:

Yes, I had a cognitive evaluation 3-4 years ago. It came out fine

llw26 :

Since then, have you had any head trauma?

Customer:

no

llw26 :

What side of your hearing is lost?

Customer:

I wear hearing aids in both ears, and when my hearing gets less (as I described) it is both also

llw26 :

Are you left or right handed?

Customer:

right

llw26 :

what does it feel like when you're in the middle of a conversation and you become disengaged?

llw26 :

Is it that you feel like you lose interest?

Customer:

no, I do not feel like I'm losing interest. I'm interested, but my responses are just "odder" and don't mirror the other person emotionally

llw26 :

Ah okay.

llw26 :

Does this happen all the time or just every once in awhile?

Customer:

I feel like I can't fully comprehend, then, too

llw26 :

What did the counselor and doctors say?

Customer:

Only once in a while. Maybe once or twice a day

llw26 :

okay

Customer:

About 4 years ago, I was diagnosed for depression. The theory for these episodes was that depression was causing my emotional circuits to be busy. But I have been successfully treated for depression, and when these events happen, they may happen for no reason, and I can't just "snap out of it".

llw26 :

Okay, so this problem has lasted for about four years? Have you had any updated services through a mental health provider or medical doctor?

Customer:

This problem has really only been in the last two years. I have had therapy and talked to my family physician. It's really weird. I can be going along, talking just fine. Then when it happens suddenly, it feels like something just happened cognitively over which I have no control

llw26 :

I would agree that it sounds odd, which is why I asked if you had seen a neuropsychologist...I think the next step for you is to see a neurologist and have some neuroimaging done in order to determine if there is something structurally abnormal.

Customer:

I also had a CAT scan done 4 years ago (when I had the cognitive test), and it was also fine

llw26 :

It could also be due to stress that this is occurring; if you are under a great amount of stress some times our neural networks get messed up (kind of like what your therapist was saying with the depression) and we may say odd things or not remember what we said

llw26 :

But you haven't had an updated one?

Customer:

no

llw26 :

so since this problem started 2 years ago; I would suggest getting an updated one in order to determine if something has occurred since then. Do you have any other problems cognitively? Such as slurred speech or speaking odd phrases (like messing up "normal" sentences?)

Customer:

My main source of stress is this problem, and how it is affecting my relationship with my wife (who is understandably bothered by this in our conversations). so I'm not sure if it is caused by stress.

Customer:

no, no slurred speech or messed up sentences

llw26 :

I could see how this would be a problem when speaking with others, as well as frustrating for all involved. Stress may increased the problem...if there is something underlying.

llw26 :

Or stress may be the overall problem, I would suggest obtaining a new CAT scan (or other neuroimaging device) in order to cross off any structural problems.

Customer:

Yeah, so I'm not sure what to do.

llw26 :

Also, speaking with a speech pathologist may help as well

llw26 :

Do you speak American Sign Language at all?

Customer:

No, I dont signDoes this sound like any psy

Customer:

Does this sound like any psychiatric problem you've ever encountered?

llw26 :

I've heard of people having this type of problem when they are extremely stressed out -- like everything in their life is stressful and they don't have an outlet for the stress...which makes their stress increase...I have found that people who continue with therapy and work on relaxation techniques can assist with the problem(s).

Customer:

So you think it may be stress induced? That's possible, but it can happen just in the middle of a normal peaceful conversation with no stressors. It's perplexing.

llw26 :

Right, but if you're in a constant state of stress then the problem may be triggered at any point in time...due to how your brain is wired it may always be turned on to the "stressful state" and never fully come down from that state, even though you may feel as though you're not stressed out. It is complex, frustrating, and difficult to understand...but in part it is our brains way of saying "slow down! I need a break and time to think." Which is why I suggest to my clients that they continue with therapy and relaxation techniques.

Customer:

So therapy and relaxation techniques. I can see that, I suppose.
But it feels like I should also be able to do something in the moment when it happens to recover. Any ideas?

llw26 :

Hm, for in the moment have you tried slowing down the conversation?

llw26 :

So you're able to process what is being said...or have the person repeat what they've said?

llw26 :

I know that can be frustrating too, but until you have this under control I would try that.

llw26 :

Also, repeating what they've said to you in your head, or out loud

Customer:

What are some of the relaxation techniques that you would suggest?

llw26 :

Have you tried deep (diaphragmatic) breathing?

llw26 :

Here is a helpful web page that teaches you how to do deep breathing : http://pilates.about.com/od/pilateswarmupandprep/a/breathingEx.htm

llw26 :

There is also relaxation where you tense and relax (from) your toes to the (top) of your head.

llw26 :

It's called progressive muscle relaxation -- here is a youtube video that assists with learning how to do this...it's helpful to have a video or audio while doing it -- http://www.youtube.com/watch?v=HFwCKKa--18

llw26 :

A lot of clients I see also do yoga or pilates, as they find these techniques calming.

Customer:

Thanks that advice about relaxation technique.

Customer:

I have a couple of more questions

llw26 :

Yes

Customer:

Is it more helpful to try to identify and reduce what the stressor(s) may be, or is it more helpful just to practice relaxation techniques regularly?

Customer:

And the other question is, why would stress cause this reaction in me at random moments?

llw26 :

I think it's important to determine what the stressors are in your life and try to reduce them; while practicing the relaxation techniques -- I don't think one overrides the other, b/c when you are stressed out and cannot deescalate your stress, you have the relaxation tools in place that you can utilize

Customer:

So do both. okay

Customer:

what about my second question?

llw26 :

Yes

Customer:

And the other question is, why would stress cause this reaction in me at random moments?

llw26 :

It's due to your brain constantly being in a stressed out mode. Your brain doesn't' just stop being stressed out when you don't feel stressed out...it continues to feel this way, especially when you're over stressed...there's a lot of neurology that goes into the explanation, but in essence you're brains on high drive until you've gotten the stress and relaxation techniques in place. Once you are aware of the stress, your brain is then able to be away of the stress and then your brain is able to come down from the heightened level of awareness (that is, stress).

llw26 :

Does this help?

Customer:

Another question - if my brain has been overstressed for 2 years, how long does it take to recover?

Customer:

And yes, that does help

llw26 :

The brain learns quickly, so if you are using the relaxation techniques and trying to slow things down...it shouldn't take too long; however, everyone is different so it's difficult to give an exact time frame.

Customer:

Does this help the brain chemically (eg. seratonin, dopamine, etc), or is it neural re-wiring (of synaptic connections, etc.)?

llw26 :

it's neural re-wiring. you're rewriting the stress response with relaxation techniques.

Customer:

oh okay

Customer:

When is the best time to do relaxation techniques?

llw26 :

When you have time, in a quiet room, with minimal distraction -- for the progressive muscle relaxation you want sufficient time, about 30-45 minutes.

Customer:

What about exercise?

llw26 :

deep breathing does not take too long to do -- that one can be 10-15 minutes (or longer if you wish).

llw26 :

you want a quiet room again with minimal distraction as you need to concentrate on your breathing

Customer:

Any thoughts about exercise? How does that impact it? Or are the relaxation techniques a better time investment?

Customer:

By the way, thanks, XXXXX XXXXX helpful

llw26 :

Exercise is always good; the relaxation techniques are specific to get your thoughts to slow down; which I think would be beneficial in your case

llw26 :

Of course; always glad to help!

Customer:

This as a reaction to stress makes a lot of sense. And I will look up the relaxation techniques that you gave me and the online links. So thanks, XXXXX XXXXX try that.

Customer:

Thanks for your help

Customer:

I guess I'll let you go now. Have a good night, I appreciate your help

llw26 :

Of course and if you have any other questions while you're doing the techniques, please don't hesitate to contact me!

llw26 :

You're welcome. You have a great night as well!

Customer:

bye

llw26 :

good bye.

llw26, Mental Health Professional
Category: Mental Health
Satisfied Customers: 54
Experience: LPC-September 2011. I am in the process of obtaining my doctorate in psychology. Forensic, Neuropsychology, Adult.
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