Out of Mind

Do you believe that the things we’ve forgotten are the things we don’t mind forgetting? Maybe. The sad fact is, there are times when we look back, and we cannot remember at all.

Dementia – loss of memory learning, reasoning, judgment – is usually brought on by chronic, progressive structural or degenerative conditions that are irreversible. The factors are unknown but hereditary, like hypertension and diabetes, followed by a stroke or several little strokes. Dementia is different from forgetfulness due to normal aging and from delirium. Normal forgetfulness preserves general information and its symptoms do not interfere with normal functioning. Delirium is the onset of symptoms that usually takes hours or days and the severity fluctuates during a 24-hour period.

Derived from the Latin “de” (out) and “mens” (mind), dementia means being out of mind. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder !V (published 2000), “Dementia is a disorder characterized by multiple cognitive deficits that include impairment in memory.”

“The cognitive deficit must be severe enough to interfere with social and occupational functioning, the onset and course are gradual and insidious, and memory impairment is an early symptom. Losing valuables like wallets and keys , forgetting food cooking in the oven, and becoming unfamiliar with common places has been to, among others, are symptoms,” Dr. Waldemar Alarkon explains.

Dr Alarkon is a US-based Filipino psychiatrist who graduated from the University of Sto. Tomas. He is a member of the American Psychiatric Association and the Connecticut Psychiatric Society.

As the disease progresses, one may develops aphasia (cannot repeat names of persons or places, frequent use of vague references like “thing” or “it”), agnosia (cannot visually identify familiar objects or places) and apraxia (cannot copy simple drawings, brush teeth or comb hair). The individual also develops disturbance of executive functions such as budgeting, planning, organizing, and sequencing. Advanced stages exhibit severe memory impairment that the person forgets his occupation, schooling, family members or even his own reflection in the mirror.

Dr. W. Alarkon adds, “When behavioral and psychiatric symptoms like confusion, screaming, head-banging, mutism, anxiety, depression, delusions, and hallucinations become severe, an individual requires supervised living, nursing, home care, hospitalization, or chronic institutional care.”

A demented patient’s mental status is characterized by loss; the schizophrenic by distortion, and the manic-depressives by mood exaggeration. In early dementia, patients may blame others or distort the reality situation in attempts to explain away their mistakes, unreasonable emotions may crop up.

Exercise and socialization are therapies. “But direct the patient away from demanding situations that are liable to exceed their capabilities. Family meetings with the physicians, nurses, and social workers, will help the family accept the limits of how much care can be accomplished,” Alarkon points out.

In old age, memory fades in the absence of apparent disease through a process for which science has no real explanation. But it does have a name: Benign senescent forgetfulness (senile dementia), which means failure in memory tend to proceed inversely with time while the past comes nearer.

Many people seem to remember best what has mattered most to them, and often it is work. For instance, a telegrapher manning the key switching towers can still see those towers in his mind. Though he cannot often remember some family names, he can name all the stations he worked at, even the Morse code.

Senile dementia is a more steadily progressive disease of unknown cause. The pathology is cellular rather than vascular and results in widespread atrophy of the brain and the gross mental loss. Alzchheimer’s disease and Pick’s disease are comparable degenerative disorders, and clinically they all share the same dementia, the same lack of response to therapy and the same fate.

Also, prolonged toxic conditions brought on either by drugs or by metabolic disturbance can sometimes lead to dementia. Years of alcoholism, drug abuse, vitamin deficiency (beriberi pellagra, vitamin B12 deficiency), or the residuals of acute insults to the brain (severe head injury carbon monoxide poisoning) heavy metal poisoning) may also cause such disease.

Memory holds life for us. The realization that we have it, so many things inside of us, is a blessing we should count. At least, we must be thankful now, to God our Creator, and keep being part of each other before memory fades and the past comes nearer.

/Rose F Martinez, March 22, 2001. The Daily Tribune, p 19.


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