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M ental I llness Concerns All carers

 

Prospective memory failure

We cannot hold living arrangements together without Prospective Memory [PM]

PM is remembering to carry out intended actions at appropriate points in the future

Even minimal reflection prompts the realization that the texture of our daily existence is inextricably bound to PM tasks.

Everyday life cannot go on without it.
These tasks include mundane demands such as

did i turn off the stove ?
remembering to pick up bread on one's way home,
remembering to mail the letter in one's briefcase,
remembering to give one's housemate the message
that a friend called, and
remembering what is going to be done tomorrow

In other words all these sort of things have to be put together, able to be done, to make a life for yourselves.
To map out, to hold onto, a daily and weekly map - which is your routine .

A poor working memory capacity is likely to fail in this.
But with a helping hand . with repetition [ see Raalten in Reference ] into a programme of activities on regular days in the week, engagement and participitation is achievable, and once done, gives something to hold attention. This takes attention away from illness, makes a support place to turn to and think about prospectively other than being caught up in illness directed thinking.

It is distraction - into illness or into whatever else is going on andt herefore shifting attention, that becomes the disability for those wih schizophrenia.

Prospective Memory needs a fully working memory system with enough capacity for ...
holding onto a command thought,
parking it somewhere, proceeding with the intention in it
dealing with other matters but not losing the intention,
coming back to the intention when required to do it, completing it, signing it off,
and preparing and going along with another intention.

It requires multiple brain areas appropriately working together with capacity to do so.

This working memory capacity is faulty in schizophrenia.
There are not enough of the new cells in the hippocampus of those with the illness, to form and sustain a working memory capable of deaing with all these considerations and yet keep on track.

The reduction of this neurogenesis activity in the hippocampus is the handicap in schizophrenia that prevents them making the prospective intentions that make for a settled daily and weekly routine to their living.
Something that others find essential.
Without this stability life is continually uncertain, and open to anxiety all the time, especially those with some degree of obsessional personality - leading to a negative schizophrenia.

Without a sustained working memory capacity - Prospective Memory - holding on to more than one thing at a time - tasks cannot be done properly

The hippocampus is part of the collective brain system ... [ a difficult read !! ] that underpins each part of prospective memory.

The shortfall of hippocampal neurogenesis in schizophrenia is the weakness that lets that whole system down.
Residual sufferers face difficulty in formulation, maintenance, and completion of an intention,

So that they lose out in building, and maintaining, a life for themselves.

working memory

Prospective Memory [ProM]can be divided into several subdomains: ProM proper or episodic ProM, vigilance/monitoring, and habitual ProM . Episodic Propective Memory brings a previously made plan back to consciousness in the appropriate context (e.g., upon noticing a supermarket) or at the appropriate time; it allows us to recognize ProM cues as signs of the previously formed plan In contrast, vigilance/monitoring requires that the plan remain in consciousness during the retention period.
Habitual Prospective Memory is similar to episodic ProM but the plan must be executed repeatedly; each time it must leave consciousness and be brought back by an appropriate context/Pros cue or time.
Accordingly, buying groceries en route home requires episodic Prospective Memory,
watching a bathtub so it does not overflow requires vigilance/monitoring,
and picking up a child from daycare every day requires habitual Prospective Memory.

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