Adapting to life with schizoaffective disorder (part 4) – cognitive issues

In the beginning of my senior year of high school, I found myself sitting at my desk in AP Calculus staring at the result of my test. D. How did this happen? I studied harder. C-. I broke out the flash cards, had friends help me study, but I could not do it. It felt like it didn’t matter what I did, I couldn’t reliably remember the formulas. For someone who was used to straight A’s, this was like a blow to the gut. No one had told me that schizophrenia and schizoaffective disorder came with cognitive deficits.

Before then, academics had always come easily to me.

At the time that I was diagnosed with schizoaffective disorder, I was about to start my senior year of high school. I was used to straight A’s, top scores, and awards and it all felt effortless. So how could this happen? I had schizoaffective disorder, not a learning disability. Right?

While I knew a little and quickly learned a great deal about psychosis, I was not aware of the cognitive deficits it causes. These include issues with executive functioning, memory, and attention. I was thinking slower, reading the same line over and over without actually processing it, easily distracted, and memorization felt impossible.

It was a struggle to adapt to these changes in high school. This was partially because I didn’t really have any well-developed study skills, but also because I still refused to accept that things had changed. I disclosed my diagnosis only when absolutely necessary. I am eternally grateful for both the discretion and support I had from two teachers, my academic counselor, and my vice principal, but by the time I graduated, I still didn’t really have it figured out.

In college, things were a mess.

I couldn’t keep up with readings. Doing homework and trying to study could take hours and I still got poor grades. In a meeting with my freshman counselor she asked me about my Intro to Psychology class. Every test was multiple choice, requiring extensive memorization. I was drowning. She gently told me that I had received an academic warning because of a D on a test. I studied harder, but my grades didn’t get much better. My grade at the end of the quarter was low enough that I did not receive credit for the class. As a psychology major and over-achiever, I was mortified. The embarrassment dug deeper when I lost my full ride scholarship at the end of the year.

My counselor put me in contact with the Office of Services for Students with Disabilities. I was surprised that I could utilize their services because I hadn’t realized that they were available to people with mental illnesses. I was initially given two accommodations – time and a half on tests, and I could take my tests in the testing room in their office. It was a quiet place with fewer students, so I could focus better. It also prevented that moment of rising panic as everyone around me finished their exams while I was only halfway through.

This new hope inspired me, and I revamped all of my study skills.

In order to memorize things for class, I had to go to the lecture, read the book, and write out flash cards. I would run through the flashcards by myself, then with my boyfriend, and I would explain the concepts to him. It was a lengthy process, but it worked. My cognitive issues weren’t gone, but I learned how to work around them and learned that help was available. And because of all of this, I was able to graduate from Northwestern University with a respectable GPA.

I became passionate about solving the cognitive issues for myself and others.

My struggle with cognition and desire to work in schizophrenia research led me to a position in the lab of a researcher at Northwestern’s medical school. He primarily studied cognition in schizophrenia and possible ways to improve it. When learning more about the lab’s eye tracking trials testing executive functioning, I had the opportunity to give it a go myself. First task, no problem. But the second was typically more difficult for people with schizophrenia. Given what I had accomplished, I thought I would do just fine.

It seemed simple enough – stare at the center dot, another dot appears to the right or left, and you look in the opposite direction. I sat down. Focus on the center. A dot appears to the left. My eyes dart left, catch myself, move right. Next trial. The same. Again and again, I struggled to look in the opposite direction. It was a stark reminder that my cognition wasn’t magically better just because I completed my degree. And that there wasn’t much I could do about it other than accept it as a piece of the disease and continue learning to cope.

The cognitive deficits impact my daily life, but they taught me something as well.

Others may not have struggled with cognition as much as I have, but it is a very real result of schizophrenia and schizoaffective disorder. It wasn’t one that I was aware of prior to my diagnosis, nor was I prepared for it. It’s also not something that will go away. In my current position it tends to make me second guess myself. I don’t trust my memory and will triple check things like names and phone numbers even when I know I’m right. I also tend to ask the same questions over and over because I don’t always catch onto things very easily. While it’s still frustrating, I get by fairly well.

Despite the challenges, it was with these cognitive issues that I began to learn that it’s okay to ask for help outside of therapy. In all honesty, it’s something I still struggle with, but it’s one of the most important things I’ve learned about living with mental illness. Help doesn’t have to end at your doctor’s door.

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