Many people with depersonalization disorder report a wide range of impairments of their cognitive performance abilities. For many, the illness is connected to a constant state of wondering and vicious thoughts. Topics include the self, the future, etc. Also, many of those affected experience uneasy thoughts that can amount to concentration disorders. Those affected have a hard time sticking to a topic and can only listen to others with great difficulty; their ability to focus is significantly impaired.
Some of those affected literally describe “brain fog” that makes thinking impossible at times. Those affected then blindly stumble around their own brains trying to find something. Thoughts are no longer within reach; they cannot think of words.
The ability to visualize images can also be limited, as well as the ability to remember things. This on the one hand manifests in learning difficulties, and on the other hand in not being able to retain what has been learnt. Also, the ability to access past memories is significantly impaired. Not being able to remember things is often linked to a sense of great shame, so that conversations about the past are avoided due to the fear of others noticing that most of what has happened has been forgotten.
The cognitive impairments combined with impairments in sensory perception often lead to constant fatigue or exhaustion in many of those affected. Often, they find it difficult to motivate themselves to do anything.
Most of those affected by depersonalization disorder experience these cognitive limitations as being very burdensome. Insofar, it is helpful to keep on reminding oneself that cognitive impairments like exhaustion or concentration difficulties are not limited to those people experiencing depersonalization. They are symptomatic of modern life with constant stress, pressure from the outside, as well as the expectation of being able to complete many things in a short amount of time. A lot of people with and without depersonalization suffer from a lacking ability to remember things. It is normal to not remember everything when considering the breadth of information and experiences.
Many of those affected by thought fatigue, emptiness in their head or brain fog report that it is helpful to stimulate oxygen transport in the blood stream to supply the brain with more oxygen. A quick walk in fresh air or inhaling oxygen from an oxygen bottle are both good methods. As was mentioned before (Physical discomforts), also actual physical deficiencies can be the reason behind lacking oxygen supply, so it may be useful to have a blood exam done and to compensate iron or vitamin D3 deficiencies, if applicable. Some of those affected state that taking Omega 3 or N-acetylcysteine capsules is helpful against thought emptiness.
Those who are affected by concentration difficulties often experience relief when they succeed in not spending too much time in front of the computer or in not having to do monotonous work. Oftentimes, the ability to concentrate improves when varied activities are undertaken or when the usual activities are varied, for example by getting up, working while standing, etc. A good way of improving the ability to concentrate is to do mental arithmetic, for example by continuously subtracting 7 from 200 until you reach 0. Such mental exercises can easily be done on the go without anyone else noticing. Many of those affected report that it is also helpful to sleep enough, that is to say that concentration difficulties are experienced when sleeping too little. Often, also relaxing for a little in-between can help.
For some time now, PC programs have been available that help train cognitive performance. Those affected who suffer from severe cognitive impairments or who have the feeling that their cognitive abilities decrease from day to day could try one of those programs.
Some of those suffering from depersonalization disorder, who have the feeling of not being able to remember things well, often resort to capturing experiences in videos or photos. By combining a documented experience with a short description, a form of visual diary can emerge. If this is used more often, experiences can remain more vibrant. It is important to note that the more sensual the way of capturing the experience is, the easier it will be to remember. However, those affected should pay attention to not only capture extraordinary experiences, but to also capture daily experiences like conversations with partners or children, as these are often experiences that are difficult to remember precisely because they are not extraordinary.
It also helps to speak to people who were part of experiences. Why not get together and speak about past holidays, birthday parties and other events? This requires a certain degree of trust, as those affected by depersonalization need to “out“ themselves to a certain extent.
When people with depersonalization disorder are affected by a lacking ability to remember pure learning content, it can be helpful to use flash cards or to use memory protocols or excerpts. Where needed, learning content can be recorded and listened to from time to time.
Losing a sense of orientation, so not being able to recall where they are, where they live or what time it is, can be very burdensome for those affected. In addition, this leads to stress, which in turn leads to a further loss of a sense of orientation. People with depersonalization should not shy away from using watches, street maps, navigation systems or apps for mobile devices.
If those affected feel impaired completely when it comes to cognitive performance, it is often most beneficial to retreat completely. Mostly, this only happens in particularly bad phases with very severe symptoms that get better after having retreated for a while. Those affected should decrease expectations about themselves in such phases and maybe get a sick note from a doctor for a few days.