By Rachel Bilgrei, PsyD
The vestibular system includes the parts of the inner ear and brain that help control balance and eye movements. If the system is damaged by disease, aging, or injury, vestibular disorders can result. Symptoms of vestibular disorders — which affect about half of the U.S. population — include unsteadiness, dizziness, vertigo, nausea, headaches, hearing and vision problems, and difficulty with concentration and memory.
Vestibular disorders affect individuals physically and psychologically. These disorders are variable not only in their physical manifestation, but in their psychological manifestation as well. And while it is important to understand your physical symptoms, it is equally important to understand your psychological symptoms as they can often trigger and/or exacerbate your physical symptoms.
Cognitive is just a fancy word for thinking. When I use the phrase “cognitive aspects of vestibular disorders,” I am referring to how your vestibular disorder affects your ability to think, specifically to pay attention and concentrate, to remember, to reason, and to problem solve.
Disorientation and confusion are common during acute stages of vestibular disorders.
In these very frightening and disturbing moments, knowing who and where you are, the time of day, etc. may not be readily available to you. Fortunately, these moments are relatively short-lived. As the physical symptoms fade, clarity and comprehension return.
Vestibular disorders can interfere with cognitive stamina/energy.
Cognitive energy is finite for everyone. If you are using a great deal of this energy to maintain equilibrium and stay steady (something that is normally done automatically), it is unlikely that you will have very much left over for other activities. As a result, cognitive fatigue sets in.
Activities that you used to be able to perform with ease and very little effort now require much more effort, leaving you drained of energy and requiring rest/naps. Spontaneity goes right out the window.
Vestibular disorders impair attention and concentration.
Vestibular disorders interfere with your ability to pay attention and concentrate. You may find that it is difficult to sustain focus for a significant length of time. You may find you are easily distracted — both by external stimuli (the noise of other people talking, the TV) and internal stimuli (your thoughts and feelings). Multi-tasking, the ability to do and keep track of two processes at the same time, can also be compromised. Another area of attention/concentration that is often affected in people that have vestibular disorders is sequencing. For example: you may find yourself mixing up sounds while speaking, or reversing numbers or letters when speaking or writing. You may have trouble following directions, filling out forms, following a recipe, or tracking conversation or plot in a movie.
Visual skills interfere with perceptual aspects of cognitive functioning.
Due to the intricate link between the vestibular system and the visual system, problems with visual-spatial tasks are common in people suffering from vestibular disorders. Eye-hand coordination may not be very coordinated; depth perception may also be thrown off-course.
The Problem With Memory
The most common cognitive complaint I have heard in my clinical experience working with people suffering from vestibular disorders has been difficulties with memory. And the problem seems to be more with short-term memory (remembering what you had for breakfast this morning) rather than long-term memory (recalling the name of your best childhood friend). Often, but not always, what is perceived as a memory problem is really a problem with attention. I like to use a bank model of memory to explain this phenomenon. In order to deposit money into your bank account, there are a series of steps that you need to execute in order to ensure your money is properly deposited so that at some later date, it will be there for you to withdraw. The same is true for your brain and processing information to be stored in memory. There are specific steps it goes through to ensure that information gets “deposited” so that it is available for retrieval or “withdrawal” at some later point. At the bank, as well as in your brain, if the steps are not followed properly, the money/information gets lost and thus is not available for future use. The cognitive strain of a vestibular disorder can interfere with this “depositing” or encoding process of information. As such, if the information is never properly encoded, there is no way it will be available at some later date for retrieval.
Next month’s article will discuss the various ways to cope with, overcome, and treat these difficulties.
Article re-printed with permission from the Vestibular Disorders Association. To read more about vestibular disorders, visit the Vestibular Disorders Association website at www.vestibular.org.
For more information locally on any type of Vestibular Disorder, including problems with balance or dizziness, you may contact Poonam McAllister at Central Illinois Institute of Balance at 309-663-4900 or www.dizzyil.com. Poonam is specially trained in the evaluation and treatment of balance disorders using a comprehensive approach that looks at the complexities of balance problems in the context of the total patient. Her office is located at 211 Landmark Dr, Suite E-3 in Normal.
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