Navigating Neuro Challenges: Seeking Guidance on Career and Health
I'm a 21-year-old woman, standing at 5 feet 4 inches tall and weighing around 130 pounds. I'm white and have no history of substance abuse, smoking, or excessive drinking, living in the USA with CareFirst insurance. My diagnosis history includes various mental health issues for which I am currently receiving long-term treatment. I've suffered from multiple traumatic brain injuries (at least five), some of which might be undiagnosed due to their subtle symptoms. Additionally, I have Epstein-Barr virus, but recent tests for thyroid function (TSH, T4, free T3, TPO antibodies) have all come back normal. The main difficulties I face encompass significant issues with concentration and severe memory loss. My healthcare team is also monitoring other symptoms, including insomnia, extreme fatigue during the day, low thirst levels, and problems related to hypotension that could be traced back to dehydration. Notably, there is no family history of dementia or similar ailments at my age. I'm acutely aware that this forum isn't a place for diagnoses, yet I feel utterly adrift. The complexities of adulthood have overwhelmed me, and I find myself at a loss. As a college student who once dreamed of becoming a veterinarian, I now face daily challenges in my studies. My memory problems are so debilitating that I often forget what I’ve eaten throughout the day and even struggle to remember friends' names in conversation. Chemistry has become particularly daunting; I'm currently enrolled in Organic Chemistry, and I've had to pause my pre-veterinary path to focus on better managing my memory issues. For years, I've been under care for mental health conditions, which include bipolar I, depression, anxiety disorders, dissociative identity disorder (a diagnosis that is still highly debated in the medical community), depersonalization/derealization disorder, autism, and ADHD. I’m currently on a regimen that includes Trileptal, Citalopram, Buspirone, and Concerta. My experience with Adderall did not alleviate my memory or concentration problems, and we’ve approached dosages cautiously. I’m still in the early stages with Concerta, so I’m waiting to see how it affects me in the coming weeks, though my initial reactions have been less than promising. In my last appointment, my treatment team suggested testing my thyroid considering my mother’s diagnosis of Hashimoto's, but the results were clear. They also recommend undergoing a cognitive evaluation with a neuropsychologist due to my TBI history, but finding one that accepts insurance has proven to be a challenge. The estimated cost for testing is around $5,000, which I can't afford right now. I'm feeling increasingly lost and would greatly appreciate any advice or insights. I’m considering asking my primary care physician about brain scans, as I’ve never had any imaging after my TBIs. My previous care involved simple advice like resting, taking Tylenol, indulging in dark chocolate, and avoiding strenuous activity for a few months. I’ve reached a point where I’m uncertain about my next steps. Any guidance would mean a lot to me, and I'm open to answering any further questions. Thank you for taking the time to read this.
Answers (1)
12/13/2025, 8:50:46 PM
OpenHealth AI
It's understandable to feel overwhelmed given the challenges you're facing with your mental health and cognitive issues. Your concerns about memory loss, concentration, and the impact of your history of traumatic brain injuries (TBIs) are significant, and it's important to approach this systematically. Here are the main points and actionable steps to consider:
Main Points:
- Cognitive Evaluation: You may benefit from a formal cognitive evaluation to assess your memory and concentration challenges.
- Symptom Management: Addressing dehydration and sleep quality may help with your daytime fatigue and concentration issues.
- Support System: Engaging with your healthcare team and seeking appropriate resources for your studies will be crucial.
Explanation:
Given your history of TBIs and the complexity of your mental health conditions, it's understandable why you're feeling lost. Cognitive issues can arise from various causes, including prior injuries and conditions like anxiety and depression. The fact that you're under ongoing care is a positive aspect, but it does sound like you need more targeted support to manage your symptoms effectively.
Next Steps:
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Request Imaging: Talk to your primary care physician about obtaining brain imaging (like an MRI or CT scan) to assess any potential structural changes related to your TBIs. This could help clarify some of your symptoms and guide further treatment.
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Hydration and Nutrition: Focus on improving hydration and nutrition:
- Aim to drink at least 8 cups (about 2 liters) of fluids daily. Set reminders if needed.
- Consider keeping a simple food diary to track what you eat, which can also help reinforce memory.
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Sleep Hygiene: Prioritize better sleep quality. Try to establish a regular sleep schedule:
- Go to bed and wake up at consistent times.
- Create a calming bedtime routine that limits screen time before sleep.
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Alternative Support for Neuropsychological Evaluation: Since you mentioned challenges in finding a neuropsychologist who accepts insurance, explore community resources or university clinics where services might be offered at lower costs. Sometimes, training programs offer assessments at reduced rates.
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Brain Health Activities: Engage in cognitive exercises that can help improve memory and concentration:
- Use apps or puzzles designed for brain training, like Lumosity or BrainHQ.
- Practice mindfulness or meditation to enhance focus and reduce anxiety.
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Communication with Your Care Team: Keep your healthcare providers updated on how Concerta is affecting you, and express any concerns about your memory and concentration. They may adjust your treatment plan or explore alternative interventions.
Remember, you're not alone in this journey, and taking proactive steps can gradually lead to improvements. Stay connected with supportive friends or family and seek out resources that can offer you assistance in managing your studies.
If you have further questions or need more specific guidance, feel free to ask!
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