Struggling with Thought and Expression: Seeking Help for Mental Clarity - Psychiatry

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The loss of cognitive and analytical abilities has severely hindered my ability to express myself verbally?


Hello, Doctor.
I have always struggled with my thinking and expression abilities.
I am seeking your help primarily to address my issues with thinking, expressing myself, and interacting with others.
Due to my poor communication skills, I have many questions and situations that I haven't been able to articulate clearly during my recent visits, so I am trying to write them down in hopes of conveying them more accurately to you.
Thank you for being willing to listen.
Doctor, I feel that I have lost my ability to think and analyze, which severely affects my ability to express myself verbally.
I am not exaggerating when I say that at home, I can only talk about my illness with my closest family member, my mother.
For several years, I have been unable to discuss anything other than my health (and even when discussing my illness, I struggle to articulate my thoughts).
I hope you can help me determine the reasons behind my inability to express myself.
I am unsure if it is due to cognitive decline, the challenges of being a single parent, or years of solitude while managing a store without social experiences.
My inherent limitations combined with insufficient training have all contributed to this situation.
I find myself wanting to know what to do, but I feel stuck, as this is not a problem that can be improved simply by interacting with more people.
The inability to express myself verbally prevents me from engaging with others (even though the people I encounter are very friendly).
There are several factors contributing to my inability to speak, and I am unsure where the problem lies in my brain.

1.
I lack personal opinions and feelings about anything.
Regardless of my experiences, such as traveling, I can only say that I went to Korea, and that's it.
However, I see others, both young and old, who can naturally express their thoughts and feelings about their experiences without needing to consciously remember them.
They can articulate their experiences instinctively without having to think of the right vocabulary.
In contrast, I cannot retain the things I see while traveling, and I have no thoughts or feelings to express, leaving my mind blank after any experience.
2.
I lack the ability to think and analyze.
New information does not enter my mind in a way that allows me to convert it into words.
I try to learn through listening to lectures, watching the news, reading books, attending classes, and watching movies, but while I can understand the words and know what is being said, I cannot comprehend or transform that information into language.
I lack the ability to summarize and organize information.
I am unsure if this is due to poor memory, where I forget things immediately after hearing them, or if my expressive abilities have deteriorated (I struggle to find words, cannot describe meanings, and my mind goes blank, compounded by my inability to remember or learn new things).
For many years, I have faced difficulties in thinking and expressing myself, to the point where I have lost the ability to speak.
I cannot communicate or think, which prevents me from interacting with others.
Some may see that I can write these words and think that I am capable of thought, but what they do not realize is that it took me nearly an hour to compose even a single sentence.
Organizing fragmented thoughts that suddenly appear and then vanish requires immense effort, and I find myself anxiously pulling my hair every second.
Even describing relatively straightforward matters can take me several days of intense thought, let alone responding in real-time conversations (outside of discussing my illness, I often find myself at a loss for words).
Doctor, I do not understand what is happening or what I should do.
Am I inherently less intelligent? Yet, if that were the case, why can I read and write, and understand spoken language but still struggle to express myself? Is it a result of a lack of training from a young age? I have tried to improve my speaking skills by reading news articles or texts aloud, but when it comes time to express myself, I still cannot find the words.
You may ask how I manage to communicate in my current life, but at the store, I only need to say simple phrases like "Hello," "How much is this?" or "Thank you." When buying something, I can say, "Boss, I want to buy this," and I can manage basic interactions like asking if someone has eaten.
However, when it comes to engaging in conversation, my mind is completely unable to think or analyze, and I have no thoughts to share.
I can only smile blankly or nod, which severely impacts my judgment and prevents me from expressing fragmented thoughts.
If I were to encounter bad people in society, I would be in serious trouble.
My current state feels like I have lost my (thought) perspective, (feeling) emotional preferences, (judgment) analytical thinking, and (communication) verbal expression abilities.
I feel like a person without the capacity for thought, judgment, or emotional connection, unable to learn new things, and only capable of rote speech.
Living a life that consists solely of eating, working, and sleeping is terrifying.
I fear the loneliness of not being able to emotionally connect with others or learn new things.
I am desperate to find the root of my problems and do not know how to restore my brain's ability to feel and express thoughts.
These words have taken me several days to piece together, with each sentence taking nearly an hour to formulate.
Doctor, I hope you can help me understand what is wrong with my brain and what I should do.
Thank you for your assistance.

Liangliang, 20~29 year old female. Ask Date: 2019/07/18

Dr. Huang Xiaoxian reply Psychiatry


Dear Liangliang: Thank you for your question and detailed description.
It sounds like your main issues are difficulties with thinking, expressing yourself, and interacting with others.
There are certain psychiatric conditions that could lead to these outcomes, so I recommend discussing these symptoms in detail with your attending physician.
This will help the doctor assess your situation and provide appropriate treatment.
Given that you mentioned having trouble expressing yourself during appointments, it might be helpful to share the information you've provided here with your doctor to facilitate a more in-depth discussion.
Generally speaking, if cognitive difficulties are due to a brain disorder, the physician may prescribe appropriate medications to improve function.
If the expression difficulties stem from anxiety, there are corresponding medications to alleviate anxiety as well.
However, your situation may require further clarification of the underlying causes for effective treatment.
Lastly, regarding difficulties in interpersonal interactions or expressing your inner feelings, exploring these challenges through psychotherapy could be beneficial.
This may help you understand how these issues have developed and find ways to address them.
You might also consider asking your attending physician about the possibility of arranging a consultation with a psychologist.
Wishing you all the best!

Reply Date: 2019/07/18

More Info


It sounds like you are experiencing significant challenges with your cognitive functions, particularly in the areas of thought processing, expression, and social interaction. Your concerns about losing the ability to think clearly and communicate effectively are valid and warrant attention. Many individuals face similar struggles, and it is important to understand that you are not alone in this experience.

From your description, it appears that you may be dealing with a combination of cognitive and emotional difficulties. The inability to articulate thoughts or feelings can stem from various underlying issues, including anxiety, depression, or even cognitive decline. It is crucial to differentiate between these possibilities, as they require different approaches for management and treatment.

1. Cognitive Functioning: The challenges you describe—such as difficulty in forming thoughts, recalling experiences, and expressing ideas—may indicate cognitive impairment. This could be due to several factors, including prolonged isolation, lack of social interaction, or even stress-related cognitive decline. Engaging in activities that stimulate your brain, such as puzzles, reading, or learning new skills, can help improve cognitive function over time. However, it is essential to approach these activities with patience, as improvement may take time.

2. Emotional Health: Your feelings of frustration and anxiety about your communication skills can exacerbate the situation. Anxiety can create a feedback loop where the fear of not being able to express oneself leads to further difficulties in communication. It might be beneficial to explore relaxation techniques, such as mindfulness or meditation, which can help reduce anxiety and improve focus.

3. Seeking Professional Help: Given the complexity of your situation, it is highly advisable to seek professional help. A psychologist or psychiatrist can conduct a thorough assessment to determine if there are underlying mental health conditions contributing to your cognitive difficulties. They can also provide tailored therapeutic interventions, such as cognitive-behavioral therapy (CBT), which can help you develop strategies to improve your thought processes and communication skills.

4. Social Interaction: While you mentioned that social interaction might not be the solution to your problems, it is important to recognize that engaging with others can provide valuable practice in communication. Start small—perhaps by participating in low-pressure social settings or joining groups that share your interests. This can help you gradually build confidence in expressing yourself.

5. Journaling: You have already taken a significant step by writing down your thoughts. Continuing this practice can be beneficial. Journaling allows you to organize your thoughts and feelings, making it easier to articulate them later. Over time, you may find that your ability to express yourself improves as you practice writing.

6. Medication: If cognitive decline or emotional distress is significant, medication may be an option to discuss with a healthcare provider. Certain medications can help manage symptoms of anxiety or depression, which in turn can improve cognitive function and communication abilities.

7. Support Systems: Lastly, consider reaching out to supportive friends or family members who can provide encouragement and understanding. Sharing your experiences with trusted individuals can alleviate feelings of isolation and help you feel more connected.

In summary, your situation is complex and multifaceted, involving cognitive, emotional, and social elements. Seeking professional help is crucial to understanding the root causes of your difficulties and developing effective strategies for improvement. Remember, progress takes time, and it is important to be patient with yourself as you navigate this journey. You are taking a positive step by seeking help, and with the right support, you can work towards regaining clarity in your thoughts and expression.

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