Page 99 - The Memory Program How to Prevent Memory Loss and Enhance Memory Power

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An ambulance screamed outside our hospital, disrupting our conversation. Such sounds are par for
the course in virtually every neighborhood in New York City. Joan lived in a quiet suburb in
northern New Jersey, but she showed absolutely no reaction to the sound of the ambulance. She sat
slumped in her chair, barely moving.

On further inquiry, she said that life was now a chore, the fun had disappeared. She couldn't
concentrate on reading the newspaper, and was having trouble getting her act together to make it to
work every morning. Her sleep was disturbed, but she still had a fair appetite and denied any
physical complaints.

I realized that quick action was needed and immediately arranged for a number of tests to help
clarify the situation. The medical diagnostic workup was within normal limits. On
neuropsychological testing, she scored slightly below normal for her age on several measures of
attention, concentration, and memory. Her test performance was confusing to the neuropsychologist,
who could not decide between the diagnosis of depression and the early stages of Alzheimer's
disease.

I was more confident about the clinical presentation. I made a diagnosis of major depression and
asked Joan if she would agree to participate in one of my studies. The study involved twelve weeks
of treatment with the antidepressant medication sertraline (Zoloft) to evaluate its effects on both
depression and cognitive deficits in people who had both these problems. Joan was quite willing to
do the research evaluation and interview procedures in the study, but she was reluctant to take
medication, as many patients are. The situation was compounded by her insistence that she had a
memory deficit, not depression, and so she did not want to take an antidepressant medication. I had
to explain the relations between depression and memory loss in many different ways before she
finally agreed to try the medication. I also told her that while the medication was likely to make her
feel better, it wouldn't exert its full effect for a few weeks and so she needed to be patient. She
wasn't, and skipped an appointment. Then she frantically called me to say that she had received an
unfavorable report from her supervisor and was afraid that she would be fired from her job.

When she came to see me the next day, she remained ambivalent, even negative, about taking
sertraline (Zoloft).

I
“ have to fight my problems without a crutch. I don't want to become dependent on this
medication,” she said.

“I never cease to be amazed by the number of people who religiously take their medications for
heart disease, blood pressure, or