A NEW CASE OF STOP STUDYING BY CONCENTRATION DEFICIT IN A UNIVERSITY STUDENT. ITS RESOLUTION WITH ANTISTRESS THERAPY.

Renato COCCHI, neurologist and medical psychologist.

 

(Other five articles on this topic) 

Summary.

It is reported the clinical and therapeutics history of an already bright university student of twenty-six years, who had a progressive decreasing of notes and since over a year he did not more succeed to sustain new examinations. He had intrusive thinking, lack of concentration and refrains of songs that sounded in her head. A current antidepressant drug therapy did not act on these symptoms. After 18 months of antistress and antidepressant drug therapy he did low his intrusive thinking. He resumed his study ability, sustaining 9 examinations and one colloquium and one module with good-high notes, and reduced refrains of songs sounding in her head. In july 2007 he had his medical degree.

Key words: Stop studying, university, student, intrusive thinking, concentration, songs, involuntary mental repetition, stress, drug therapy, recover studying.

 

Testo in italiano.

Attention and concentration troubles, and stop studying.

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What follows is the report of a new case of blocking the ability to study and its resolution with antistress drug therapy. For some features it was an unusual case, which confirmed preceding intuitions.

Being a College of Medicine's student, the description of himself by the same was accurate, even if some interpretations of his discomfort show traces of a cultural psychologistical stereotype.

 

The case history.

20.03.04. (By E-mail): I am a medicine student of twenty-four years and I am studying at the ** university. I think to suffer even me from troubles of the concentration.

My problems began with moving from my ex university in Sicily to the new one in north Italy. I did get stress of adaptation to a new reality where there are not present any references to models. There I did not have friends, parents, the climate less typical than that of south Italy.

Here instead I found physical and mental stress (travels and moving, quarrels with the engaged girl by phone, the examination of Human Anatomy to sustain). So I flowed into a reactive syndrome from stress by maladjustment with depressive, anxious and obsessive aspects. Excuse me for the nonprofessional diagnosis made by a student of the fifth year with many examinations still to sustain.

I was always a bright student, but after the transfer to another university. Here I am without succeeding to study and to give examinations from more than a year because the easiness I can to divert my mind during studying.

After my depressive "ordeal" (as loss of self-esteem, guilt senses, suicide thoughts, increased weight with bulimia for sweets and chocolate). Besides it I suffered from an anxious state (heaviness and void in my head, neurasthenia, chronic tiredness, palpitations, lump in the throat).

So, I decided to consult a neurologist of the Local Health Department of the town where I am attending the university.

He prescribed me as the first approach, Alprazolam 10 drops three times per day for about one month, vitamins (citicoos) [?], and 10mg escitalopram daily. After about two months I may say that I recovered the depressive and anxious symptoms, but I discovered the obsessive-compulsive troubles.

These last could have preceded what you say as the thought with fluctuating and parasite content that avoids the information to transfer from the short term memory store to the long term one.

Result: in spite of the drug therapy, still I did not recover my problem of the concentration.

Now I decided to return in my southern habitat where I can find again friends, uses, flavours, odours of my earth. Since sometime I do no other than to dream my country, the mountain near my country where I went as a child. This is the sign of a great unconscious desire to return in the reality from which I moved me perhaps in a too traumatic way [??]. Here I shall find this relaxation that in my new situation doesn't occur because the lack of amusements, the lack of the group of my old friends. All that increases day after day in me the inadequacy and maladjustment feeling.

Among the other things, my constitutional habitus has some predisposition to this kind of problems. In fact, both my mother and my sister suffer from depression, and both my brother and my sister needed nearly ten years each to graduate.

I escaped the Sicily to look for to get me out the destinies of my brothers, and so, as often it happens, looking for shortening it ends instead to lengthen the walk. I wish to continue the therapy I remembered, first by looking to see if my rest in Sicily will help me, by allowing me to find the concentration in studying. I hope it does also stop the refrains of the songs that sound in my head and that I don't succeed to stop.

If a negative result would happen, I have thought to ask my neurologist about a chlomipramine prescription as the elective drug for the OCD instead of escitalopram.

21.03.04 (by E-mail): I am much cheerful of getting your attention. However I can tell you that I took alprazolam only for one month, and currently I am taking only escitalopram, omega 3 (EPA+DHA) and a vitamins compound.

I read a little all the articles on your site concerning stress and, in particular, the articles on the dropping-out for the concentration deficit.

24.03.2004: The first consultation: A Medicine student, he has troubles of the concentration, and he did not sustain any examinations since over a year. Now, he would do Physiology. In the preceding examinations he had a progressive decrease of notes. He refers all that to the moving to the north from a Sicilian university.

Recently he has done antidepressant-anxiolytic drug therapies that acted a little on the depression and for nothing on his ability to concentrate. There is a familiarity for the depression.

Problems of half-brain dominance: To the test " Which is the opposite of the colour Red?" he answered: Green, with some hesitation. Ideas of opposition-aggression come out but he has never led them in action. Into his head there is unwilling repetition of musical refrains. He has "thoughts with fluctuating and parasite content that avoids the information to transfer from the short term memory store to the long term one" with troubles of the concentration. He doesn't count objects for any reason, and he never did it.

Stress symptoms: He suffers from the cold and has oversweating in all the face. He eats the chocolate as an antidepressant, and he had always greediness for sweet things. Usually he doesn't look for milk and dairy, does not like the meat or cube broth, but he likes the meat. At the mornings he has breakfast at once. He is doing better in the mornings. At night he sleeps well, does not have bad dreams, in past he had drooling, but not currently. No nighttime muscular cramps occur, but he wakes up not tired. In past he suffered from the frontal headache and could stop them with alprazolam. With the light he is better. Some dizziness occurs. No faint feelings reported, nor tachycardia, but some palpitations. Currently he not has air hunger's feelings. In past he had feelings of mediastinal oppression, and of the lump in the throat. He does not suffer from gastric ache, nor from colic and diarrheas. Sudden asthenias for no reason happen. Ovesweating pertains to his hands, his feet, his breast and his armpits. His hair is fat.

Test therapy (daily doses, by the oral via): Carbamazepine 100mg; Oxazepam 15 mg; Chlomipramine 10mg; Glutamine 250mg; Pyridoxine 150mg.

18.04.2004 (by E-mail): The drug therapy is going well. The return in my habitat and to the active social life with my old friends is helping the therapy. Even the sleep is improved in quality and at the morning I feel me reloaded by more energy and I feel that I have more forces to react to the stress, inclusive the studying.

When I crossed the Straits of Messina, as usually it happens to me in every time return, intense shines open my heart, and it is as if I feel me lifted up again. The same air I am breathing seems different, more healthy, and the odours are as what every one of us feels and recognizes when he returns in the own house. There is a strong meteoropathic component in me, and I don't know if I never get the ability to manage it.

To now, I feel my head more clear from thoughts and from the obsessive songs, even if these latest return sometimes. On the other hand I am finding the ability of detaching me from them. I am enough happy and calm, and above all I am confident in recovering my abilities and energy.

Tomorrow I leave for ** and I will test yet my vulnerability to the climate change, to the sun and light exposure, to the life style. I hope well.

28.04.04 (by E-mail): Yesterday I brightly did the colloquium on surgical semeiotics with 30/30 note. What amazed me is that just one month since the beginning of the drug therapy I find again the same myself of some years ago. The person who succeeded to study with ability and speed, who centred the matters, and had great synthetic and synoptic ability. I restarted to do schemes as previously.

Among the others I can maintain the concentration. Now I do not have more those asthenia and chronic tiredness that did me tired at once on the books and forced me to divert my mind by watching hours and hours at the television. The first day I arrived to M. I was feeling about badly, because I sensed by suffering the difference of brightness between the sun of the south and that of the north. But the following day, after a restful night, was sufficient to do me understand that my body adapted in less than a day and I did not suffer more as first!

As for me, it is as I went out from the purgatory or from the hell. Nearly I do not believe in it, and then it is an amazing thing to come back to the time when I memorized the things quickly, and when I woke in the morning by repeating unconsciously the things that I studied the day before. Since much time it doesn't happen? Nearly two years! What a torment, what a time loss, what suffering ...

05.05.2004, the first checkup, after 40-days drug therapy. He is doing well, as he has already anticipated by electronic mail.

Problems of half-brain dominance: The concentration improved, for which he is studying better. His head has less plentiful of thoughts, and he has fewer obsessive repetitions of musical refrains. The opposition-aggressive ideas reduced.

Stress symptoms: He says that bears better the physical stress, and he is not more asthenic. Hair is lesser fat. The oversweating did not change. Now he eats less chocolate, because he feels less its need. He is better even in the afternoon, and the difference with the mornings is much decreased. The frontal headache disappeared, and night drooling did not reappear. In some moments he has the feeling of bitter in the mouth. The palpitations are diminished while dizzy episodes did not vary. The sudden asthenias stopped.

Therapeutic variation (daily doses, by the oral via): Carbamazepine 200mg.

23.06.2004: SMS information: He sustained the examination of Psychiatry, with 30/30 note. Now he is studying Physiology for September.

28.07.2004 by E-mail: In the meantime I sustained other three partial examinations (Ophthalmology with 30/30 note, Otolaryngology and Audiology (27/30), and Dentistry and Maxillo-facial surgery (27/30). On my academic book they were reported as a unique examination with 28/30 note (the average of the three partials).

In four months then he overcame two examinations and one colloquium, with high notes.

 18.09.2004 by email: I just sent you an sms. Nevertheless, I am writing you by emal that I sustained Physiology with 23/30 note! I am very happy and now I shall work hardly with some other subjects. See you soon.

November 2004, by email: I did the examination of Radiology and Diagnosis by Imaging (30/30 and laudation)

31 January 2005, Communication by email; Before leaving the university for the Christmas holidays I overcame Chemotherapy, a part of pharmacology, and Haematology but I refused of the note ( 21/30) . . .

25 March 2005. by email: I did other examinations as Orthopaedics ( 30/30 ), Haematology ( 27/30 ) and Medicine of the Work ( 26/30 ). Now am attending the lessons of Gastrenterology, Endocrinology, Nephrology, Urology, Rheumatology, Clinical Immunology, Abdominal Surgery and Infectious Illnesses. I hope well.

07 August 2005, by emaI: ... In July I did the writing and the oral of the integrated examination of nephrology, rheumatology, clinical immunology and urology with a good note (27/30). In last days of July I prepared forensic medicine in a short time, and I overcame it with 23/30, but I refused this note because this is an examination whose calls are much frequent. I want to study it again in fewer days and so I may easily obtain a better note to lift my notes' average. ...

31 September 2005, by emaI: ... the day 21 I have overcome the integrated examination of cardiology, cardiac surgery, vascular surgery, thoracic surgery and pneumology with the final note of 28/30. ....

 In 18 months then he overcame 9 examinations + one colloquium and one module, with good or high notes.

July 2007: He was a MD.

 

Discussion.

The patient has clear to have a familiarity for the depression, of which he suffered and had to treat with drugs, then instead he says strange things on the sun, on the landscape, on the perfumes of Sicily, which would have had to be therapeutic, but, evidently, for him they did not work, or they were no more therapeutic.

He is aware that depression and trouble of the concentration are two different troubles, and the therapeutic improvement of the first did not act on the second.

On the contrary, always according to him, the exit from the depression would have unmasked obsessive-compulsive aspects, which really I have not clear. Surely he means the continuous repetition into his brain of musical motives, and the eliciting of opposition-aggressive ideas, never brought into the action. Although having of uncontrollable repetitiveness (Is this that induced him to speak of obsession and compulsion?), personally I think that they are symptoms of fluctuating half-brain dominance. The recent therapeutic history seems to confirm this second interpretation.

The result on the resumption of his ability to study was perceived by the patient just after one month from the beginning of the drug therapy. The resumption of the examinations with good or high notes, after over one year of stop, is the demonstration of the efficiency of these improved concentration and consequent memorization.

The drug therapy is only an antistress therapy with the need to act on serotonin and noradrenaline with the chlomipramine. The recent antidepressant therapy with escitalopram, an other antidepressant drug, probably, even in this field, was only partially effective.

 

 (Other five articles on this topic) 

 

References.

Cocchi R. Problems of attention and concentration leading to interruption of studying by high school and University students: A report of 4 cases. It. J. Intellect. Impair. 1994, 7: 29-38. <www.stress-cocchi.net/Droping1.htm>

 Cocchi R. Scientific college dropouts and the risk for psychotic outcome: Four male cases. It. J. Intellect. Impair. 1995, 8: 37-43. <www.stress-cocchi.net/Droping2.htm>

 Cocchi R. The trouble of the concentration, and stop studying in three university students. Relief after antistress drug therapy. July 2003.<www.stress-cocchi.net/Droping3.htm>

 Cocchi R. Lack of concentration and academic delay in a female university student with peculiar neuropsychiatric Gennaio 2004.<www.stress-cocchi.net/Droping4.htm>.

 

Posted on internet on August 2004. Copyright by Renato Cocchi, 2004.

 

Author's address: dr Renato COCCHI, via Rabbeno, 3

42100 Reggio Emilia

renatococchi@libero.it

 

Testo in italiano.

Attention and concentration troubles, and stop studying.

Home Page  / / /  Pagina iniziale