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.
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
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
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
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
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
Attention and concentration troubles, and stop studying.
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