645800 tn?1466860955

Making decisions

At times I have a very very hard time making decisions.  

I mean how hard should it be to decide on what to have to eat when you only have a couple of things in the house to eat? I have skipped eating a meal because I just couldn't decide. Or like with my recent hospital stay trying to decide if the hospital should notify my PC? I eventually picked option 1, not because that is what I decided on, but just to get them to stop asking me.

I can see having a hard time making a decision when you have a lot of options like when I bought my latest PC. It took me over a year to decide that one. But even that was excessive since I knew what I wanted before I even started looking and ended up buying exactly what I wanted from the start.  So I'm not even really sure if I decided that or again just defaulted to option 1 in that as well.

I don't always have trouble deciding things though. Like when I bought my house in ME. I really did decide that one. Or when I bought my pickup last year. Again that was an easy decision for me.

So I have been wondering lately if this is a manifestation of cognitive problems due to MS. Does anyone else have this type of problem due to MS?

16 Responses
1831849 tn?1383228392
It seems to me that you don't really have a hard time deciding the important things. The things that are not consequential, by definition, don't raise strong feelings one way or the other. For me it's trying to decide which move to rent. More often than not I end up watching Big Bang Theory reruns :-)

5485096 tn?1375574235
Yes!!! I can't decide on anything... Xmas shopping has been a nightmare and I only just now figured out my stress of it... The decision!!

My husband does not have ms but he is the same.... We fight over two things as a couple ...
One being time/sleep ....
2nd is for the other person to make the decision... "You decide, no you decide"

645800 tn?1466860955
Oh but I do have a hard time deciding things with huge consequences. When I had my first MI I could not decide if I wanted the angioplasty done or not. Eventually I just told the doctor for him to decide. It was also the same when it came to the 3x bypass with my second MI.

So I have trouble with both important and non important decision.  I have yet to be able to figure out what makes the difference between being able to decide something or not.

4943237 tn?1428991095
I think difficulty deciding on things goes with the territory of neurological diseases.  I can't decide the simple things or the major ones because of what gluten ataxia has done to me, and another friend with another Neuro issue has the same problem.  It does make it easier in some respects though - if the kids want something I just tell them to ask their father!!

Avatar universal
I have noticed 2 things with my cognitive issues and decisions. When something requires a lot of information or consequences, I tend to drag my feet a long time but if it is something fun I tend to go overboard and seem to be almost impulsive.

Basically I think that processing a lot of info is so tiring that I take frequent "breaks" from it and it takes a lot of energy to get back to it.

Since I am a procrastinator by nature I think my changes are only somwhat affecting my decisions, it also doesn't help that I am analytical by nature and I prefer a lot of information prior to making a decision. Might be a control thing too. :-)

Is it unusual for you to need a lot of time to make a decision?

645800 tn?1466860955
That only works as long as your hubby doesn't turn things around on you by telling them it is up to you. LOL That happened quite a lot when I was married and had lost my decision making ability.

But I have noticed one good thing myself. Many times I have seen something in a store that I wanted but didn't really need. Since I could not decide to get it or not it has saved me a lot of wasted money.

645800 tn?1466860955
I am one of those famous or infamous depending on your point of view "A" type personalities.  This gets me in trouble a lot to this day as I will push myself beyond my limits quite often and then pay big time for it.

I was always able to make decisions very quickly as well even when my mind was doing other things at the same time. When I was designing computers I would be keeping a running tally of the timing of a dozen circuits while at the same time deciding what type of gate would be needed next in each of the circuits. And yes my mind was analytic by nature processing as much information as possible. Several of my fellow engineers would kid me by saying I had a computer for a brain after watching me work on a design.

When I had my NeuroPsych evaluation the doctor told me that the more complex a problem I had to solve the slower my brain worked. So that kind of explains the problem of deciding on more complex things. But why do I have trouble deciding simple things as well. That is what bothers me the most about this decision making issue.

Avatar universal
OMG Kyle! Me too! (About the BBT ReRuns :) )
987762 tn?1331027953
Hey Dennis,

They have identified many of the MS cognitive area's of dysfunction, i think your issues with decision making, fall under 'executive dysfunction' but i also think you talking about your 'information processing speed' being slower, and the changes to your attention and concentration or multi tasking skills is also a identified issue of MS dysfunction too. I tried to find some basic information on the different cognitive issues with MS and came across this (see below) that was a lot easier to comprehend that a lot of the others, lol the site is kind of ironic though........


"Like the physical symptoms that can occur in MS, the cognitive changes are highly variable from one person to another. One person may experience a lot of problems while another person experiences none or very few. In other words, no two people experience the same changes in exactly the same way. However, the following types of problems are the most common in MS.

Until fairly recently, experts believed that the primary memory problem for people with MS was with the retrieval of information that had been stored in memory. In other words, these experts believed that a person could learn new information and tuck it away in memory, but then be unable to recall or retrieve it from storage when needed.

More recent evidence suggests that the problem may involve the initial learning phase. People with MS may need longer time or a few more repetitions to learn and store new information successfully. After it has been stored, however, it can generally be recalled without difficulty. For example, if you have memory problems, it may take you longer than someone without memory problems to memorize a list of words. But once you have the words memorized, you'll remember them just as well as the other person does.

Information processing
Slowed processing is important because it may be the primary reason why a person with MS needs more time or repetitions to learn new information. When processing is impaired, the person has trouble keeping up with incoming information, whether it's from conversations, TV shows, or books. People describe this slowing by saying, "I can still do everything I used to be able to do, but it all seems much slower — like my brain needs to be oiled."

Attention and concentration
Attention and concentration, which form the basis for many other cognitive functions, can also be impaired by MS. For example, people who are used to being able to focus on many complex and competing tasks at the same time may notice some frustrating changes, such as being easily distracted by interruptions or competing stimuli, having difficulty moving smoothly from one task to another, or finding it more difficult to multi-task (an essential skill in any occupation, particularly parenthood).

Executive functions
Executive functions include the high-level processes of planning, prioritizing, and problem-solving. Research has shown that people with MS may find thinking through complex problems or projects more difficult because they lose the mental agility to shift from concept to concept along the way. People often describe this impairment as "feeling stuck" or "lost in a maze."

Visual perceptual skills
Visual perceptual skills, which include simple perception or recognition of objects, as well as sense of direction and orientation in space, can be affected in MS. These problems can interfere with activities ranging from reading a map or driving, to programming your VCR or dealing with those pesky "some assembly required" projects.

Verbal fluency
Verbal fluency includes the ability to find the word you're looking for quickly and easily. "It's on the tip of my tongue" is a particularly common complaint from those who have MS, as is "I'm talking to someone and all of a sudden I'm stuck without the word I need." People who experience these kinds of problems may feel less confident about their ability to talk smoothly and comfortably with others.

General intelligence
People with MS sometimes say they feel "dumber." The good news is that general intelligence is usually not affected in MS. However, individual functions that make up general intelligence, such as memory, reasoning, or perceptual skills, can be affected or slowed temporarily during a relapse or more permanently over the course of the disease. So, a person's intelligence quotient (IQ), which is a composite score made up of individual subtest scores on all these functions, can become lower over time."

Unfortunately i have cognitive issues I never had through out my life, decision making is definitely on my list........i don't know how to start and buying Christmas presents this year has been 'that will do' rather than the well thought out presents of years gone bye, lol hopefully no one will notice but me :D Let me know if you want more information, because a lot of these issues are what i use to help the kids with, so i've got more.

645800 tn?1466860955
Thanks. Yes I have problems in all of those areas (lucky me) including the IQ. When I first developed MS symptoms the social security administration sent me to a doctor to be evaluated. This doctor reported to them that he felt I had lost 70 points in my IQ based on what I was doing for work. when I looked up the usual IQ for people doing my work and subtracted 70 points from it putting my IQ at the level of someone with moderate mental retardation. But I also knew that my IQ was substantially higher than what the doctor assumed so the drop was even greater. Talk about a shock! LOL Of course I was going through a flare that lasted several years at the time so the MS was effecting me greatly at the time.

When I had my NeuroPsych evaluation the doctor noted deficits in all of those areas to some degree or another, but my executive function was the most impacted.  This is why I understand why I can't decide on complex things. But I'm still having trouble understanding why I can't decide on simple things. I guess it could be that I don't understand that because of malfunctions in another area LOL

987762 tn?1331027953
Dennis, I don't think it makes much difference, if the decision is complex or a simple one, when the decision making area of your brain is wonkie lol I sometimes thing the simple decisions are harder, just because they don't really matter so nothing is at stake if you decide wrong.

It might help if you try to simplify things for awhile (borrowing workable ideas for people with Autism) you might want to try routines to minimise the problems free choice brings you. Things like a weekly time table for meals, eg Monday = meatloaf & salad, Tuesday = steak, veg & jacket potatoes Wednesday = favourite restaurant etc  You would need to work out what you can cook lol though most people have around 3 meals they always repeat each week, so if you write them down first, it might be enough to get you started.

Yep totally understand the shock of finding out just how many IQ points you've lost lol don't get me started :D


5112396 tn?1378017983
JJ, I just wanted to thank you for those ideas. And Dennis, thank you for starting this topic. It's so tricky (to me at least) trying to tease out what are challenges I have on my course due to MS and what's just me being off the academic horse for a while or just 'not being disciplined enough'.

It can be tough when people who love seem to see this inexplicable, self-induced implosion of all your efforts and enthusiasm for something. And I'm never one to give myself the benefit of the doubt that it might be something other than my own failings. I feel very conscious that MS could become my catch-all excuse for everything in my life, so it's interesting to hear this discussion framed in a way that seems there may be something to it ("it" being heightened struggles with decision-making).

Thanks again, JJ, for providing a concrete example of something I can do, as I'm not sure there's anything by way of medication to fall back on here. Thinking of having at least a place to start is reassuring.
987762 tn?1331027953
I totally understand what your saying, though i often think huge assumptions are made by the people who love us, when we don't fess up to the cognitive issues we are struggling with, we can't really blame them for guessing our problems. hmmmm i had to put my big girl panties on and explain to DH that i wasn't meaning to make things more difficult this year and i really wasn't avoiding Christmas shopping until the last minute. I was just having a bit of a problem knowing where to start and i needed his help in choosing things.

He knew something was going on but he thought i might of been embarrassed using the chair lol how he got that idea i haven't a clue. Once he understood that he had to be involved in the decision's of what to get and where to get it, something he'd never had to do before, the next event wasn't such a big deal for me because i had him for back up and by my logic its 'his' fault if the choice was wrong :D

You wouldn't believe half the tricks i use, to make up for my missing brain cells, i'm sure it's not odd to make a spread sheet to work out Christmas for 7 people lol well its not the oddest thing i've done :D

5887915 tn?1383378780
Dennis, I am the worlds worst decision maker & would rather someone else make the decisions for me. I have to confess that I started to type my answer to this question & I thought What's the question again. I just keep getting lost with things & I'm not sure if I don't concentrate well enough or just don't listen. I just know that my brain doesn't work like it used to. I have done the same as you with trying to decide on something to eat. I often sit back down after browsing the kitchen & end up with nothing.

JJ, What you have written is incredibly accurate for me. Every single one of them. I kept saying to someone the other day "I never used to be this dumb honest" because I really feel like my brain has gone on holiday at times. It can be very embarrassing to see these changes in oneself. Xmas gifts are going to be fairly basic from me this year.....thank heavens for gift vouchers.  

Karry. :-)

645800 tn?1466860955
Thanks again! I think the main reason I brought this up now is because of all the decisions they were trying to make me make while in the hospital. I got very frustrated with them badgering me to decided when I just could not do it. So naturally I wanted to know why so that I might be able to fix the problem.

I am or at least use to be a very good cook. It drove my wife crazy that I was a better cook than she was. Our friends were always telling me I should open a restaurant or bakery. But now between fatigue, vision problems, and memory problems I'm lucky if I can boil water. LOL One night I was making homemade potato chips  and instead of  lifting the basket out of the oil I started to reach into the pot with my bare hand to check if they were done. If my daughter had not been watching and screamed at me I would have severely burned my hand.

I do for the most part keep my meals on a schedule. Not so much for decision purposes but for memory problems. Unless I do this I have a tendency to forget to eat. I don't really ever feel hungry most of the time. Hmmm, that's a thought. I wonder if that is part of the problem of why I have a hard time deciding on what to have for dinner? But I do go to certain restaurants on certain days and nights. Chinese of Friday nights, Saturday is the one local restaurant, Sunday I go out for breakfast as they always have strawberry shortcake on the buffet. The rest of the time I tend to make my meals according to how I am feeling.

The shock of the drop in IQ was nothing compared to the experience in 2004. I had been feeling pretty good for about a year and though my brain was working pretty good as well. So I thought I would look into getting some training to be able to go back to work. So I applied to the state of Florida for Vocational Rehab. The first part of the program is 3 days of testing in order for them to figure out what they could train you to do. After 1 and a half days the manager called me aside and told me that I might as well go home because I was too bad off for them to train me to do anything. I mean they train people with autism and other mental problems all of the time, but I wasn't even able to meet those minimums when I thought I was feeling pretty good.

4943237 tn?1428991095
Dennis, you bought a tear to my eye with your last paragraph.  I think this is one of my biggest frustrations, the fact I'm approaching being good for nothing vocationally.  My degree is now almost useless and although I do still teach a couple of classes, between my cog fog, severe memory issues and less than perfect speech, I know my days are numbered there.

Neuro issues suck

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