Ask HN: Struggling with poor memory and executive function. What to do?

[regainmemory]

In my late 30s and have always struggled to effectively build a career, network, life. Has only occurred to me that this may due to what seems to be a deficiency in my memory. I've had a wealth of experiences, both good and bad, but few have found their way into my mental models of how the world works, and so I keep making the same mistakes or am unable to effectively navigate my way to a specific goal.

From learning new topics & skills, to learning how to network, to learning the dynamics of how an organization and how to navigate various relationships, to making well-reasoned and effective decisions, my mind often feels like mush, totally blinded to the realities of the world. I feel I've been stuck both cognitively and emotionally at a late-teen stage. Poor emotional regulation, difficulties with thinking in nuanced details, constantly flying at 1000 feet.

The older I get with no improvement, the more it feels my goals keep drifting farther away. I want to get fit, I want to read more, I want to develop skills, I want to build relationships, I want to be an entrepreneur. These are things many of my colleagues have been working towards for years. It feels like I just wasn't given the playbook, and worse, am incapable of piecing one together.

Have any of you dealt with this? Any advice? Are there coaches that can help?

[nvch]

Let's assume that you have followed the advice to check if your health is fine, and it is (or you have found ways to improve it).

On a high level, what's going on in your life may not be considered the best by some "social standards", but it's not necessarily "bad".

You can start by checking if your desires are in line with the standards, or if you would rather have a more "unconventional" way of being, accept it, and try to find ways to work and relate to people from there.

The next part is that a lot of what you see as the problems are skills and you can learn them.

* Emotional regulation is a skill, it has to be learned and practiced.

* Concentration is a skill; some meditation practices are a way to develop it.

* Thinking is a skill; "real" thinking can be difficult and uncomfortable, especially at first.

* Building coherent models of reality is an advanced skill and requires thinking, modeling, verification, self-reflection, and other skills.

* Being a successful entrepreneur is a very advanced skill, requiring all of the above and much more.

Next, you can define your skill learning priorities and decide for which skills you can use some help from professionals and which skills you can train yourself.

If you do your work and come back to the same topic in a year, you will have more experience and better understanding. Identify what you're missing and keep going. Eventually you will be in the much better state.

Good luck!

[Vatyx]

What are you referring to with "'real' thinking can be difficult at first"?

[solardev]

Have you considered professional therapy from a licensed professional (whatever that might be in your region)? Not because that's the only way to improve your life, but because you specifically mentioned a "deficiency in memory", relationships, and emotional regulation – all traditional fields for such therapists to work in, and they often partner with psychologists who can diagnose underlying medical conditions and prescribe medication if necessary.

There might be some combination of drugs and therapies that could help some or all of those conditions. It doesn't work for everyone, but if you have never tried the mainstream approach, it might be worth a shot.

If you can start to see small improvements in some of those areas, then you can build other practices on top of them and keep improving those skills.

There are also many alternative modalities (doctors of naturopathic medicine, for example) with different approaches, if you prefer. You can try multiple providers/modalities until you find one that works for you, if you can afford it.

Best of luck to you! 40 here, and my life's also a mess, but I have no neurological/biological excuses lol, just my own personal failures. Hopefully you'll find some helpful approaches once you start looking.

[SammyStacks]

> "...you specifically mentioned a "deficiency in memory", relationships, and emotional regulation – all traditional fields for such therapists to work in..."

I support the recommendation of seeing a mental health professional, and wanted to emphasize that the scientific literature suggests a moderate to strong link amongst the symptoms you mentioned (citations below). I selected articles that reference ADHD and Cluster B personality disorders because they very broadly map onto the symptoms you're describing; I'm by no means making a diagnosis, but only trying to provide additional insight.

From the abstract of a journal article regarding the link between emotion dysregulation and ADHD [1]:

> "Emotion dysregulation, a major contributor to impairment throughout life, is common in ADHD and may arise from deficits in orienting toward and processing emotional stimuli, implicating dysfunction within the prefrontal cortical network. Understanding the nature of the overlap between emotional dysregulation and ADHD can stimulate novel treatment approaches."

From the abstract of a journal article regarding the link between emotion dysregulation and Cluster B personality disorders [2]:

> "Individuals suffering from personality disorders, particularly borderline personality disorder, often evidence substantial problems in regulating and managing their emotions...The newly developed brief General Emotion Dysregulation Measure (GEDM) has shown good reliability and validity with a clinical sample of 100 individuals diagnosed with Cluster B personality disorders."

I am not a licensed clinician but have considerable experience in clinical psychology research, so if anyone has any questions, please feel free to reach out. But to be clear, I am offering academic views; a licensed clinician offers medical views.

[1]: https://psychiatryonline.org/doi/full/10.1176/appi.ajp.2013....

[2]: https://www.journals.uchicago.edu/doi/abs/10.5243/jsswr.2010...

[MollyRealized]

I'm going to turn 50 in less than a month. Up until very recently, I had undiagnosed CPTSD and ADHD.

Trauma disorders, not to put too fine a point on it, fuck up your memory something fierce. CPTSD in particular can cause emotional flashbacks, where you're not audiovisually experiencing the prior trauma, but your brain is playing back the emotions. Thus, the emotional dysregulation.

I would strongly echo other people's comments here about therapy, a big benefit to me. I've always seen it as something with no stigma - you are just adding tools to your mental toolbelt. There is a good book by Pete Walker on complex PTSD; it may be worth a buy to see if it sounds familiar to you.

I also would suggest to you this: one of the best slogans I've ever heard is that we don't see other people's films, we see their highlight reels. You may have 100 different places you want to go. You may think everyone is going to each of their 100 different places.

But be kind to yourself. Believe it or not, it's not just an emotionally kind idea, it's a good one from a productivity viewpoint. If you're attacking yourself, you're putting yourself into fight-flight mode, and that redirects a lot of blood flow towards the more reactionary, less cognitive parts of your brain. Higher-order thinking is actually easier when you are not attacking yourself.

Hope this is helpful.

[roughly]

Second and third all the advice to talk to a therapist and/or an MD.

Beyond that, though, three things that have been Big in helping me build my mental capacity (and they’re all deeply stereotypical, but):

1. Sleep - more than anything else, consistently getting 8+hrs of sleep improves my cognition and consequently my productivity and my mood. I spend a lot of effort on sleep hygiene (dim red light and no screens at night, bright light or sun in the morning), but a couple days of good sleep are irreplaceable.

2. Related to 1, cut booze. Mostly because it ruins effective sleep, but also because it’s a depressant and a stand-in for all the other stuff I’m trying to improve for myself. Less booze, better sleep, better mood, better health, repeat.

3. Exercise - I can’t do cardio for shit, but I started doing strength training a while back and love it. It’s a great mood booster - physiologically, you’re basically doing a nervous system reset when picking up a sufficiently heavy thing. It also helps me sleep better, reduces a bunch of weird aches and pains, and makes me feel like a badass.

Again, go see a professional - my therapist’s how I learned all the above - but in the meantime, those three things have been enormous to improving my mood, capacity, and productivity.

[nicoburns]

I would add:

4. Water. Make sure you're hydrated.

5. Diet. Ensure you have a sufficient intake of all important nutrients and try to eat a diet that isn't too carb/sugar heavy (this doesn't need to be taken to extremes).

[seoulmetro]

Unfortunately I did all 5 of these and still felt severe brain fog and poor short term memory. I can think insanely quickly on things that don't matter or have logical cues. I can't think on things with a string of procedural cues. So even simpler things are harder than complex things if they take more than a few steps.

GYM body is so good and only takes a year in the gym, I love it and it does help get rid of aches and pains.

When you do all 5 well and still feel hindered in some spaces, it really sucks. I assume I'm just extremely lazy but with a huge willpower that turns on and off. I always experienced on/off stages with work, either creativity and leisure flows, or work and engineering flows.

[2OEH8eoCRo0]

Setting aside time to relax and read an actual book made me feel sharper.

[pastorhudson]

There’s a lot of great answers here. See a doctor. But here’s a tip for memory. Accept you can’t remember stuff and stop trying.

Externalize your memory and put it on other people. Here’s what I mean.

My wife calls and asks me to stop at the store and starts telling me a list of a few things she needs me to pickup. I say “Sure I’m happy to help. Can you txt me the list so I don’t forget? I’ll leave it unread to remember to look at it.”

I then read it and mark it unread. Over the next hours before I go to the store the little notification icon will bug me and I’ll go to read it only to realize it’s the grocery list. And then mark it unread. When I leave I’ll go to the store and look at the list while I get things. Then I double check the list and my cart before I checkout. Same with people I work with. “Sure I can send you that report and you shoot me an email so I don’t forget?” I’ll leave that unread or pinned till I do it.

When someone asks me to remind them of something I say “I’d love to but there’s no way I’ll remember to do that.”

I use kanban / trello to organize my work tasks and make notes immediately because I just accept I won’t remember tomorrow.

Once I started doing these things I have way less anxiety about forgetting. I think people rely on remembering stuff way too much. It’s like keeping your money in a pocket with holes in the bottom.

Bonus: remember names by making a big deal about it. “What’s your name?” I then use it several times. And when I forget then I just ask them “What was your name again?” I say the name that comes to mind when I see them “Your name was John right?” If they say “No it’s Steve” then I say “Ah Steve. I was so close!” And we laugh. Honestly they probably don’t remember my name so this whole schtick helps them too.

[alfiedotwtf]

Seeing a doctor for a referral to see a psych should be step one here.

But man… time blindness? I’ve recently started using an Apple Watch to set reminders, timers, calendar events, and alarms. Game changer!

Some days I can make over 30 reminders for that day alone, and the cool thing about this is that I can’t forget any items because it’s all externalised.

In contrast, keeping your TODO list internalised is like walking to a room for a specific purpose, not remembering what you needed to do when you got there, or worse do something ELSE in that room but because you’ve achieved something you go back to what you were doing before and only a few hours later when you’re in bed you realise you forgot to do something critical

[annie_muss]

I was in a similar situation. Couldn't keep a consistent job, couldn't keep a long term relationship. Jumped from one thing to another again and again. Struggled with poor emotional regulation (but hid it very well).

I was diagnosed with ADHD in my early 30s and things started to turn around. I've kept up the same job for longer than I ever had before, I'm in a long term relationship and I am better able to handle the general ups and downs of life. Things definitely aren't perfect. I still have to handle forgetfulness, distraction, lack of focus and so on, but getting diagnosed helped me immensely.

Talking to medical professionals of all kinds can only help you. Maybe they find some simple, fixable cause. If they don't, you haven't really lost anything.

[thornton]

Yeah this. Sounded like a specific flavor of ADHD I’ve been lucky enough to build a toolset and team around my ineptness in a bunch of places including memory.

Ironically poster sounds pretty smart and good communicator

[nullindividual]

Go to a doctor, many different conditions can cause memory issues. HN makes for poor medical advice.

[hackit2]

Asking anonymous strangers on the internet that don't have your best interest in mind how to handle your medical problems is a great recipe for success.

[christoff12]

I didn't see it mentioned so wanted to add that it's possible that ADHD's impact on working memory[1] leads to issues with long term memory[2].

Basically, we struggle with holding stuff in RAM which corrupts writes to disk.

The effect is more prevalent with auditory inputs vs visual ones[3]; learning this helped explain why I find myself more likely to engage with a lecture or meeting while simultaneously doodling[4].

---

[1] https://laconciergepsychologist.com/blog/what-is-working-mem...

[2] https://www.verywellhealth.com/can-adhd-cause-memory-issues-...

[3] https://pubmed.ncbi.nlm.nih.gov/24232170/

[4] https://www.additudemag.com/focus-factors/

[wNjdbfm]

From my own personal experience I’d recommend getting your B12 checked. I had similar problems, bloodwork came back with B12 a little low and the doc recommended I supplement it (monthly injections). Helped a ton. Obviously I’m not a doctor and can’t give medical advice, just relaying something that happened to me.

[taurath]

Yes, I have dealt with this and am still dealing with this, and much of it it all came down to early childhood trauma and how I needed to survive situations as a kid. I ended up that I had a pretty extreme amount of dissociation and symptoms of PTSD, and after grappling with literal decades of therapy and many diagnoses I started looking into dissociation, from which things truly clicked into place and finally I had a model to understand how I worked. If you have memory issues, please check in about CPTSD and dissociation - it’s not well known and it’s been life changing for me, and it’s massively undiagnosed compared to people who have them (6% of the population has one).

With the help of therapists and peers I have been able to figure out how I work and make progress on things I haven’t been able to for much of my life, after dealing with a spate of pretty extreme burnout. There’s no telling what your journey might hold, but I can say with experience that it is possible to figure out what underlies the hangups that have been hamstringing you.

[regainmemory]

That's oddly reassuring in that I have CPTSD. How has your memory improved? And through what modality – just therapy?

[autoexec]

Has dealing with your PTSD actually improved your memory or has the damage already been done?

[keiran_cull]

There are many things that could result in what you're describing. If in USA, you should visit a psych MD to discuss your concerns.

I have experienced similar issues and received medication for [underlying condition], which has helped immensely.

[regainmemory]

May I ask what condition you had/have and what medication helped?

[nathanasmith]

Here's a couple of practical tips.

A very powerful method for remembering facts long term is spaced repetition. There's a go-to app called Anki that makes it easy to get started. A good write up on how it works and why is here: https://gwern.net/spaced-repetition

If you want a neat way to help with more "absent minded" type stuff, just associate whatever you're trying to remember with something unusual in your environment. For example say you're driving home and you want to make sure you stop by the store to get milk on the way. If you wear a watch, flip the watch the other way around on your wrist. Now every time you notice your watch you'll immediately think, "oh yeah the milk." If you don't wear a watch just pick something else in your vicinity and arrange it in an unusual way. Every time you see that object you'll immediately recall the thing you don't want to forget.

[aussieguy1234]

Definitely seek the help of a doctor or psychologist and follow their advice, they could help find the root cause. They can often find treatments and strategies that can help.

But on a more practical level, I have found that using a calendar and a notes app (I use Obsidian) has been invaluable for my memory and organisational skills. Also having a daily routine and sticking to it.

[HKH2]

There are also habit trackers that help with repetitive tasks if you find routines too difficult.

[omayomay]

Hi, i can relate to that due to my adhd related poor executive function, and lack of proper internal structuralisation (both organisational and time or task related)

Have you checked if you have adhd? In any case, it is always a good idea to get a professional help from both a psychologist and a psychiatrist if you can.

On the other hand, i recently start practicing tai-chi, it helps you to center and ground yourself, might not seem like a direct solution to those problems but definetely helps to have a centered and grounded psychological base to look around and yourself. (And i believe complex nature of the moves trains executive functioning)

https://scottjeffrey.com/center-yourself/ https://scottjeffrey.com/how-to-ground-yourself/

[gauravgoriyan]

Many people struggle with similar issues. Here's what you can do:

See a doctor: Rule out any underlying medical conditions. Seek professional help: Therapists or coaches specializing in executive function and memory can provide personalized strategies. Develop routines and systems: Use calendars, to-do lists, and reminders to stay organized. Break down tasks: Tackle big goals in smaller, manageable steps. Practice mindfulness: Meditation and other mindfulness techniques can improve focus and emotional regulation. Connect with others: Talking to friends, family, or support groups can be helpful. Remember, you're not alone and there's help available. Start with small changes and be patient with yourself.

[jimcollinswort1]

I can relate, 67yrs of dealing with the same. Have always tried to ensure I have external guidance and pressure, keep me on track and focused. Control your environment to set up for success, good managers and plans, remove distractions. We need others to help focus our power!

But the real suggestion is pick a passion - paint, write, run, write, act.... anything that can motivate you to focus, develop new physical and mental skills, generate lots of dopamine. Mine has always been music, but working on art now. Give your mind and body a different place to go for that part of the day, your brain is learning constantly. Your executive system will thank you.

[dSebastien]

Considering only the practical advice, and not the medical side, I think that what would help you is to develop a knowledge management system. Journaling to capture tasks, events and learnings you want to remember, and periodic reviews to review, look back, and look ahead.

I discussed my own system here [0].

Personal Knowledge Management helps avoid having to rely on a weak system (your brain), and instead rely on a trusted system.

In it, you can track your goals, vision, plans, progress, lessons learned, and much more.

[0]: https://www.dsebastien.net/overview-of-my-personal-knowledge...

[dSebastien]

Writing is really the key skill to focus on. I've stopped relying on my memory a long time ago, and have developed systems that help me remember. Write to forget.

[bamboozled]

I'm going through something similar. I think you need to try doing less, try to reset. Someone said "Think big, start small", this might help you.

I play golf with this older Japanese guy, he has this super cool aura about him and is amazing at golf even though he is a cancer survivor in his late 70s and is getting a bit frail. He would always say to me "soft, soft". It's crazy how much this works.

The fact you're making this post tells me you're pretty ambitious, you want to achieve things...maybe you're just going too hard but not in the right directions?

[guhcampos]

There's some sound advice in this thread, including the obvious ones: talk to a therapist, psychiatrist, get disciplined, etc. etc. What some people don't get is that for the person on the other side, all these advices are usually a given.

I'm relatively successful in tackling my mental health issues and neurodivergence, have been on therapy, medication constantly for over a decade, but when I'm in a particularly bad shape from a depression or attention deficit, I'll actually drop the very things that have worked in the past, even when I'm perfectly aware they help. It's weird and absolutely irrational.

The only advice I can give you, really, based on this personal experience, is to get a third-party to "coach" you into doing the right stuff. Anybody. It can be family, a friend, anyone. If you already have a therapist, most will be likely happy to do it. All you need is someone to hold you accountable for the stuff you know you need to do. That person will keep tabs on you for a few weeks until you follow all the obvious advice here: find a therapist, a psychiatrist, a gym, quit booze, etc. In worst case scenarios, that person can go ahead and schedule appointments for you.

Once you're in therapy and|or medication and|or good habits for a couple months, you'll get traction to do everything else, and with some luck (finding the right professional, the right drug, the right methods is a trial-and-error) you'll build up some momentum quickly and won't need anyone keeping tabs anymore.

[regainmemory]

I am desperate for a coach. The therapists I’m currently seeing are not providing actionable advice. We spend most of our sessions introspecting and self-validating, which has run its course.

I’ve been on the hunt for a life coach of sorts who specializes in ADHD. Ideally someone who’s familiar with tech employees & entrepreneurs, but I’m probably chasing a unicorn.