The super-long neuropsych exam

Yesterday was my super-long neuropsych exam. As stated, it did indeed take a full day, and the doctor is going to be calling me for about 30 minutes of additional interview questions at some unspecified point in the next few weeks.

So what I learned is that my verbal IQ is still off the charts. He said it was 132, which put me in like the 122nd percentile or something. But that was the only aspect of my intelligence that was still good.

Every other aspect of my IQ score was 99 or below. My math score was in the 44th percentile. He said that I very likely had a learning disability related to math because many people with childhood depression and abuse or neglect have those problems. He said that very likely I had compensatory mechanisms to deal with my math learning disability and I lost them once I developed MS.

He also said it’s extremely unusual to have that wide of a gap between math and verbal IQ scores. He said it’s usually only about 10 points difference between the two. But I haven’t been able to verify if that’s true or not, and I kinda doubt it will matter to social security.

I don’t know what I think about that learning disability thing, but it’s interesting. He referenced several researchers who had studied childhood depression and neglect and discovered that it led to substantial white matter loss, which in turn impeded math learning in particular.

He said that if I had had a more supportive and nurturing childhood, I probably would have become a doctor or scientist. Seeing as how I once wanted to be a doctor, that kinda made me cry on the inside.

But back to what the exam revealed about my functioning. Like the doctor provided by social security disability who examined me, he found that I had persistent depressive disorder (formerly known as dysthymia) and periods of major depression. The combination of the two is “double depression.” I’ve been diagnosed with that before, so it was no big surprise to me.

He also said antidepressants usually don’t work in cases like mine. That’s true; they don’t. At the same time, if I’m not getting treatment, social security doesn’t recognize the problem as valid because there are no records. If I go to county mental health, they’ll just give me meds, no therapy. If I seek out therapy, they can’t give out much info about my diagnosis due to HIPAA rules. See where that feels like a no-win situation?

As for his findings that may help my case:

  • I have severe short-term memory loss and virtually no working memory. Obviously, that’s going to make it nearly impossible to learn most jobs.
  • I have significant right-sided damage from my last relapse in August 2017. I didn’t feel like I ever fully recovered and his tests showed that. Since that’s my dominant hand, I am measurably very slow in everything from reaction time to motor skills.
  • My spatial relations abilities are so poor it affects my balance and sense of where I am.
  • I show significant fatigue after less than a full day’s tasks and make many more mistakes the more tired I get.
  • I also have significant attention deficits, which also get worse the more fatigued I am. These also mean that I make more careless errors, which explains why I’ve had so much more trouble with the writing and editing work I used to do.

So basically, he found that I have multiple conditions at once, not just depression (which is very hard to prove for social security unless you’re regularly hospitalized) but also the damage from my MS. He said that he would also add the learning disability in his report, but I’m not sure that matters to social security.

Yet I have to be honest, I’m really afraid that my awesome verbal IQ score is going to make it harder for me to get disability. Even though all my other functioning has declined so badly, shouldn’t I still be able to do my previous job of freelance writing if my verbal IQ is so good? I know I can’t because I can’t put words together in a pretty way anymore. But I can still read at a high level and my vocabulary is stellar. I’m just not sure what job that qualifies me to do.

I should be happy with the findings, right? But I’m not. Because after my exam with the doctor provided by social security, I was very hopeful. She said I clearly had significant enough problems and in her words, I was “the kind of person disability was meant for.” And I still got denied anyway.

My lawyer said winning my case is ultimately up to me. I have to see more doctors and complain more when I go (being honest, of course.) That’s a lot of pressure and it’s giving me a ton of anxiety. Like if I get declined, it will be my fault. And I already blame myself for everything anyway.

But as of February 1st, I won’t have health insurance anymore. I have to get through all the bureaucratic red tape and hassle of signing up for the public county health plan. And then wait to get assigned to a general practitioner and see them. And then get a referral to a neurologist. My attorney warned me that this is likely to be a huge hassle and I’ll likely have to fight a lot to get a referral to a neurologist.

I was just ready to start taking disease-modifying drugs for my MS. But now I feel like everything will be on hold until I can deal with all the bureaucracy and finally see a neurologist on the public plan, and who knows when that will be?

If it takes too long to see a new neurologist with county health, will that still give me enough records to win my disability case?

Part of my lifelong depression means that I tend to give up on things when they get too hard, especially if they’re things for myself. And so not surprisingly, I want to give up on this, too. It sounds overwhelmingly difficult. And that just makes me want to sleep and hide from everything.

After the grueling test today, I just have more proof that my functioning is significantly impaired and not likely to get better. And yet that doesn’t give me any more faith that I’ll actually get disability. It just convinces me that I need it and that I’ll be really screwed if I can’t do the right things to convince social security that I need it.

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