Brain Training, Ruzzle, and CET

20130511-112031.jpgThe Zipper Girls (besties and participants in the annual Girls Adventure Weekend) introduced me to Ruzzle on our last trip. Ruzzle is a word-search app for all your i-technology. I can waste spend literally hours playing against myself, the Zipper Girls, and complete strangers. Whenever Stan hears the Ruzzle ten second count-down (each game is timed), he says, “Again? Really?” But when the term “addiction” gets tossed around, I just put on my smug face and say, “Researchers have shown that elderly adults who engage in mentally stimulating activities are less likely to develop dementia.” Is there even such a thing as RA? (Hello, my name is Trophydaughter, and I’m a Ruzzleaddict.) Yep, classifying my Ruzzle time as mental exercise let’s me engage guilt-free.

Seriously, I worry about dementia. That is, when I’m not worrying about the economy, the puffy circles under my eyes, the devaluation of the dollar, how fat I actually look, whether or not I need to own gold, the overall health of our nation, my job, my husband’s job, how outdated my house is, my sister’s health, the deer eating my yard, our healthcare system, and the ultimate fate of social security. When my grandmother died, she didn’t know who I was. The last time I visited her at the retirement community, she said, “Why are you here? Will you please stop following me?” My dad has also had some inexplicable cognitive episodes. Once he was angry with Mom for a week for stealing $20 from his top dresser drawer. Mom said he’d never even kept money in his dresser drawer.

I’ve also noticed some inexplicable cognitive issues with my sister since re-entry into her life. She can’t keep up with her stuff. She is constantly “losing” things, leaving stuff in my car, misplacing her apartment keys. She struggles with memory (as do I) but she will tell me something one day and when I bring it up again, say, “I don’t know why I told you that. That never really happened.” She will chalk a mistake up to a “life lesson” and then repeat the same mistake in a month or two as if she’s completely forgotten what happened the last time. Recently, she allowed a new friend to spend the night at her apartment and woke up to find the friend gone along with her new Nexxus tablet (which she’d saved for for months). Previously, when she’s allowed friends to stay over, they’ve stolen medication, clothing, and food from her. So why does she keep doing it? She will call me 3 or 4 times a day to tell me something because “If I don’t tell you right this minute, I won’t remember it later.” I do this too at times but I’m juggling a LOT of stuff. Which is not the case for Jerri.

She complains about her ability to concentrate. While I tend to tuck these comments away in the “How can I convince Terri I really do need Adderall?” file, I know Jerri truly believes her ability to focus has diminished significantly. She also took an online Autism test recently and scored in the “moderate” range. I’ve observed her awkwardness in many social situations – she doesn’t always pick up on visual cues and she goes down inappropriate conversation paths at times.

It has been challenging to discern what is illness vs. cognitive impairment from medication vs. this mysterious, unnamed “something else.” Just yesterday Jerri said to me, “I’ll never be the person I was before. There’s been too much brain damage.” I refuse to accept this.

user:Looie496 created file, US National Institutes of Health, National Institute on Aging created original / / Public Domain Mark 1.0

The brain is an amazing organ and has the natural ability to repair itself which is called neuroplasticity. Neurons, or nerve cells, are the basic building blocks of the central nervous system which includes the brain. The connections between nerve cells, called synapses, allow information, in the form of nerve impulses, to travel from one neuron to the next. The human brain is made up of trillions of synapses. Its this network that allows us to feel, behave, and think. The more connections in your brain, the greater your cognitive function. When connections are broken, it impacts cognitive ability. Connections that are used regularly become stronger. Connections that aren’t used eventually get eliminated through a natural “pruning” process. “Use it or lose it” is actually a fact when it comes to connections in your brain. Drug use and excessive alcohol consumption can cause connections to deteriorate or break as can exposure to some heavy metals and pesticides, and brain trauma. But because of neuroplasticity, broken connections can sometimes be restored.

Given all this, I was enthralled by an article about CET, Cognitive Enhancement Therapy (Improving Cognition in Schizophrenia) in the Spring edition of the NAMI advocate. Per the article:

Many individuals with schizophrenia and related disorders exhibit signs of impaired cognition: they have problems paying attention, remembering, solving problems, and making decisions. Brain-imaging studies have revealed that individuals with schizophrenia show reduced activity in the prefrontal cortex, precisely the area of the brain involved in attention, working memory, and judgement.

Wow, this sounded like Jerri so my first question, since she doesn’t have a diagnosis of schizophrenia, was what are “related disorders”? Turns out that a study funded by the National Institute of Mental Health (NIMH) was just published on February 28, 2013 (Lancet, Identification of Risk Loci with Shared Effects on Five Major Disorders: A Genome-wide Analysis) that identifies specific gene associations between schizophrenia, bipolar disorder, ADHD, depression, and autism. This so fits what I’ve observed in my own immediate family where besides Jerri’s bipolar disorder, others have been diagnosed with depression, ADHD, and mild forms of autism.

But back to CET. CET involves structured activities that exercise the brain and mind. CET Cleveland is the first CET program to be established outside of academia and is currently only available at 21 sites in 10 states, however, new sites are in development in other states and YAY!!!, North Carolina is one of them. (Still trying to track down the location of the site and when the program will be up and running.) The program requires one 3.5 hr session per week for 48 weeks. Each session involves 3 components: computer-based exercises, group-based interactions, and one-on-one coaching sessions. Complete brochure in PDF format is available here. Participants are able to improve overall cognitive functioning by strengthening and developing new neural connections. Through group-based interactions and coaching, they are able to increase their understanding of how society and the workplace function. Most graduates of the program continue to improve and go on to enroll in school, work, or volunteer. To me, CET is a missing link for my sister in her recovery. This is definitely another opportunity Jerri and I will be keeping our eyes on as CET becomes more widely available. Learn more about it at


11 Comments on “Brain Training, Ruzzle, and CET”

  1. Lisa says:

    I have had concerns with Ruzzle . I played it too thinking it would be great brain exercise but then I started realizing it was almost taking over my thinking . Meaning that I started playing Ruzzle in my head instead of daydreaming or holding thoughts and feelings . It disturbed me enough that I eventually quit playing the game

  2. JanefromLondon says:

    After spending hours and hours on Ruzzle, I put into Google ‘does Ruzzle exercise my brain?’; your blog was the top result. I’m glad I stumbled across it, you cover some very interesting topics, I love your writing style and the content is relevant as there is some mental ill health in my family too. I played a lot of Ruzzle over my Christmas break and now I’ve returned to work I can honestly say I’m finding it easier to consider/work through complex problems than before the break. Maybe it’s a coincidence; but just in case, I think I’d better persevere with trying to improve my statistics!

    • Thanks for finding me, JaneFromLondon. Google never ceases to amaze me. It’s like a really smart best friend who has nothing better to do than answer my questions. I also recently downloaded FitBrains on my iPad. Fair warning though-it says it’s a free app but only the first 5 rounds of brain training are free. Just enough to hook you. Also, apologies for not responding sooner. I’m just back from a 7 month sabbatical. See today’s post (March 4, 2014) for details.

  3. Melzzartt says:

    I can understand being concerned, given your family history. Though, worrying will only stress you out about everything more. Any time you find yourself projecting into the future and worrying, bring yourself back into the present. Right now, you don’t have dementia. Right now, you can do all you can to try and prevent it. If it happens, you’ll find some way to deal, at that time. (These are the kinds of things I tell myself when I find my mind’s marble rolling into the lower corners.) Your sister needs your loving, compassionate support. Do only what you can, distance yourself when you need to, take care of yourself, first. That’s not selfish; it’s being proactive and doing what you were meant to do–take care of yourself.
    There is an overlap between the different diagnosis in mental health. It think it’s time for medical practitioners to put their heads together and do further research, be honest with their patients, stop pushing drugs, and help society find better ways to handle illness.

    • Very sound advice. I couldn’t agree more that medical practitioners need to put their heads together. Please check out my new post on the memoir “Brain on Fire” for some exciting news on that front.

  4. Hi – Thank you! thank you! thank you! The clubhouse program my sister was in lost their funding and ended a few months ago. I’ve been helping her identify other volunteer opportunities and she’s close to one. However, I will also look up this program as it looks like it’s being offered in Philadelphia. What you are doing is great and takes commitment and you’re sharing it with us. It’s so important! By the way I play candy crush saga and words with friends…and yes its an addiction!

  5. What a load you carry! People are lucky to have you in their lives.

    • Thanks for saying that, Whatwereyathinkin, but I don’t think I’m doing anything special. I’m just trying to understand what’s happening to my sister and help her be as healthy as possible. I think all of us have times in our lives when we just need a hand. I’ve been there, will probably be there again.

    • Thanks, Lynette. Some days I feel like Jerri’s illness is a puzzle I need to solve. Learning about cognitive dysfunction associated with bipolar disorder was like finding a missing piece.

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