When we think about the side effects of depression, we often think about either the emotional effects (things like sadness, guilt, irritability, and hopelessness) or the physical effects (things like fatigue, restlessness, upset stomach, and general body pain).
But what we don’t talk about nearly enough are the cognitive effects—or, in other words, the effects that depression can have on the brain’s ability to function.
Cognition, by definition, refers to the “mental processes involved in gaining knowledge and comprehension.” These processes include things we tend to take for granted, like thinking, knowing, remembering, judging, and problem-solving. But, as anyone who has experienced depression knows, the depressed brain is often operating at a very much diminished level—otherwise known as “cognitive impairment,” or more colloquially, “brain fog.”
Below are a few of the brain’s executive functions that are commonly impacted by this infamous “brain fog,” as well as a few tips that can be helpful in overcoming them.
Memory
When a person is depressed, their brain’s processing speed—or its ability to take in information quickly and efficiently—becomes impaired, which affects how it processes and retrieves memories.
The two areas of memory that suffer the most under the fog of depression are retrospective and prospective memory. As their names suggest, the former refers to remembering previously learned information or details of past events (like specifics from a conversation with a friend), and the latter refers to remembering to carry out a planned activity in the future (like picking up groceries on the way home from work).
Another interesting facet of depression’s impact on memory is that, while healthy, non-depressed people generally remember positive events over neutral or negative events, depressed people tend to suffer from a dominant negative recall. In other words, they’re more likely to recall bad memories. They also tend to ruminate—or fixate on upsetting situations or events—which occupies neural resources that the brain could spend on other functions, like memory.
Those suffering from depression triggered by trauma or PTSD may also suppress memories to the point where they’re unable to remember entire months or even years of their lives surrounding the traumatic experience.
TIP: Journal! Specifically, give gratitude journaling a try. Writing in a gratitude journal on a regular basis has been praised for helping to not only remember things that happen, but also fight the negative bias and give more attention to the positives.
Decision-Making
Decisions, even ones as simple as what to eat for lunch or which brand of toothpaste to buy at the drug store, can feel like absolute torture to someone dealing with depression.
The first component of this has to do with anticipatory regret. Because people tend to experience more regret for active (rather than passive) choices, anticipatory regret may create a bias that leads a person toward inaction, because the person may believe that they are minimizing their responsibility for potentially negative outcomes by accepting a default option passively as opposed to making a choice actively. In other words, they believe if they don’t make the decision, it can’t be their fault if it goes wrong. This is something that everyone experiences to an extent, but it can be particularly crippling for those suffering from depression.
It’s not only harder for depressed people to make decisions—it’s also harder for them to make good decisions. Since their minds tend to skew toward pessimism, they are more likely to assume any given situation will go poorly and are therefore more likely to make the decision that will bring them away from it. So, for example, someone who is depressed may turn down a promotion offered to them because they assume they will fail in the new position.
TIP: Ask yourself, “What would [person] do?” Find someone you admire—someone who is insightful, grounded, and makes good decisions—and think about what they would do or say in a given situation. Sometimes, decision-making is easier when you can trick yourself into believing that you aren’t actually the one deciding.
Focus & Concentration
Depression can even have serious effects on a person’s ability to concentrate. For example, they may find themselves unable to complete a thought, finish a task at work, or pay attention to a movie or TV show—and, unsurprisingly, these difficulties can negatively impact everything from personal relationships to job performance.
Because depression causes attention problems, projects are often left unfinished, and a person with depression may come to view this as a failure on their part rather than seeing it for what it is: a symptom of their mental illness.
An inability to concentrate can also stem from a primary symptom of depression: anhedonia. People who experience anhedonia have “lost interest in activities they used to enjoy and have a decreased ability to feel pleasure,” so it’s possible that the apathy toward previously enjoyable activities is causing the struggle to focus on them.
TIP: Take breaks! Contrary to what some may think, stepping away from a task has been proven to actually increase productivity. Whether it’s walking around the block, meditating, or even taking a quick power nap, your brain (and body) will thank you for the ability to refresh—and you’ll find yourself more able to focus when you return.
Depression runs deep, and managing its many diverse side effects can sometimes feel like one big puzzle. But recognizing some of the less talked about negative effects—and taking small steps toward overcoming them—can help fill in some of the pieces.