Depression, sometimes called major depressive disorder, can hurt your ability to think through even simple daily tasks. Doctors call this decline in thinking skills "cognitive impairment."
Cognitive remediation can help you deal with this thinking problem. It has helped improve thinking skills in people with schizophrenia, bipolar disorders, ADHD, anorexia nervosa, OCD, and depression.
What Is Major Depressive Disorder?
Major depressive disorder, or simply depression, is a common, treatable, mental health problem. You may feel sad and lose interest in activities you once enjoyed. It can lead to problems in your work and home life as well as other emotional and even physical problems. It could also cause:
- Pacing, handwringing, and other restless activities
- Slowed speech and movements that others notice
- Difficulty focusing on tasks or making decisions
- Changes in appetite
- Weight loss or gain unrelated to dieting
- Sleep problems, either too much or too little
- Low energy and tiredness
- Feelings of guilt or worthlessness
- Thoughts of death or suicide
If you notice symptoms that last more than 2 weeks, it may be time to talk to your health care provider.
What Is Cognition?
Cognition is another word for thinking. More specifically, it is a collection of skills that let you recognize, process, and respond to information. Cognition helps with everything from talking to a friend to buying groceries. There are six main types of cognition:
- Attention: The ability to select a task and stay focused on it or to divide your attention across different tasks in a productive way.
- Executive function: The ability to plan and make decisions, remember information needed to do a task, and respond flexibly.
- Learning and memory: The ability to remember and recall information in both the short and long term.
- Language: The ability to express yourself with the right language and think of the right words.
- Perceptual-motor skills: The ability to make sense of visual and other sensory information, such as sounds and smells, from other people and the world around you.
- Social cognition: The ability to make logical judgments about other people's intentions and wishes and to control your own emotions in a socially appropriate way.
How Does Major Depressive Disorder Affect Cognition?
Depression can weaken your thinking skills and hurt your ability to:
- Pay attention
- Learn new things
- Remember or think of information
- Process or "make sense of" new information quickly
- Respond to new information in an appropriate way
If you lose some of these abilities, your quality of life may not be as good as it once was. You may not be able to function at work. You also might not respond as well to your treatment and could face a higher risk of another bout with depression.
Some evidence suggests that your thinking skills, once they start to decline from depression, could continue to worsen, even at times when you don't feel especially depressed.
What Is Cognitive Remediation?
Cognitive remediation is a treatment for some types of cognitive impairment. It gives you a set of tools to improve attention, memory, and other brain functions that can worsen with depression.
The aim is to improve your quality of life and productivity at work or school and in social situations. The strategies in cognitive remediation vary, but you might do some of the following exercises:
- Write in a notebook or daily planner to remind you of important tasks and deadlines
- Break tasks down into a logical set of steps to help you complete them
- Practice attention and thinking exercises to help improve your ability to hold onto and recall information
- Set goals with a health care provider to customize your treatment and track your progress
You can use these strategies on your own, but they tend to work even better with the help of a therapist or support group.
How Does Cognitive Remediation Help Depression?
Cognitive remediation may improve certain thinking skills in some people with major depressive disorder. Though research so far is limited, an analysis of available studies showed that cognitive remediation can lead to improvements in attention, working memory, and overall thinking skills.
It's hard to tell from the current research whether this therapy helps directly with depression symptoms too. Scientists continue to study the best ways to use cognitive remediation to help with major depressive disorder. Talk to your doctor if you feel depressed or have a diagnosis of depression and think cognitive remediation might be helpful for you.
Where Do You Get Cognitive Remediation for Depression?
Your primary care doctor can help connect you with a mental health specialist who treats depression. Different therapists use different approaches, sometimes including cognitive remediation.
Before you schedule an appointment, you can ask a therapist whether they use cognitive remediation and whether they would consider the treatment for your particular case. (Some therapists may wish to have one or more sessions with you before answering the second question.)
If you already have a therapist that you see regularly, ask them whether cognitive remediation could be an appropriate tool for you.
Another option is to go to a group cognitive remediation session. You may need a referral to attend some of these groups. A mental health professional familiar with cognitive remediation would be the best guide for group treatment.
American Psychiatric Association: "What Is Depression?"
Frontiers in Psychiatry: "Current Status of Cognitive Remediation for Psychiatric Disorders: A Review."
Psychological Medicine: "Effectiveness of cognitive remediation in depression: a meta-analysis."
New York-Presbyterian Hospital/Weill Cornell Medical Center: "Cognitive Remediation."