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Memory: Depression’s Most Conspicuous Casualty

 November 7, 2016

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

America still has a long way to go when it comes to mental health awareness. No other medical issue carries the stigma that mental illness still bears. Sadly enough, the tragedy of suicide has been the catalyst for many of the non-profits and organizations spearheading the movement. Perhaps we can take a step back and consider the most conspicuous casualty of depression: memory. Memory loss can be traumatic but at least it is not fatal.

What is depression?

Depression is not having a bad day. If any other organ, function or feature of our body were to malfunction, we would not become esoteric or subjective in our assessment. Even the heart, similarly associated with our ‘soul’ as our brain is with our ‘mind’, warrants only the most clinical assessment as well as the most state-of-the art equipment. When our brain has a glitch, far too much association is made with one’s personality or identity. What is the solution?  Education is the mortal enemy of ignorance, after all. Let’s take a moment to learn about the symptoms of depression:

  • Depression attacks your higher brain functions, making it difficult to concentrate, make decisions or remember things.
  • Depression causes you to lose interest in people and activities you typically find rewarding.
  • Depression affects your eating and sleeping habits.
  • Depression makes you feel fatigued around the clock.
  • Depression leads to thoughts of death, suicide and self-harm.

How does depression affect memory?

Our higher brain functions require chemicals called neurotransmitters in order to coordinate with one another and store memories. An imbalance in these chemicals fundamentally alters the messages being sent. The average person tends to recall happier events when feeling happy and sadder events when feeling sad. A depressed person, however, tends to experience an unhealthy, disproportionate focus on negative recollections of the past.  If this persists, the person’s very outlook changes. The omission of healthier memories not only impacts his or her overall health but also seems like a form of memory loss to others.

The deficit of attention and concentration that can result from depression will ultimately impair one’s ability to form long-term memories. Try this on for size. What if an experience is not forgotten, just never remembered in the first place? Apparently, a depressed person’s distracted mental state can cause him or her to overlook the need to store events at all.

Working memory is what is at work in the present moment. Its job is to assess experience and pass it on to either short-term or long-term memory. What depression will do that present moment is distract the working memory from ever passing on those memories. You never had them so you can’t forget them. 

How can memory be restored by treating depression?

Serotonin is a brain chemical that regulates blood flow in the brain. A reduction in serotonin means brain cells have less fuel to operate. Arousal is affected most. Pretty much any reaction to pleasure is diminished. Mission one for most psychiatrists treating depression has been to increase serotonin. That is the primary function of the latest anti-depressant drugs. So, does boosting serotonin levels reverse memory loss?

In the past, the medication would alleviate the mood disorder but make the memory problems worse. With the aforementioned modern updates on the medication, the hope is for less side effects, including memory loss. Medication alone won’t do the trick. Today, it is standard for a medical doctor to prescribe the drugs while suggesting psychotherapy to supplement the effects of the medicine. Talking to a therapist is supposed to help build an arsenal of techniques that will promote thoughtfulness and coping mechanisms. The aim is to stem the tide of negative thoughts, reduce the symptom of forgetfulness and thus restore a person’s ability to remember more of what makes life worth living.

Treating the person.

The hippocampus is the part of the brain that controls memory. Individuals suffering from major depressive disorder (MDD) tend to have smaller ones. The longer a depressive episode lasts, the smaller it gets. The amygdala is also related to memory and found to be more active in those who have MDD. As medical experts, the care managers at AdvancedRM are well aware of all parts of the brain and their respective functions. Connecting you with a neurologist, psychiatrist or therapist would be one of the functions we might serve. The only thing we do not do is treat the disease. We treat the person. In the instance of memory loss, many feel as if they are losing parts of who they are. Right up front, we remedy this by affirming hope. Affirming hope reverses the flow of negative thoughts triggered by depression and welcomes people on board for their own advocacy. While we as advocates do the heavy lifting, we find having our client fully on board helps us achieve optimum results.

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