Authors: F. Matcham; S. K. Simblett; D. Leightley; M. Dalby; S. Siddi; J. M. Haro; F. Lamers; B. W. H. J. Penninx; S. Bruce; R. Nica; S. Zormpas; G. Gilpin; K. M. White; C. Oetzmann; P. Annas; J. C. Brasen; V. A. Narayan; M. Hotopf; T. Wykes · Research
How Do Persistent Cognitive Difficulties Affect Depression and Daily Functioning?
Research reveals strong links between ongoing cognitive problems, depression severity, and difficulties with daily activities.
Source: Matcham, F., Simblett, S. K., Leightley, D., Dalby, M., Siddi, S., Haro, J. M., ... & Wykes, T. (2022). The association between persistent cognitive difficulties and depression and functional outcomes in people with major depressive disorder. Psychological Medicine, 53, 6334-6344. https://doi.org/10.1017/S0033291722003671
What you need to know
- People with ongoing cognitive difficulties tend to experience more severe depression symptoms
- Problems with executive function and working memory have the strongest impact on daily activities
- Regular monitoring of cognitive function could help identify those at risk of poor outcomes
Understanding the Connection Between Thinking and Mood
Have you ever noticed how hard it is to focus or make decisions when you’re feeling down? For people with depression, problems with thinking, memory and concentration are common symptoms that can persist even as other symptoms improve. These cognitive difficulties can make everyday tasks feel overwhelming and may play a key role in how depression affects daily life.
The Study and Its Methods
Researchers followed over 500 people with recurrent major depression for up to two years. Participants used smartphone apps to regularly assess their cognitive function through both self-reported questionnaires and performance-based tests. These tests measured different aspects of thinking ability including attention, memory, processing speed, and executive function (our ability to plan and organize). The study examined how persistent cognitive difficulties related to depression severity and ability to function in work and social situations.
Key Findings About Cognitive Difficulties
The research revealed that people who experienced more persistent cognitive difficulties throughout the study tended to have more severe depression symptoms and greater functional impairment in their daily lives. Interestingly, people often underreported their cognitive difficulties compared to what the objective tests showed - about 40% of participants showed signs of ongoing cognitive problems on the tests, while far fewer reported noticing these difficulties themselves.
Different Types of Cognitive Problems Matter
Not all cognitive difficulties had the same impact. Problems with executive function (ability to plan and organize) and working memory (holding and manipulating information in mind) were most strongly linked to difficulties across all areas of life - from work performance to social relationships. Processing speed difficulties were particularly associated with more severe depression symptoms.
What This Means for You
If you’re experiencing depression, paying attention to cognitive symptoms is important. Consider discussing any difficulties with memory, concentration, or decision-making with your healthcare provider, as these may be signs you need additional support. There are strategies and treatments available that specifically target cognitive symptoms, such as:
- Breaking tasks into smaller, manageable steps
- Using tools like calendars and reminders
- Practicing cognitive exercises
- Exploring cognitive remediation therapy options
Conclusions
- Cognitive difficulties are a core part of depression that deserve more attention in treatment
- Regular monitoring of cognitive function could help identify those who need additional support
- Different types of cognitive problems may need different treatment approaches