The Hidden Cost of Depression: How It Disrupts Your Working Memory
Most of the time, when someone seeks out help for depression it's because they're feeling sad and hopeless. They may complain about being tired, not being able to clean their home, or can't get out of bed to go to work. The hopelessness and lack of motivation are key symptoms... but depression goes far beyond how we feel.
Depression affects the brain in ways you might not expect. Thinking ability and memory are impacted by depression! One of the brain systems most affected by depression is working memory - your brain's ability to hold pieces of information and then use that information to do something (follow directions, solve a problem, implement strategies).
What Is Working Memory, and Why Does It Matter?
Working memory is like a scratchpad where your brain works with bits of information. It lets you juggle information while you're actively using it. It helps with things like following a conversation—you have to hold on to the bits of information a person is saying, make sense of it and connect dots, as well as interacting by asking follow up questions. Working memory also allows you to make a grocery list in your head, or remember the directions to the post office and make the turns to get there.
You may have also heard about short-term memory. This is the precursor to working memory; it's the ability to hold bits of information (but not necessarily do anything with it).
Long-term memory is a little different as well, because it's what we use to hold on to information forever (or a really long time). You know your birthday and you may even remember your childhood phone number! That's long-term memory.
Working memory helps you stay focused and efficient in real time; using your short-term memory to take action. It helps you make decisions, solve problems, and regulate emotions as you take data from your short-term memory and do something with it.
Depression can negatively impact working memory. If you've had depression, you probably realize how difficult it was to think clearly and make decisions. Everyday tasks are just a little bit harder. You might notice that you:
- Forget what you were going to say in the middle of a sentence
- Have to re-read the same line over and over
- Space out or lose track of conversations while speaking with someone
- Generally feel "foggy" or disoriented
And these issues aren't just minor inconveniences or frustrations (they're that too); they create roadblocks to healing. We'll talk more about how working memory impacts recovery in just a moment!
The Link Between Depression and Cognitive Impairment
While it's not often discussed, the consistent link between depression and deficits in working memory have been well documented in psychological research. Brain imaging studies have revealed that key regions involved in working memory—like the prefrontal cortex—show inefficient activity in people with depression.
I think it's important for people struggling with depression to realize they're not alone! You're not lazy or dumb; your working memory system just isn't at it's best right now.
It's equally important to recognize that even if the depression lifts, these memory challenges won't just go away on their own. According to researchers, even after emotional symptoms subside, people can continue to struggle with working memory deficits, as well as selective attention and long-term memory.
All of these cognitive impairments create a mental fog that makes it difficult to engage in therapy. Risk of a relapse into depression is more likely, and the person may experience stress in relationships, work, and other daily tasks.
Why This Matters for Recovery
If you’ve ever felt like your brain just isn’t working the way it used to during a depressive episode, you’re not imagining it, and you're not alone. It can be discouraging when you've started medication or therapy, and perhaps the emotional symptoms are improving... but you're still struggling to think clearly!
Working memory is just one of several cognitive abilities impacted by depression, but it really makes a big difference in recovery. Let's think about how working memory shows up in therapy...
Your therapist is teaching you new emotional regulation strategies in your session. You need to remember those bits of information... then put them together and do something with it in order to make a difference in your daily life. If working memory is impaired, you may struggle to actually apply that new strategy the next time you're feeling overwhelmed.
Working memory is the way we plan ahead, stay organized, and follow through on goals. So if the working memory system is struggling, you might have difficulty planning your day. You might miss therapy appointments, show up late for work, and struggle to stay on track with your mental health goals.
Poor working memory also interferes with social interactions. Following a conversation requires you to track information and put it together. You also need to respond appropriately, and at the right time. When social interactions are exhausting, you'll tend to minimize those instances and withdraw.
This means that cognitive symptoms need to be addressed directly—not just as a side effect of depression, but as part of the core experience. Strengthening and improving cognitive function means that you're able to engage in therapy in a more meaningful way. It helps you put what you learn into action. And means that you're able to interact with your friends and family without being totally wiped out.
What Can Help
The key message I want to send with you is that there is hope. Cognitive Remediation is a treatment approach aimed specifically at healing and strengthening the brain. With targeted exercises, we can bring the brain back online so that it's working with you toward a healthier and happier life.
Other helpful strategies include:
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Breaking tasks into smaller steps
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Using external memory supports (like reminders or to-do lists)
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Reducing distractions to improve focus
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Tracking symptoms to identify patterns
Therapists, coaches, and mental health professionals can also help you build a personalized toolkit for cognitive support with helpful strategies. If you think you're struggling with the working memory issues we've discussed here, you may want to seek out a Cognitive Remediation therapist to directly address the brain aspect of depression!
Final Thoughts
We don’t talk enough about the cognitive symptoms of depression—but they can be just as disabling as the emotional ones. By recognizing the role of working memory in mental health, we can take more informed, compassionate, and effective steps toward recovery.
Cognitive impairments—such as working memory, attention, and executive function difficulties—interfere with a person’s ability to engage in and benefit from therapy (understanding instructions, completing exercises), which can lead to poorer treatment outcomes. This is important for both patients and therapists to understand!
These cognitive impairments often persist into remission, contributing to functional stress in relationships, work, and daily life. As a result, individuals with lingering cognitive symptoms face a higher risk of depression relapse, underscoring the need to address cognition directly during treatment.
If you or someone you love is living with depression and feeling mentally foggy, know that this too is part of the illness—and that there is hope for healing, both emotionally and cognitively.
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