Memory problems: a ubiquitous phenomenon in depression

A cardinal feature of depression, like other mental health conditions such as anxiety or trauma, is difficulty with memory: remembering, recalling, and—sometimes in severe cases—recognizing people, things, tasks, memories, events, and to-dos. Often, people with depression will have great difficulty remembering where things in the house or at work may be, feel unable to remember different tasks they did or that have to be done, being forgetful or disoriented about what one needed: “Why am I in the laundry detergent aisle when I am looking for strawberries?”

Unipolar and Bipolar Depression: How Memory Is Affected

But depression can manifest as unipolar depression (also known as major depression) or bipolar depression. Unipolar depression is where a person just feels down and out, has low energy, thinks and feels sad most of the time, maybe feels helpless, hopeless, has thoughts of ending their lives (in more severe cases), has trouble eating and sleeping, and has lost interest in things they once enjoyed.

Bipolar depression on the other hand, has two poles: the depressed end like the above and swinging from this pole to another, which is the more physically activated state that can be characterized by agitation, heightened energy, impulse behaviors (excessive spending, potentially a lot of and risk sexual behaviors), low need for sleep and rest, grandiosity, extreme mood swings, elated mood, and a false sense of positivity and can-do attitude.

Research on unipolar depression has shown it being associated with three key problems in memory:

1. Difficulty with recalling information emotionally loaded or simple day-to-day information. All of this seems like an effort—one more thing to do or manage by oneself.
2. Poor memory for positive events, which means that positive events and memories don’t stick in the brain. The person isn’t able to recall them in addition to the bad and banal memories. The saying glass being half full symbolizes this problem and the one below.
3. A greater inclination to remember the bad, dark, negative with an enhanced capacity almost, or having a better memory for negative material.
4. Difficulty with generating a more holistic autobiographical narrative from memory. Autobiographical memories are personally important memory representations. They are the content of the self and define who we are, who we have been, and importantly who we can evolve into in the future. They are, therefore, one of our most important bodies of knowledge about ourselves and our lives.

Let’s discuss the last point further: the word “food” might trigger a memory of what you eat as a vegan or a more specific and elaborate response such as, “I changed my relationship to food when I had health issues and began learning more about the vegan lifestyle. I feel so much better now.” In depression, especially unipolar depression and in those toying in their minds with thoughts (albeit fleeting) about not being alive, these memories are very general: a word like “food” might trigger a response like, “I don’t have an appetite,” vs. “I enjoy eating guacamole and chips and remember this one time at a Mexican restaurant, eating the freshest guacamole ever!”

The Role of Stress and How to Re-work It

Most cases of depression in my professional experience have begun with stress. This happens to be one of the most common and powerful triggers of initial depressive episodes. For those dealing with chronic stress, brain chemical changes impact both depression and memory functioning. So, a big goal in ameliorating depression is re-working stress in one’s life.

Additionally, the relationship between depression and memory is bidirectional: depression affects memory, but memory problems likely exacerbate depression, like with someone who has dementia or Alzheimer’s. A bias to repeatedly retrieve painful memories could clearly sustain a depressive episode, and problems with not being able to take in the good stuff and store this in mental containers that are easily accessible can in turn affect one’s mood and way of being, which in turn impact memory making. Now, here’s how you can begin to address memory problems in depression:

Start taking in “small infusions” of goodness. It can be good gestures, doing things that makes you feel good, lead to a smile, feed your soul, give you meaning.

1. Consciously work on keeping your life simple, by getting help to organize, prioritize, and de-clutter.
2. Proactively reach out to people, even though when depressed and stressed, reaching out may not be your go-to strategy.
3. Take notes, using colored paper and sticky notes, to remind you.
4. Stick to routines and make them enjoyable.
5. Make time for meditation, breathing, and relaxation.
6. Bathe in nature and clear the mind.
7. Keep a journal of your day. Write down and practice that autobiographical memory retrieval and narration skill. Remember this helps with being the author of your past, present, and future.
8. Practice naming facts, pausing on the emotional labels.

*Priyanka Upadhyaya is a clinical psychologist who specializes in the treatment of trauma, depression, anxiety conditions, and life transitions, as well as divorce, chronic illness, and acculturation-related issues. She has a practice in Midtown Manhattan and Northern NJ called Thrive Wellness and Mediation.

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