How Depression Affects Executive Functioning
We usually think of Depression in terms of mood - feeling low, feeling sad, feeling ‘blue’. But it’s actually much more impactful than that. One profound affect of Depression that is often easily overlooked is its impact on executive functioning. We’ll learn about what executive functioning is, why it’s important, how Depression can influence it, and what we can do about it.
What Is Executive Function?
“Executive Function” - it’s a phrase that is used a lot in certain communities, like the ADHD community and other mental health circles. But what exactly is it?
Executive functioning are skills that are (in part) stored in the prefrontal cortex of your brain. It’s a highly skilled cognitive set of skills that help us ‘function’ by helping us regulate and manage our thoughts, actions, and emotions to achieve certain goals. There are many executive functioning skills, but we will talk briefly about just a few here.
Working Memory: The ability to hold and manage information in mind over short periods.
Cognitive Flexibility: The capacity to shift attention between tasks or adapt to changing circumstances.
Impulse Regulation: The ability to suppress impulsive responses or irrelevant information.
Planning and Organization: The skills required to set goals, develop strategies, and manage tasks.
Self Monitoring: The ability to track one’s performance and adjust behavior accordingly.
When you struggle with these skills (as with ADHD or other disorders like Depression), you may experience its effects in so many (even surprising!) areas of your life, like managing everyday activities, making decisions, controlling impulses, and maintaining focus.
The Impact of Depression on Executive Function
As we said, Depression is not just a disorder of mood, it is a far reaching disorder that also influences our general functioning. The cognitive impacts of Depression often includes disrupting executive function, which can have profound affects in our daily lives.
1. Working Memory Impairment
Working memory allows us to hold and manage information in our minds over short periods, enabling us to perform tasks like following a conversation, solving problems, or making decisions. On the flip side, if you have Depression, you may find yourself forgetting really important information, unable to complete simple tasks with simple instructions, getting lost or distracted in conversations with others, or forgetting about plans that were important to you. This can lead to frustration, increased stress, strain on your relationships, and even a sense of incompetence, which just adds fuel to the Depression fire.
2. Reduced Cognitive Flexibility
Cognitive flexibility is the ability to adapt to new situations or shift focus between tasks. As members of a fast moving society, cognitive flexibility is an incredibly important skill - for example, you may be in the middle of a task and have your attention called away to another item that requires your attention. This may seem intuitive and effortless for some of us, but those of us with Depression can often experience rigid thinking patterns, where we find it hard to adapt to changes or consider alternative perspectives. This inflexibility can make problem solving more difficult, as our ability to think creatively or come up with new solutions becomes diminished. When we get stuck in rigid thinking patterns, it can also lead to rumination, getting stuck in a loop of negative thoughts and is unable to shift our focus away from them.
3. Impulse Regulation Challenges
Impulse regulation is the ability to manage impulsive responses and ignore distractions. This is a skill we develop as we develop as human beings. Babies are not known for regulating their impulse to cry, poop, sleep, or eat - but as adults, we are much more able to regulate those impulses. However, those of us with Depression can struggle with this impulse regulation, which can lead us to make dangerous impulsive decisions, engage in negative behaviors, or be unable to stay focused on a task. When we engage in behaviors that we normally wouldn’t have (if we were better able to regulate our impulses), it can also add to feelings of guilt, worthlessness, and self blame.
4. Difficulty in Planning and Organization
Planning and organization require setting goals, prioritizing tasks, and developing strategies to achieve those goals. These are high level cognitive tasks that require a lot of ‘brain juice’ to do. When we are Depressed, it may feel immensely challenging to organize our thoughts, or to break down big tasks into smaller manageable tasks, or even to follow through with our best-laid plans. When we struggle with planning and executing our plans, we can then become overwhelmed by those tasks, and maybe even deal with that overwhelm by avoiding those tasks all together. That's how we end up with living spaces that have not been cleaned for months, or why we may struggle with even the most basic of self care items, like regular dental hygiene or showers. When we get stuck in that spiral, it can then increase our feelings of helplessness and hopelessness against our Depression.
5. Self Monitoring Deficits
Self-monitoring is the ability to assess our performance and make adjustments as needed to meet our goals. When we are Depressed, our ability to self monitor (and therefore make the necessary adjustments to be successful) can be greatly inhibited. This means that we may easily ‘fail’ at achieving goals that we think we should meet, which can distort our self perception and label us as ‘failures’. This cycle of self criticism, and punishing ourselves for these perceived failures can painfully further deepen our Depression.
Dealing with Depression Induced Decreased Executive Functioning
While the cognitive effects of depression can be challenging, there are strategies that can help manage these impairments and improve overall functioning.
1. Medication
Depression is a disorder that impacts our brain chemicals, and sometimes we need other chemicals to help manage that. Antidepressant medications can help alleviate the cognitive symptoms of Depression by balancing the neurotransmitters in our brain. Medications like SSRIs (Selective Serotonin Reuptake Inhibitors) can improve mood and cognitive function, making it easier to manage daily tasks and responsibilities.
2. Mindfulness and Relaxation Techniques
Mindfulness practices, like meditation and deep breathing, are incredibly powerful in helping us improve our focus and cognitive flexibility. These techniques can also reduce rumination and help us shift our attention away from negative thoughts, enhancing our ability to manage tasks and responsibilities.
3. Organizational Tools
Using organizational tools like planners, calendars, and to do lists can help us with Depression manage our tasks more effectively. Breaking tasks down into smaller, manageable steps and setting realistic goals can make it easier for us to stay on track and reduce those feelings of overwhelm that can be debilitating
4. Regular Physical Activity
Exercise has been shown to improve cognitive function, including executive function, by increasing blood flow to the brain and releasing endorphins. Not only that, regular physical activity has been shown to reduce depressive symptoms, improve mood, and enhance overall cognitive performance.
At the End of the Day..
Depression’s impact on executive functioning is a significant aspect of the disorder that deserves our attention and care. Because executive functioning helps us ‘function’ in our lives, when that gets impaired, it can impair countless areas of our lives, which then can worsen Depressive symptoms by adding feelings of frustration, guilt, worthlessness, and powerlessness. Thankfully with the right strategies and support, it’s possible to manage these challenges and improve our executive functioning.
Understanding the connection between Depression and executive functioning is crucial for those of us experiencing these challenges and also for those of us supporting them. By addressing both the emotional and cognitive aspects of Depression, you can take a more holistic approach to understanding and navigating through your Depression. If you would like more support in navigating through Depression and executive functioning, please reach out for a phone consultation.