Overcoming Depression For Dummies

by Smith, Laura L.

  Adam looks at the world through an inadequate life-lens. As a child, his father had no patience for teaching Adam anything; instead, he got fed up with Adam whenever he made the smallest mistake. For his entire adult life, Adam has shied away from acquiring new skills because of his fear of looking clumsy and stupid. He even hires a carpenter to put up shelves in his lounge, rather than attempting to put them up himself. When his wife says that they need to get out more, and suggests dance lessons, he feels like crawling under a stone and going into hiding. Nonetheless, Adam decides to try writing a letter to the source. Figure 7-1 shows the letter he writes to his father.

  Figure 7-1: Adam’s letter to the source.

  At first, Adam feels guilty when he starts writing his letter to the source of his life-lens. But he realises that he has no intention of actually sending it and that he has a perfect right to feel the way he does. Note that he includes not only his feelings of anger, shame, and humiliation, but also his plan for choosing and putting on a new life-lens. If you’ve struggled long enough with a destructive life-lens, try the Writing a Letter to the Source exercise.

  If you want even more ideas for how to ‘find and replace’ problematic life-lenses, we recommend Reinventing Your Life by Jeffrey Young and Janet Klosko and Why Can’t I Get What I Want? by Charles Elliott and Maureen Lassen.

  Schemas: The astonishing power of life-lenses

  Psychologists have another term for what we are calling life-lenses – schemas. Schemas work like lenses. They’re the mind’s way of organising and making sense out of the bewildering onslaught of information it’s receiving.

  Schemas can be useful, because they allow us to take shortcuts in interpreting a vast amount of information. However, these mental frameworks also cause us to exclude relevant information in favour of information that confirms our pre-existing beliefs and ideas. Schemas can contribute to stereotypes and make it difficult to hold onto new information that doesn’t conform to our established schemas. They are thought to be the central and enduring themes in a person’s life. Schemas reflect deep, difficult to change views of ourselves, others, and the world. They also refer to a broad organising structure that significantly influences our moment-to-moment experiences .

  Schema-focused therapy, a form of CBT, particularly developed by the clinical psychologist Jeffrey Young, is a psychological therapy that has been found to be very useful in treating chronic depression. There’s a great deal of research and clinical work on schemas, which demonstrates how using distorted schemas laid down in early life can affect the mood of adults – and how it is possible to work to successfully modify long-established schemas.

  In a famous experiment, volunteers wore glasses that literally turned their world upside down. After much discomfort and confusion the volunteers eventually reported that they saw the world the right way up through their glasses. The brain had taken the inverted image seen by the eye, and turned it the right way up. The only problem was, when the volunteers took their glasses off, their perspective remained inverted! Eventually the brain switched the inverted view (which was still being seen even without the glasses) back to the right way up. Just goes to show the influence your brain has over what you see – even to turning your world upside down, just to make it look right!

  Chapter 8

  Amending Your Memory

  In This Chapter

  Understanding how your memory works

  Looking at how depression affects your memory

  Caring for your memory

  Investigating strategies for improving your memory

  Depression is bad enough. You feel absolutely awful. Your sleep may be disturbed, your appetite practically non-existent, and nothing seems like fun any more. Is worse to come? Well, you can add memory problems to the mix – a serious lessening in your ability to remember such things as names, dates, tasks, and even shopping lists.

  But why single out memory as a special concern? Mainly because a misbehaving memory messes up your everyday life. Also, when you notice memory problems, beating yourself up for having the problem is all too easy. And you certainly don’t need any more triggers for negative thinking than depression is already giving you.

  Depression and memory impairment go hand in hand. Here’s the good news – when your depression lifts, your memory is likely to improve. But in the meantime, there are a number of techniques for making your memory perform better for you, which may in turn lift your spirits.

  To appreciate how depression affects memory, we talk about how memory works, and then describe the different kinds of memory. Next, we show you the ways depression can wear down and disrupt your memory. Although being a bit forgetful is perfectly normal, we explain how to recognise if you have a problem and if your memory is in need of help. Finally, we give you sound strategies for dealing with memory problems and boosting your memory skills.

  Making Sense of Memory

  Think back to when you were a child. What’s the earliest memory you can recall? Do you remember where the event took place, who was there, and what you looked like? Good. Now try to remember what you had for lunch today, a fortnight ago. What? You can remember something that happened way back in the mists of time, but you can’t remember something that happened only two weeks ago?

  This little exercise proves that memory processes are complex. You can’t remember everything that happens to you. We’re pretty sure you were awake and paying attention to what you ate two weeks ago. But you probably don’t remember the food on your plate unless it was unusual, special, or important to you in some way.

  Scientists agree that all memory begins with how you view incoming information, or an event, using one or more of the senses. Many factors determine the perception that forms a memory and whether you’re going to recall that memory. Briefly, here are the most important processes involved in memory:

  Immediate memory: Think of immediate memory as a multi-sensory recording, including all your senses – sound, vision, touch, taste, and smell. The recording of each moment is briefly held in your immediate memory, but then most of the detail quickly dissolves. Right now, you’re reading these words, but your senses are also aware of the temperature of the room you’re in, the sounds of cars going by, the level of light, and the comfort of your seat. You can turn your attention at will to any of those sensations, but most of them are never really brought into your awareness.

  Your lunch two weeks ago was in your immediate memory for a short time. Unless something unusual occurred, such as choking on a fish bone, the memory of your lunch is probably never going to be transferred from your immediate memory to long-term memory (which we describe later). Instead, the memory is going to dissolve and be lost for ever.

  Working memory: When you pay attention to information, your working memory (a temporary holding zone) allows you to use, manipulate, build up, or send the information into long-term storage. Working memory is like a blackboard in your brain where memories are constantly being rubbed out and new ones being chalked up. Without working memory, you’d be unable to solve many types of problems that involve thinking about more than one idea at a time. Here’s an example: say all the letters of the alphabet (which you now retrieve from your long-term memory) that rhyme with the word me. To search for these letters, you have to use your working memory to picture all the letters, scan through them, and work out if they rhyme.

  Long-term memory: Most of the information that passes through immediate memory and through working memory is quickly forgotten. But when the brain places a memory into long-term storage, the memory then lasts a while – maybe even a lifetime. When asked to recall the alphabet, you (hopefully) have no problem remembering the letters. But unless you’re a schoolteacher, you probably haven’t had to specifically practice writing or reciting the letters in order since you were a kid. You can thank your long-term memory for keeping this little nugget of infrequently-used information on file. Your long-term memory can store huge amounts of information; it’s what m
ost people think of when they use the word memory.

  Retrieval: You have billions of memories stored in various places in your brain. But sometimes you can’t easily find those memories. When you can’t remember someone’s name and then a couple of hours later it just seems to pop into your brain, you’ve had a retrieval problem. Retrieval (or recall) is the process of pulling stored information into conscious awareness. The earlier memory failure is actually a retrieval problem.

  When all’s well, the brain processes, stores, and recalls memories with efficiency and ease. However, memory can be subject to many disruptions, including those caused by neurological injuries or diseases, problems with concentration, drugs, alcohol, and emotional disorders. Depression can also be one of these disruptions, and it can temporarily damage the sophisticated memory system.

  Depressing Disruptions

  Depression fills you with sadness. Your ability to think clearly can be clouded by feelings of hopelessness, helplessness, guilt, and low self-esteem. But depression also affects your ability to think clearly by having a negative influence on all aspects of your memory. In the following list, we describe the ways that depression affects each aspect of memory. (For more on each aspect, see ‘Making Sense of Memory’, earlier in this chapter for experimental evidence of depressed versus non-depressed memory.

  Immediate memory: Depression decreases your ability to pay attention to what’s going on around you; you may not even notice important information. Things that you normally pay attention to may just slip by.

  An overwhelming depression slows Piotr down and he practically crawls through his morning routine. He notices the time and realises that he’s going to be late for work. Piotr starts searching frantically for his keys. He tosses papers aside, digs in his briefcase, and scurries from room to room. ‘Damn, damn, damn,’ he fumes, as his rising panic and irritation grow. Suddenly, his hand discovers the keys, in his pocket, where he put them just minutes earlier. ‘Damn, damn, and double damn!’ Everyone probably experiences something like this from time to time, but Piotr is having this problem almost every day. His immediate memory is impaired.

  Working memory: Depression disrupts your ability to concentrate and hold onto information. Your problem-solving ability sharply declines.

  Throughout her company, colleagues know Isabella as an energetic, kind, and intelligent manager. Lately, she has been experiencing a lack of energy, a poor appetite, and a huge decrease in her usual enthusiasm for her job. Today, she’s chairing a meeting with six other managers to work on solving a company problem. She begins the meeting by asking the managers to report on their understanding and views of the situation. She expects to find a solution easily once the problem has been examined from all sides. But as the meeting progresses, Isabella finds it increasingly difficult to listen and hold onto the various ideas in order to compare and contrast them. Her mind floods with negative thoughts. At the end of the presentations, she realises that she doesn’t have a clue how to approach this problem. Her working memory isn’t working very well.

  Long-term memory: Depression makes acquiring new information much harder. Tasks such as studying for an exam can become extremely difficult. Concentrating is more difficult, and the information just doesn’t seem to stick. Information refuses to be properly filed into the memory’s retrieval storage system – your long-term memory.

  The cold, slushy, dreary days of winter are especially depressing to Eric. His mood matches the long dark days of the season. But this winter seems worse than past years. Eric loses his job at a building society, deepening his depression. The job market looks terrible, so he decides to change careers and move into accountancy. He gathers all the study materials, thinking that it doesn’t look too difficult to train in this field, but finds that he can’t remember anything of what he reads. He’s never experienced this kind of problem before. He reads through the books twice, and keeps notes. He takes a practice test and fails miserably. His struggles add to his depression. Eric is having trouble storing new information in his long-term memory.

  Retrieval: Depression makes recalling information like dates or doing the shopping without making a list more difficult. Previously known names, faces, and facts are harder to remember. Happy events are particularly difficult to recall. When you’re depressed, you’re more likely to come up with sad and depressing memories, because depression floods your brain with negative memories. You may actually have trouble remembering whole periods in your life when you were happy.

  ‘I’ll never find Mr. Right’ Emma complains to her friend Heather. ‘Every time I think someone’s nice, I find out he’s married, or just not interested in me. And even the guys who seem interested are only after one thing: sex. I’ve never had a good relationship. They all fail miserably. I may as well just give up once and for all.’

  Picturing the depressed brain

  Researchers are certain that depressed people have real problems with memory. Exciting new brain-imaging techniques are now helping scientists see what depression looks like in the brain. With this knowledge, they’re beginning to understand the complicated relationship between mood and memory.

  One explanation for poor memory during depression may be found in increased levels of corticosterone, a hormone that’s released when people experience severe stress. Corticosterone levels increase during depression. Research in Canada and California has found that high levels of this hormone significantly increased depression-like behaviour and impaired rats’ ability to retrieve information previously acquired or stored in long-term memory. Another possible explanation for poor memory may be the decreased levels of the brain chemical serotonin found in depressed people. Serotonin helps regulate attention as well as the ability to be interested in pleasurable activities.

  When the body is under stress, it produces extra quantities of a hormone called cortisol. In the short-term, this helps you deal with difficulty and danger. But long-term raised levels of cortisol can be harmful. Usually, cortisol levels are highest in the morning, and then steadily decreases. For depressed people, there’s a different pattern. Often they’ve had long periods of uncontrollable stress, which goes with higher cortisol levels. This seems to affect the transmission of the brain chemical serotonin. The result can be clinical depression. Physical illness can also disrupt cortisol patterns, and therefore also have an effect on attention, memory, and depression.

  Other research suggests that people who have suffered from depression may have a smaller hippocampus, a key area in the brain that is important for storing information and recall. There is a theory, that the stress hormone cortisol may have toxic effects on the hippocampus.

  Heather is astounded. She remembers plenty of men who were interested in Emma, and she recalls several long-term, stable relationships that Emma actually broke off. Emma has more dates than anyone in her circle of friends. In fact, Heather has always been jealous of Emma’s ability to attract the opposite sex. What’s going on? Emma is suffering from depression. She really can’t remember the good times.

  Forgiving Forgetfulness

  When you experience memory problems as a result of depression, worrying about these problems may deepen your depression, adding to your forgetfulness. If you’re depressed, don’t be too surprised if you forget where you parked your car, can’t remember a specific word or someone’s name, or if you misplace everyday items. Getting upset about minor memory problems can easily make you even more depressed.

  For example, following a serious car accident, one of the authors of this book, Elaine, suffered post-traumatic shock. One of the distressing symptoms of her shock was what she calls ‘holes in her head’ – memory problems. On one occasion, a friend rang to ask why she’d missed their lunch meeting. Elaine was astonished; she had no recollection whatsoever of making plans to meet her friend. But rather than beating herself up for her memory lapse, Elaine forgave herself. She accepted that her friend was telling the truth, gave herself permission to nonetheless be unable to r
ecall their plan, even with prompting. Elaine’s approach lessened the additional stress and misery of getting angry with herself about a perfectly normal and forgivable event.

  Try going easy on yourself, telling yourself that your memory ‘hiccoughs’ are because of your depression. These memory problems are likely to be resolved when your depression lifts. You can also begin to take a more active approach in beefing up your memory, using the tips and techniques we provide in ‘Assisting Your Ailing Memory’, later in this chapter.