Effective treatments for cognitive deficits in depression do exist to help the many people with depression suffering from cognitive deficits in areas like memory, concentration, psychomotor skills (relating to muscular activity associated with thought), brain processing speed (slowed thinking) and decision making. Several strategies for treating cognitive deficits in depression have been developed to deal with these challenges.
Remediation Techniques in the Treatment of Cognitive Deficits in Depression
Remediation techniques are drills and exercises designed to reduce the cognitive symptoms associated with depression. These exercises may be done by hand, online or in groups. Computer assisted learning lessons that exercise memory in the form of a game is one example of a remediation technique.
Remediation techniques may also be applied holistically and focus not just on specific cognitive deficits but on psychosocial functioning as a whole. For example, the Neuropsychological Educational Approach to Rehabilitation (NEAR) technique has goals including:
- Improving neurological/psychological functioning
- Gaining an understanding of learning style and providing positive learning experiences
- Promoting awareness of social-emotional context
- Promoting independent learning skills
- Promoting confidence, competence and motivation
The NEAR approach uses computer-assisted learning sessions multiple times per week plus group sessions where sharing is encouraged and specific activities are done to improve cognitive functioning.
Compensatory Strategies in the Treatment of Cognitive Deficits in Depression
Compensatory strategies in the treatment of cognitive deficits in depression focus on trade-offs, positing that there is more than one way to accomplish a given task. These strategies focus on a person's cognitive strengths to make up for their cognitive deficits.
Usage of mnemonic devices is one compensatory strategy. For example, if one needs to get five things from the market but knows he or she is likely to forget all five, they might be able to remember a sentence more easily such as, "Eggs are good for you." This would remind the person to buy eggs, artichokes, gala apples, figs and yogurt.
Understanding one's most effective learning style and creating simple plans that require the least amount of effort are needed to make compensatory strategies work in the treatment of cognitive impairment.
Adaptive Approaches in Dealing with Cognitive Deficits in Depression
Adaptive approaches don't treat the cognitive deficits in depression but, rather, admit that some cognitive deficits are persistent and find ways to work around them.Changes in the environment are used rather than changes in the individual. The usage of human and non-human resources are used in this approach.
A simple example of an adaptive approach is the use of a cell phone to write down grocery lists or record the audio of a task list. Family members may also find they adapt to a person's cognitive deficits by acting on his or her behalf in certain situations.
Medication in the Treatment of Cognitive Deficits in Depression
Medication is not typically used in the treatment of cognitive deficits in depression. However, in a recent systematic review, it was found that some antidepressants do improve cognitive impairment in depression. Data suggests that the following depression medications may improve cognitive deficits:
- Selective serotonin reuptake inhibitors (SSRIs)
- The selective serotonin reuptake inhancer, tianeptine (not approved in the United States)
- The serotonin norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and vortioxetine (Brintellix)
- Other antidepressants bupropion (Welbutrin) and moclobemide (not approved in the United States)
No definitive information on dosages or which medications are best in which circumstances is currently known.