Depression and sleep are common bedfellows. There’s a strong connection between sleep problems and depression, and understanding the relationship between them can help you put both to rest. Let’s explore how they’re connected, how sleep impacts depression, and what to do about the sometimes-toxic relationship between depression and sleep.

If you’re experiencing both sleep problems and depression, you’re not alone. A Harvard Medical Letter (n.d.) highlights the scope of the problem.

• Over half of all people diagnosed with major depressive disorder (MDD) have significant sleep difficulties.
• More specifically, 65-90 percent of adults with MDD have some type of sleep problem.
• Around 90 percent of children diagnosed with MDD have sleep issues.

In their article Depression and Sleep: Understanding the Connection (n.d.), professionals with Johns Hopkins Medicine inform us that people with insomnia have a risk for depression that is 10 times higher than those who don’t have sleep difficulties. Lack of sleep, then, can be a cause of depression. This can be harder to identify than it seems, however, for depression can be the cause of lack of sleep.

Something to keep in mind is that the numbers don’t speak equally to everyone. It’s becoming increasingly understood that depression affects people differently at various ages; likewise, sleep problems differ across the lifespan, too. For example, sleeping too much (hypersomnia) is a depression sleep problem, but that can change as people age. Forty percent of young adults with depression experience hypersomnia, while only ten percent of older adults have hypersomnia.

It’s important to understand the relationship between sleep and depression, and it’s also important to keep in mind that both experiences are very individualized. Know the facts and know yourself for the best possible outcome.

The Relationship Between Depression and Sleep

We know that depression and sleep are strongly linked, but which one comes first? Does depression cause sleep problems, or do sleep problems cause depression? The two are so closely linked that each one can contribute to the other. Some research has indicated that depression and sleep may share risk factors as well as biological features, making them rise and fall together (National Sleep Foundation, n.d.).

Johns Hopkins researchers have linked insomnia to depression via the emotions. When someone suffers from lack of sleep, they have a more difficult time regulating their emotions. Their overall emotional resilience—the buffer of positive emotions that allows people to deal with stress—deteriorates, leaving them vulnerable to depression.

Other biological factors unite sleep problems and depression. Seasonal affective disorder (SAD), or seasonal depression, is largely caused by the low light levels of fall and winter. These lower light levels alter the body’s natural circadian rhythms, throwing off our sleep patterns and contributing to SAD.

Depression is connected to both too much sleep (hypersomnia) and too little sleep (insomnia, either difficulty falling or staying asleep or both). Regardless of the cause or nature of your sleep problems (too many or too few zzz’s), sleep problems negatively impact depression.

Sleep and Depression: How Sleep Problems Affect Depression

Having depression and being unable to sleep properly is frustrating. Beyond that, it can make things worse. People with depression and sleep difficulties also are prone to

• Anxiety
• Cognitive problems
• Physical problems

It’s still unknown whether problems like insomnia or hypersomnia make existing depression more severe because study results are mixed. Out of the lab and into the world, some people have more intense depression symptoms when their sleep is off. Others find that sleep difficulties are annoying but don’t affect their symptoms.

This points out the fact that depression and sleep are both individualized experiences. Everyone is unique with their own biology, personality traits, and genetics. Your own experiences aren’t wrong. And whatever they are, they can be treated.

Treating Sleep Problems and Depression

If you are experiencing both sleep disturbances and depression, treating just one might not be enough to significantly help the other. Because they are so closely related, they respond best when both are addressed. And because they are intricately connected, depression and sleep problems often can be helped by the same treatment approaches.

Effective ways of overcoming both depression and insomnia or hypersomnia include:

• Therapy—specifically, an approach called cognitive behavioral therapy for insomnia (CBT-I) uses strategies that correct negative thoughts that plague you day and night
• Nutrition changes
• Learning and using effective sleep hygiene
• Discovering and implementing relaxation techniques
• Enhancing your support system
• Medication

Understanding the relationship between sleep and depression and recognizing your own experiences can help you get the right treatment. Treatment can help you overcome both sleep and depression as well as prevent depression relapse. Notice if you’re having sleep problems and how they’re affecting you you’re your depression symptoms. Seeing your doctor can help you overcome both.

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Sometimes, when we're really stressed, our thoughts seem to race. The opposite of this – slow thinking – can happen when a person is depressed. You might notice when talking with a person who is depressed, they exhibit slow speech or difficulty understanding and registering information. It often feels, to the person who is depressed, as if it's very difficult to think and it takes more than the usual effort to do so. Sometimes, it's referred to as "brain fog."

It's important to note that while some depression medication side-effects may include slowed thinking (check your psychiatric medication side-effects), impaired processing speed has been shown to exist even without the presence of medication side-effects.

Depression and Slow Executive Thinking

Some of the slow thinking processes in depression are called "executive thinking skills." These are the skills required to plan, organize and problem-solve. They are more complicated forms of thought than others because they require you to act on a set of information.

For example, even if you know how to drive a car, driving to a friend's house is an executive thinking task because it involves planning when to go, ensuring the car has enough gas, mapping a route and changing that route should problems, like road construction, arise.

If you have depression, you may have slower executive thinking processing speed. So it is more difficult for you to come up with a plan as to how to cook a meal, drive to a location or hire an accountant and your thinking is also slowed if you have to find an alternative if your plan is blocked.

Pronounced deficits in executive thinking are present in approximately 20-30% of people with major depressive disorder. There are notable executive thinking deficits that also fall outside the realm of processing speed, specifically.

Research on Depressed Mood and Slow Thinking

In studies, it has been shown that people with depression think more slowly than others. For example, in a task where participants were asked to count backwards from one hundred by seven (100, 93, 86, etc.) people with depression were slower in doing so and made more mistakes.

It has also been noted that people with depression have more slowed thinking when dealing with negative emotional stimuli.

Depression may produce even greater slowed thinking in the elderly and in those with more severe depression symptoms or repeated depressive episodes.

Depression and reduced processing speed is even noted in people who are experiencing euthymia (a non-depressed, reasonably positive mood state). Additionally, some studies have noted that late-onset depression (people who experience their first depression in adulthood) may produce more pronounced cognitive processing speed deficits in euthymic patients.

Treatment for Slowed Thinking in Depression

Slow thinking in depression is not typically treated in and of itself, rather, the focus is on treating the depression as a whole. However, it has been shown that cognitive remediation (drills and exercises) can be effective at increasing cognitive speed (read: Treatment of Cognitive Deficits (Symptoms) in Depression).

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For many people, talking with your doctor about a medical or psychological problem can be difficult, but if you have the symptoms of depression, it's important to discuss them with your doctor and receive appropriate depression treatment.

When you visit the doctor, you may feel rushed or forget to ask some important questions about your symptoms, causes or treatment of depression. So here is a list of questions you can print out to bring with you to the doctor's office. Add your own notes about your symptoms, medical conditions you may have or any medications or herbal supplements you are currently taking plus any personal questions about depression to the list.

1. Do I have depression or is it something else?
2. What caused my depression? Is it possible that it's related to a medical problem or medications I may be taking?
3. What depression treatments are available that don't include antidepressant medications?
4. Do you think I need antidepressant medications for my depression and why?
5. If I need antidepressants, how do they work? What should I expect when I start them? And how long do they take to relieve my depression symptoms?
6. What antidepressant side-effects should I expect? Will they affect my sex life or daily functioning? And what can I do about the side-effects from antidepressants?
7. Should I see a therapist as part of my depression treatment?
8. What else should I do to relieve my depression and keep the symptoms of depression from coming back? Any lifestyle or behavioral changes?
9. Can I call you if I have more questions or any problems relating to my depression or treatment?
10. What should I do if I feel suicidal?

Brain fog is a change in cognition and mental functioning. It’s a broad term that’s used to describe those times in which someone just doesn’t feel like himself. When someone is experiencing brain fog, she is dealing with mild impairment in various high-level brain functions. While this description of brain fog is accurate, it doesn’t fully explain it. Here’s a closer look at this common condition to answer the question, “What is brain fog?”

What is Brain Fog? Fatigue is Why Your Brain is Foggy

When your brain is foggy, it is because it’s exhausted. When the brain is in a state of fatigue, it has a hard time functioning. Peak performance is impossible. When your brain is foggy, you might experience any of these mental states:

• Forgetfulness; memory/recall problems
• Confusion
• Problems focusing, paying attention, concentrating
• Difficulty processing information you hear or read
• Planning (short- or long-term)
• Quickly switching between tasks
• Disorganization
• Learning difficulties
• Communication deficits (such as having a hard time selecting words or understanding what someone is telling you)
• Sluggishness, feeling out of it or not with it
• Feeling detached from people and situations around you

Someone with symptoms of brain fog might have nearly all these experiences, or he might have just a few. Brain fog varies in severity and intensity, but living with even a small number of these symptoms can be overwhelming and discouraging. Brain fog is a cognitive deficit that, even in its mildest form, can negatively impact lives.

Life with Brain Fog

Living with a foggy brain can be summarized in one word: frustrating. It’s not something that causes disability, but it can seem like you’ve lost your ability to think and function in your life. Brain fog can interfere with all areas of your life: work or school, relationships, ability to run your home and care for others.

When your brain is foggy, your thinking is slow. It can take an extraordinary amount of effort to move from moment to moment. A definition of brain fog might be any one of these statements:

• An experience that causes you to forget where you parked while you’re standing there staring blankly at your car
• Something that makes you forget what you’re saying while you’re saying it
• A condition that makes you want to scream in frustration because you’re normally so productive but at the moment you don’t know how to organize your desk or use your calendar to plan your day

Brain fog is something that makes you feel like you are stuck in one spot while the world operates normally around you. It’s like one of those dreams where you’re trying with all your might to run somewhere important, but a strong force holds you back.

Brain fog arises when the brain is fatigued and simply can’t work the way it’s supposed to. Brain fog, however, is not brain damage. It’s a temporary experience rather than a permanent illness.

Brain Fog Isn’t a Diagnosis, but It is Real

Even though brain fog is recognized by medical and lay people alike, it’s not a diagnosis in its own right or even a stand-alone condition. Brain fog is considered a to be an experience that’s part of other conditions.

The cause of brain fog can be part of both physical and mental illnesses. It can also be a symptom of mental or physical illness or a contributing factor to them. It’s not a separate diagnosis because brain fog always occurs in the context of something else. That said, brain fog is a real thing. Medical and mental health professionals can test for it with cognitive tools, and it shows up on brain scans.

Researchers at the University of Michigan Medical School, Department of Psychiatry studied brain fog in women with mood disorders. Cognitive testing showed deficiencies in attention, focus, and speed of response to questions. Brain scans reflected this change in processing.

Brain fog, therefore, is an actual experience that accompanies a wide variety of mental- and physical health conditions. When your brain is foggy, you might experience a variety of frustrating cognitive difficulties that interfere with your life. Brain fog may be exasperating, but it’s not life-threatening. Also, you can treat brain fog and regain your optimum level of functioning.

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Psychomotor skills are skills where movement and thinking are combined. This includes things like balance and coordination. Psychomotor skills are known to be negatively affected by depression. Greater psychomotor skill impairment is seen in older individuals and in people with longer and more severe depressions. It is not clear why depression affects psychomotor skills but magnetic resonance imaging (MRI) has linked the deficit to changes in the brain seen in depression.

Depression and psychomotor skills are mentioned specifically as diagnostic symptoms in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the manual used to diagnose all mental illnesses.

What are Psychomotor Skills?

Psychomotor skills are skills in which the brain and body must work together. A common example of this is hand-eye coordination tasks. Hand-eye coordination tasks include everything from pouring yourself a glass of juice in the morning to catching a ball in a game of baseball. Catching a ball is more difficult than pouring a glass of juice and so depression may affect that difficult skill more prominently.

Examples of hand-eye coordination psychomotor skills include:

• Folding laundry
• Applying makeup
• Writing

Psychomotor skills also include other types of movements such as those that require manipulation, dexterity, grace, strength and speed. Fine motor control used in things like operating small instruments is also a psychomotor skill that can be affected by depression.

Psychomotor skills are typically skills that are learned, such as juggling, and can be improved with repeated performance.

Psychomotor Agitation or Retardation

Specifically mentioned in the DSM-5 is psychomotor agitation and retardation and these are considered core symptoms of depression. These are global psychomotor effects rather than effects on specific skills.

Psychomotor agitation is generally defined as an "inner restlessness or tension associated with increased motor movement." In other words, there is a feeling inside of you that you have to keep moving and this manifests as repeated, often purposeless, movements like leg shaking, fidgeting, hand-wringing or pacing.

Psychomotor retardation, is, of course, the opposite. Psychomotor retardation is a slowing down of psychomotor movements. Manifestations of psychomotor retardation in depression include slowed speech, slowed movement (such as slow walking) and impaired thinking.

Effect of Depression on Psychomotor Skills

Depression negatively affects psychomotor skills and can cause a lack of coordination, lack of movement control, a slowing of movement or repeated movements. This can hamper everyday life in many ways from signing your name on a check to practicing yoga, to even keeping up in conversation. In its most severe form, psychomotor retardation can even result in a catatonic state where little-to-no movement, including speech, is present. These detrimental effects hurt the lives of sufferers at home, work and school.

Treatment of Psychomotor Effects of Depression

Treatment of psychomotor effects of depression involves treating the depression itself, often with standard treatment such as with antidepressants and possibly also practicing the affected skills. The literature is unclear but it may be the case that tricyclic antidepressants are more effective in cases of psychomotor retardation. In severe cases, such as in those where catatonia is present, electroconvulsive therapy may be preferred and is considered effective.

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Depression in young adults can interfere in a newly independent life. When you’re experiencing independence and new responsibilities for the first time, life can be exciting, but if you are living with depression, excitement is often replaced by apathy and hopelessness. When it hinders job performance, depression in young adults can prevent people from doing what is needed to stay independent.

How Depression in Young Adults Can Cause Problems at Work

Depression is an illness (not a personal flaw) that causes extreme fatigue and lack of energy to do even simple tasks. It interferes with someone’s ability to concentrate and focus on a task long enough to complete it. Work pressures and stress become harder to manage when you have depression.

Depression and work problems become a vicious cycle that can have dire consequences:

• For the above reasons, depression makes it difficult to do your job
• Poor performance can lead to reprimands from your boss or conflicts with your coworkers
• At its extreme, poor job performance from depression can cause you to lose your job
• Job loss can deepen depression
• Sinking deeper into depression makes it more difficult to find another job and can make career development and advancement stall

Depression can cause work problems for people of any age. Depression in your 20s, however, can bring unique difficulties simply because you are a new adult.

Why Depression in Your 20s Makes Work Problems Even Harder

When you’re emerging into adulthood, you’re new enough on the scene that you usually don’t have a long history with your workplace. Even if you held part-time jobs in high school or college and are used to the working world, when you first start in a new career field, you don’t immediately have established, trusting relationships with bosses and coworkers. If you have major depression, that lack of history works against you:

• People at work don’t have a context of what you’re like without depression and may not understand why you’re struggling
• Employers might be less likely to give leeway to new and/or young adult employees when they need time off or need extra time on a project
• You haven’t had time to build up sick leave, so taking time off because of major depression isn’t always an option

When you’re a young adult and lack work experience and a history of relationships that would help people be more understanding of your illness, depression can feel like a career disaster. Catastrophizing, or believing things are more disastrous than they really are, is a common thinking style in depression. Here’s a bit of encouragement: There are ways to make work easier when you live with depression, and, perhaps surprisingly, working can help improve depression.

Tips for Improving Job Performance and Minimizing the Impact of Depression at Work

Specific strategies can help you continue working and do your job well.

Practice self-acceptance. Be kind to yourself. You are not your illness. You have many strengths, talents, and positive qualities that got you hired in the first place. Depression may be a huge obstacle, but it’s not a character trait. Consider journaling daily to record your successes of the day and things you accomplished despite great difficulty. This will help you remember and accept that you have much to offer.

Let go of negative thoughts. Depression makes most people highly self-critical. It also makes them extra sensitive to things that feel like criticism. Mind-reading is a common negative thought pattern that causes problems at work. It’s easy to catch a stray look from someone or have someone pass you in the hall without a word and think that they disapprove of you. In truth, it’s impossible to know what others are thinking. Catch yourself thinking this type of negative thought and remind yourself that you can’t know what others are thinking. Repeat this process because internalizing it takes time.

Break up tasks into smaller parts. When you live with depression, to-do lists feel overwhelming. Divide big tasks into smaller components that you work on in 15- or 20-minute segments before taking a short break to take a brief walk around the office, drink water, or eat something healthy and energizing. Working this way is depression-friendly and helps you feel accomplished—because you are accomplishing things.

Be inspired. Depression makes you markedly un-inspired. Counter that by personalizing your work area and making it a pleasant place for you to be. Decorate it with pictures, quotes, and images that remind you of your reason for being there and your vision for your future.

When you create small successes at work, you’ll begin to notice your depression symptoms improve. This provides a boost to continue your momentum, and in time, depression will no longer hinder your job performance. You will recover from depression and enjoy your career once again.

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Do I have depression, or am I lazy? That is a worry that plagues many people experiencing depression symptoms. It can make people afraid to see a doctor or therapist for help. No one wants to be formally accused of being lazy, to be told to just bite the bullet and get on with their lives. Here’s how to tell the difference between depression and laziness.

Depression or Lazy?

Depression and laziness can look similar at a quick glance, but they are very different experiences. This brief contrast highlights what each one is.

Laziness is

• A trait
• Personality-based
• Often limited to specific circumstances
• A choice

Laziness can be used as a description to explain what someone is like. Of course, having the trait of laziness doesn’t necessarily make someone completely idle and unmotivated in every circumstance of their lives. Everyone feels lazy sometimes, and those times can be mentally healthy when we use them to destress and recharge.

Depression is different. Even though our society tends to use the term “depressed” freely to describe people, no one is depressed at their core. Just as illnesses like diabetes aren’t what someone is like, nor is depression. Contrast the above description of laziness with this depiction of depression.

Depression is

• An illness
• Brain-based
• All-encompassing
• Not a choice

Depression and the Illusion of Laziness

Part of the stigma around depression is that people living with it are lazy. Many of the symptoms of depression can give the illusion of laziness to those who don’t understand depression. (Once people learn about what depression is and what it does to people, they usually stop equating the illness with the trait).

Depression makes it nearly impossible to start, engage in, and/or complete even simple tasks. Getting out of bed can be so exhausting that someone needs to fall right back into it. This means that working at any job can become impossible. Sometimes people with severe depression have to quit working and receive unemployment benefits. This isn’t laziness. It’s depression lethargy.

If you have any of these depression effects or symptoms and do not meet the criteria for laziness delineated above, you might be experiencing depression rather than laziness:

• Sleeping too much
• Crushing fatigue despite sleep
• Difficulty with self-care such as showering
• Loss of interest in activities or people you once enjoyed
• Taking longer to complete ordinary tasks
• Difficulty starting anything because of fatigue
• Low self-esteem

Exhaustion Points to Depression, Not Laziness

If you’re concerned about whether you’re experiencing depression or laziness, take a look at your energy levels. Are you always tired? Does your fatigue make you feel heavy? Are you lethargic? Does it slow you down? “Yes” answers point to depression.

Researchers Ghanean et al. found that over 90 percent of people with depression suffer from fatigue. Exhaustion makes people unable to do certain things. Laziness, in contrast, makes people unwilling to do things.

Depression causes fatigue by negatively affecting certain neurotransmitters in the brain. Hormones associated with alertness and the reward system, for example, impact energy levels. Other causes of depression fatigue are sleep problems—both too much and too little sleep cause fatigue—a diet high in processed foods and low in nutrients, stress, and even depression medications.

Depression Isn’t Laziness

Reminding yourself of this fact can help you stop criticizing yourself and taking the stigma around laziness to heart. Reframe your notion of productivity, work, or whatever concept is your opposite of laziness—each day, or parts of each day, create one small goal. Do that one little thing and be proud that you did it. Doing a tiny act despite having an illness takes effort and strength. That’s not laziness.

Know that there is no shame in depression. A good doctor will know the difference between depression and laziness and will start to help you heal. Starting with a medical doctor is a good idea so they can rule out other causes of your fatigue and inability to do things. Then, a therapist can work with you to overcome depression and get your motivation back. It’s possible because depression, an illness, isn’t laziness, a trait.

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The idea that there are medications that cause depression is surprising to many people, including a lot of doctors. Medication, after all, is supposed to help you feel better, not worse. Sure, prescriptions often carry side-effects that range from mildly annoying to miserable, but a mental health disorder shouldn’t be among them. However, many medications can and do cause depression. Depression caused by medication is called drug-induced depression and is alarmingly prevalent.

A University of Illinois at Chicago study published in 2018 found that more than a third of adults in the United States could be taking medications that can cause depression or increase their suicide risk. That is nearly 110 million people who either have or are at significant risk for drug-induced depression (If you think you may have depression, take our short depression test and share the results with your doctor).

Perhaps this number is so high because of the large number of drugs that have depression as a side effect. Currently, that number is more than 200 (University of Illinois at Chicago, 2018). This encompasses both prescription and over-the-counter (OTC) medications. Knowing the types of medications that can cause depression will help you know the risks of what you’re taking as well as when to watch for depression symptoms.

Types and Classes of Medications That Cause Depression

The medications listed below are general categories of medications. Each group has multiple individual drugs. While not every drug in a given group causes depression, enough do to warrant its inclusion on the list.

This list of depression-inducing drugs can help you make informed decisions when working with your doctor.

• ACE inhibitors (for blood pressure, heart disease)
• Agents to stop smoking
• Allergy and asthma medications (both OTC and prescription)
• Antianxiety drugs
• Anticonvulsants (to control epileptic seizures)
• Antihypertensives (for blood pressure)
• Antivirals (to treat some viral infections)
• Barbiturates (to treat anxiety, prevent seizures)
• Benzodiazepines (for anxiety, insomnia)
• Beta blockers/beta-adrenergic blockers (help high blood pressure, heart failure, angina, abnormal heart rhythms, migraines, anxiety)
• Calcium-channel blockers (to treat chest pain, high blood pressure, congestive heart failure)
• Corticosteroids (to reduce inflammation)
• Dermatologics (for skin conditions)
• Estrogens (for hormone-replacement therapy, menopause, osteoporosis)
• Fluoroquinolone antibiotics (to treat bacterial infections)
• Heart medications not already on this list
• Hormonal birth control medicines
• Opioids (for reducing pain)
• OTC proton pump inhibitors and antacids (for acid reflux, indigestion)
• Statins (to lower cholesterol)

Your risk for depression increases when you take more than one depression-inducing drug.

Polypharmacy is the term for taking more than one prescription drug at once, and when you are on more than one depression-inducing drug, your risk for drug-induced depression increases. Because polypharmacy is vey common in the elderly, they are especially at risk for depression from their medication.

Knowing about the link between medication and depression (a serious mood disorder) can help you prevent or diminish it. Dima Qato, the lead author of the above-mentioned study, summarizes a takeaway from the study:

“With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue…patterns of medication use should be considered in strategies that seek to eliminate, reduce, or minimize the impact of depression on our daily lives.”

Reducing Drug-Induced Depression

The 200 individual medications within the above classes do offer benefits. Whether they’re prescription or OTC, people take them for good reason. Many are life-saving. Therefore, as with any medication and side-effects, it’s important to discuss the benefits and risks with your doctor. Medications are highly individualized as are the reasons for taking them. Keeping or changing medication is evaluated on a case-by-case basis.

Also, perspective is important. While one-third of American adults develop depression as a result of taking a depression-causing medication, two-thirds do not. It’s important to be aware and cautious. Watch for symptoms of depression such as despair, overwhelming sadness, and lack of energy or motivation, and talk to your doctor if you experience them. Because stopping some prescription medications can be dangerous, always work with your doctor regarding anything medication-related.

Many medications can cause depression. By being aware of the side-effects of medications you take and observing your mood and energy levels, you can prevent or reduce this serious mental health effect of some medication.

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Brain fog can be defined as "a state of mental confusion, detachment, and forgetfulness," according to Dictionary.com. While not a technical term, "brain fog" is a term with which many people with depression identify. Indeed, forgetfulness (memory loss) is a common cognitive deficit found in depression and confusion and detachment can be felt as a part of depression as well.

Brain Fog Signs and Symptoms

Brain fog symptoms and signs include:

• Confusion – confusion, itself, is not a particular cognitive deficit in depression, but the components of confusion such as slow thinking and indecision are. These cognitive deficits are noted parts of depression for many people. Confusion and forgetfulness are often closely linked.
• Detachment – brain fog detachment can be thought of as emotional detachment or an inability to connect with others emotionally. This can also be called "emotional numbing." Detachment may be a coping mechanism used not only to detach from others, but also to detach the person from their painful depression symptoms. Detachment is actually measured in depression as part of the most common depression rating tool, the Montgomery-Åsberg Depression Rating Scale (MADRS).
• Forgetfulness – impairment in memory, both short- and long-term, is also a cognitive deficit found in depression. People with depression may have particular trouble remembering verbal information.

(Learn how cognitive deficits affect someone with depression?)

Brain Fog Causes

It is not known why people with depression experience brain fog but it is likely that a combination of mood and cognitive effects, together, create a sense of a "foggy" brain.

It is also possible that a sense of brain fog may be a side-effect from a medication such as an antidepressant. If the person with depression experiences brain fog only after starting a medication, it is likely medication related.

Stop Brain Fog

So is there a treatment for brain fog? If the brain fog is an element of the depression itself, brain fog can be treated by:

1. Treating the underlying depression
2. Treating the specific cognitive deficits leading to brain fog

This can involve medication, psychological techniques, drills and exercises and adapting to the environment to compensate for the specific cognitive deficit.

If the brain fog is caused as a medication side-effect, the medication itself or its dose should be adjusted by a medical professional.

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Does Depression Affect Concentration?

Unfortunately, depression is associated with several types of cognitive deficits and one area of deficit is in attention. An inability to focus in depression is common. In fact, "diminished ability to concentrate" is an official, diagnostic symptom of depression in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the manual used to diagnose all mental illnesses. Combined with other common depression-related cognitive deficits, like impairments in memory and thought processing speed, depression and attention problems can make learning and retaining information very difficult.

Causes of Attention Problems in Depression

It is not known, specifically, what causes attention problems in depression. It may have to do with the gray brain matter shrinkage that is typically present in people with major depressive disorder. What is known, though, is that both people with unipolar and people with bipolar depression experience concentration problems and both youth and adults with depression experience this cognitive deficit. Fatigue, another symptom of depression, may also play a role in negatively affecting attention span.

It's worth noting that some antidepressant medications that are used to treat depression may have cognitive side effects such as attention problems. If these problems arise after starting a medication, the treating doctor may decide to alter the dose or the medication type. (Psychiatric Medications: Uses, Dosage, Side-Effects)

Also, many people with attention deficit/hyperactivity disorder (ADHD) also experience depression and when these illnesses are present together, they may compound each other.

How Does Depression and an Inability to Focus Affect People?

Of course, anything that requires sustained attention is negatively affected by depression and concentration problems. This includes things like:

• Reading a book
• Engaging in an in-depth conversation
• Paying attention to a set of instructions/directions
• Watching a movie

And because depression causes attention problems, projects are often left half-done and unfinished. Unfortunately, the person with depression may view this as a failure on his or her part rather than seeing it for what it is: a symptom of depression.

Additionally, tasks that require divided attention, such as multitasking, also suffer during a depression. Engaging in a conversation while completing another task is an example of something that can be very difficult. Depression and a lack of concentration may negatively impact a person's employment where multitasking is often required.

Treatment for Depression and Concentration Problems

There is no specific treatment for concentration problems in depression but there are techniques used to treat cognitive deficits in depression and in general. This can include things like drills and exercises, learning compensatory strategies and using external devices (such as voice recorders) to improve, or work around, cognitive deficits.

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