The Cognitive Symptoms of Depression Psych Cent

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DEPRESSION Quiz Symptoms Causes Treatment
What Are the Cognitive

Symptoms of Depression?
Medically reviewed by Danielle Wade, LCSW — By Nancy
Lovering — Updated on November 9, 2021
Attention Learning Executive function

Processing speed Treatments Recap
Depression can have both physical and

mental aspects. Learning about its
cognitive symptoms can help you
understand its effects.
Depression does more than deplete your energy

and motivation. It can also bring about physical and
cognitive changes that impact your daily life.
If you experience cognitive declines as a result of

depression, you may notice a difference in your
executive functioning, which includes planning,
problem solving, and decision making. Depression
can also affect learning and memory, attention and
concentration, and processing speed.
If left untreated, your symptoms of depression may

last longer and become more severe over time.
The good news is that there are treatments that can

improve your mood and cognitive abilities long-
term.
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Reduced attention and concentration

There are many reasons a person might have
trouble paying attention or concentrating, such as
fatigue or lack of interest. Depression can also
cause this issue.
You might be experiencing depression-induced

attention and concentration problems if you:
catch your mind wandering more than it has in

the past
make careless errors with tasks you know well
miss parts of conversations
lose track of your surroundings
can no longer multitask
feel overwhelmed by distractions
If this sounds familiar, it’s important to remember

that it’s not a reflection of your intelligence. It just
means that your depression is making cognition
more challenging than it needs to be.
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Impaired learning and memory

An impaired ability to remember is another example
of how depression affects cognition. Learning also
suffers, since memory is part of acquiring new
information.
If you’re experiencing a change in your memory and

learning ability, you might:
need to reread the same material more than

once
forget things that you’ve just heard
feel confusion more than you have in the past
miss appointments
misplace items more often than you use to
make uncharacteristic errors at work
One theory for the connection between depression

and poor memory is a disruption in dopamine
activity during memory encoding.
Dopamine release is part of the formation of stable

memories. Since depression is linked with lower
dopamine reward signaling, this may make it harder
for memories to form.
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Executive dysfunction
Executive function refers to higher-level thinking.
The executive functioning system is sometimes

called the CEO of the brain, because of the way it
allows you to supervise your own thinking. You use
executive functioning to manage your life and reach
your goals.
Depression can cause executive dysfunction. If

you’re experiencing this, you may notice changes in
your ability to:
plan
solve problems
make decisions
manage your time
control impulses and emotions
take initiative
You’re not alone, and it’s not your fault.
A study  featuring 448 participants uncovered

cognitive changes in students with depression.
They experienced executive dysfunction in the
following areas:
memory
inhibition control
planning
flexibility
Other students in the same study who had stress

and anxiety experienced similar brain changes.
Another study involving 1,123 college

undergraduates revealed similar results. Depressed
mood interfered with their ability to maintain task
goals and caused executive function deficits.
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Lower processing speed

Processing speed is the rate at which you can
acquire information, assess it, then respond.
Sometimes depression can slow your processing
speed.
A slower processing speed could mean that you

sometimes:
miss social cues
need more time to make decisions
feel overwhelmed by a lot of input at the same

time
have trouble following instructions
need to reread information before you

understand what you’ve read
Research indicates that people experiencing

depression have a slower processing speed and
reaction time for the things they see, except for sad
faces, which generate a faster response. This
suggests that people with depression have a bias
towards negative information.
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How is depression treated?

Since depression creates symptoms in more areas
than just mood, effective treatment for depression
should be a combined approach. You might have
more than one person involved in your care, like
your family doctor and a therapist.
Mood
Medication can help to ease the mood changes that

accompany depression. There are several types to
choose from. Consulting with your doctor to discuss
the benefits and side effects of each is a good way
to find a medication that can help.
Some medication options include:
Selective serotonin reuptake inhibitors

(SSRI): sertraline (Zoloft), paroxetine (Paxil),
escitalopram (Lexapro)
Serotonin and norepinephrine reuptake

inhibitors (SNRIs): duloxetine (Cymbalta),
venlafaxine (Effexor XR)
Tricyclic antidepressants (TCAs):

clomipramine (Anafranil), imipramine (Tofranil)
Medications for depression work by balancing the

neurotransmitters in your brain. These chemicals
affect health and wellbeing in numerous ways, so
having the right amounts at the right times can be a
tremendous help.
Talk therapy may also help to ease a depressed

mood. An effective option is cognitive-behavioral
therapy (CBT). This therapy explores the underlying
thoughts that can affect the way you feel.
The goal of CBT is to identify the thoughts that are

bringing you down. Your therapist can help you
examine the accuracy of those thoughts and
replace them with more realistic ones that are more
helpful. CBT is also about understanding learned
behaviors that may be maladaptive and connecting
with unhealthy means of coping.
Cognitive changes
Cognitive remediation therapy (CRT) may be able to

help with some of the brain changes brought about
by depression.
CRT involves training individual cognitive skills so

they can be applied to real-life situations later. For
example, computer or pencil and paper tasks target
areas like sustained attention and working memory.
Physical effects
Depression can cause physical changes as well as

emotional and cognitive ones. If you live with
depression, you might also experience issues like:
back pain
sleep disruption
fatigue
aches and pains
headaches
nausea
Some of these issues may fade as you get

treatment for mood and cognitive issues, or some
may persist and need their own treatment. It’s
helpful to communicate regularly with your doctor
about how you’re feeling so that your treatment can
be adjusted as needed.
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Let’s recap
Depression affects more than just emotion and
mood. It can also change the way your brain
functions.
The potential cognitive changes from depression

include executive dysfunction, impaired learning
and memory, reduced attention and concentration,
and lower processing speed.
Treatment is available to help. Medication and

therapy can treat mood and emotional symptoms,
and cognitive remediation therapy can help to
repair depression-related brain changes. Physical
symptoms may fade as you progress with treatment,
or you may need additional treatment.
Learn more about how to cope with depression

here.
Last medically reviewed on November 9, 2021
 10 sources
Ajilchi B, et al. (2017). Executive functions in students

with depression, anxiety, and stress symptoms.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5535328/
Cognitive remediation therapy. (2020).

https://www.sciencedirect.com/topics/medicine-and-
dentistry/cognitive-remediation-therapy
Dillon D. (2015). The neuroscience of positive memory

deficits in depression.
https://www.frontiersin.org/articles/10.3389/fpsyg.2015.0
1295/full
Executive functions. (2021).

https://memory.ucsf.edu/symptoms/executive-functions
Keller A, et al. (2019). Paying attention to attention in

depression.
https://www.nature.com/articles/s41398-019-0616-1
Perini G, et al. (2019). Cognitive impairment in

depression: recent advances and novel treatments.
Warren S, et al. (2020). The structure of executive

dysfunction in depression and anxiety.
https://www.sciencedirect.com/science/article/abs/pii/S0
165032720328299?dgcid=rss_sd_all
What is cognitive behavioral therapy? (2017).

https://www.apa.org/ptsd-guideline/patients-and-
families/cognitive-behavioral
What is depression? (2020).

https://www.psychiatry.org/patients-
families/depression/what-is-depression
Zuckerman H, et al. (2018). Recognition and treatment of

cognitive dysfunction in major depressive disorder.
https://www.frontiersin.org/articles/10.3389/fpsyt.2018.0
0655/full
v  FEEDBACK:  
Your Guide to Treating

Depression Naturally
Medically reviewed by Lori Lawrenz, PsyD — By
Hilary I. Lebow on August 3, 2021
Vitamins Supplements Herbs

Techniques and exercises Psychedelic therapy
Foods Natural remedies vs. medication
Takeaway
Cultures around the world have used

natural options for ailments like
depression since ancient times. Here’s
what the research says.
kate_sept2004/Getty Images
If you live with depression, you may feel like you

want to tackle it from all directions: therapy,
medication, lifestyle changes, and natural remedies.
But which ones are safe?
Complementary or alternative medicines (CAM) are

becoming more respected in the Western model of
medicine, as researchers study them in clinical
settings.
As with every depression treatment, there’s no one-

size-fits-all approach. Some remedies may help as-
is if your symptoms are mild, but in most cases, they
should be considered complementary to other
therapeutic approaches, not a replacement for
them.
If you’re interested in trying CAM to help treat your

depression, it’s important to work with your
treatment team to figure out the best and safest
plan for you.
A note on supplements
Getting nutrients from the foods you eat is
almost always the better choice.
If you’re interested in trying a supplement to

boost your intake of a certain nutrient, it’s best
to speak with a healthcare professional first to
discuss the best dosage and any potential
risks. Some supplements can interact with
certain medications or be harmful if you take
too much.
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Vitamins for depression

Science has found a link between various vitamins
and mood. In some cases, a deficiency in certain
nutrients may be linked with depression symptoms,
in other cases, a higher intake of certain vitamins
may be associated with improved mood. Quite
often, however, research is mixed.
Vitamin D
The research on vitamin D and depression is mixed.

Several studies have noted the link between vitamin
D deficiency and depression symptoms.
Yet a recent study  with more than 18,000

participants found that vitamin D supplementation
did not help boost people’s mood in a significant
way.
Still, you may find some benefits. You can get

enough vitamin D through spending time in the sun,
supplementing with cod liver oil, or eating certain
foods.
Dietary sources of vitamin D include:
beef liver
cheese
eggs
fortified products like milk
mushrooms
oily fish, like salmon and sardines
Vitamin C
Research shows that vitamin C helps regulate

neurotransmitters like dopamine, the “feel-good”
chemical, along with norepinephrine and
epinephrine.
Some studies  show that vitamin C

supplementation can help improve mood, while
others  note little difference between those who
take vitamin C and those who do not.
A review of the existing literature suggests that

more studies are needed to be sure.
You may already know that oranges are rich in

vitamin C, but that’s not all. Other sources include:
broccoli
Brussels sprouts
citrus fruits
peppers
potatoes
strawberries
Magnesium
Research shows a link between low magnesium

levels and depression, but a consensus on how
exactly the two are related has not been reached.
Interestingly, a study of more than 17,000 adults

found that daily magnesium supplementation was
helpful for women but not men.
Yet other studies show it can be helpful for all,

regardless of sex. One study found that taking 500
milligrams a day for 8 weeks could improve
symptoms of depression.
In addition to supplements, magnesium can be

sourced from:
avocados
bananas
dark chocolate
legumes
nuts
tofu
seeds
Calcium
Research  shows a connection between low levels

of calcium and depression, but so far the evidence
for whether supplements help is inconclusive.
To try increasing your levels of calcium through

food, consider adding more:
cheese
dark leafy greens
milk
sardines
soybeans
yogurt
Zinc
While there is older research  to show that zinc can

help symptoms of depression, newer research does
not indicate statistically significant improvement.
More research is needed.
Still, you may find that it works for you. Beyond

supplements, zinc can be found in:
beans
milk
nuts
seafood
seeds
Folate (vitamin B9)
Folate (vitamin B9) has long been suggested  to

improve how well antidepressant medications work,
and newer research shows that those with
depression have lower folate levels.
A combination of folate and vitamin B12 may ease

symptoms, according to one study.
Vitamin B9 exists in its natural form, folate, and as

an artificial form, known as folic acid. To ensure
people get enough vitamin B9 through their diet,
some foods like certain grains are often fortified
with folic acid.
Folic acid supplements are also available. However,

getting too much folic acid through supplements
may come with health risks, as unmetabolized folic
acid can build up in your blood.
Food sources of vitamin B9 include:
asparagus
broccoli
Brussels sprouts
leafy greens
sunflower seeds
peanuts
fortified grains
Niacin (vitamin B3)
Niacin  (vitamin B3) helps synthesize tryptophan

into serotonin, a neurotransmitter that helps
regulate your mood.
There is not enough research to show that niacin

can help improve depression symptoms alone, but
some studies suggest that a combination of B-
vitamins may help.
There have also been positive findings  for niacin

and mood disorders like bipolar II.
Sources of niacin include supplements, as well as:
eggs
dairy products
fish
legumes
nuts
poultry
Vitamin B12
There is some older research  to show that taking

vitamin B12 with antidepressants can improve how
well they work.
While there is not enough new evidence to show

that B12 can directly improve mood, there is a
correlation between low levels of this vitamin and
depression symptoms.
Supplements aside, dietary sources of vitamin B12

include:
eggs
fish
milk
nutritional yeast
poultry
tempeh
Supplements for depression

If you find it challenging to get all the nutrients you
need from diet alone, supplements may help. Still,
it’s important to speak with a healthcare
professional before trying a new supplement to
determine the best dosage and discuss potential
side effects or medication interactions.
Probiotics
Probiotics are live bacteria that aid your digestion

and destroy cells that cause disease.
Some say  the second brain is in the gut, and for

good reason. There’s a growing body of research 
in support of using probiotics for depression.
One recent study showed that people with major

depressive disorder (MDD) had improved symptoms
in just 8 weeks.
Sources of probiotics include:
kefir
kimchi
kombucha
miso
sauerkraut
tempeh
yogurt
Omega-3 fatty acids
Omega-3 polyunsaturated fatty acids give your

heart, immune system, and endocrine system
(hormones) ample energy to function.
A recent review study  of 180 articles found

positive effects of omega-3 fatty acids on
depression, compared with placebo treatment.
Other studies have shown that omega-3 fatty acids

are safe for pregnant women, children, and seniors
alike, and they do not have side effects .
Omega-3s can be found in fish or vegan algae oil

capsules, as well as:
chia seeds
cold-water fish
flaxseeds
walnuts
soybeans
SAMe
S-adenosyl-L-methionine (SAMe)  is a natural

compound synthesized from methionine, an amino
acid (the building blocks of protein) found in your
diet.
While there have been at least 40 studies on SAMe

and depression with some positive results, the
evidence is not conclusive.
One study  found that SAMe performed better than

placebo, but the evidence was considered low to
very low quality.
Another study  observed that SAMe may help

symptoms of neurocognitive, substance use, and
psychotic disorders, but the body of evidence there
is limited, too.
Still, you may find it helps. Beyond supplements,

sources of methionine include:
Brazil nuts
egg whites
seafood
sesame seeds
sunflower seeds
NAC
N-acetyl cysteine (NAC) is a precursor to L-cysteine,

an amino acid found in your body.
Research from 2018  and 2020 explored this

supplement as adjunctive therapy to treatment-
resistant depression and depression-induced
anxiety with promising results.
Studies have shown that it can also be used

alongside antidepressant medications, though more
research is needed in this area.
You can supplement with NAC or find it in foods

high in protein, including:
eggs
legumes
poultry
sunflower seeds
yogurt
GABA
Gamma-aminobutyric acid (GABA) is a

neurotransmitter produced by the body to promote
relaxation, regulate sleep, and prevent depression.
For those who live with depression, research shows

there may be abnormalities with the GABA system
in the brain.
Currently, there is not much evidence on how well

GABA reaches the brain in supplement form.
Studies  suggest it only changes brain levels in
small amounts.
A 2020 study  shows supplements may have some

positive effects on sleep and stress.
It’s too soon to say whether this is an effective

treatment for depression. It may be more beneficial
to do activities that promote GABA, like exercise
and meditation.
Apart from supplements, foods that stimulate GABA

include:
berries
brown rice
lentils
seafood
potatoes
tomatoes
Melatonin
Melatonin is a hormone naturally produced by your

body. It keeps your circadian rhythm in check and
lets you know when it’s time to go to sleep.
The research on whether a supplement of

melatonin can help depression is mixed. A 2016
study found that it may actually cause short-term
depression.
On the other hand, both a 2017  and 2018  review

found that it may help depression symptoms in
some people.
You can support melatonin production with

supplements or foods  including:
cherries
eggs
fish
grapes
peppers
tomatoes
mustard seeds
Creatine
Creatine is an organic compound obtained through

animal products like:
milk
poultry
red meat
seafood
It’s stored in your muscles and used to build lean

muscle mass and improve energy.
It’s a popular sports supplement, but recent

research  suggests that it may also have an
antidepressant effect for those who live with major
depressive disorder.
New research also suggests that increasing

creatine in the prefrontal cortex of your brain may
improve mood, but more research is needed.
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Herbs for depression

Herbal remedies have been used around the world
for centuries to help relieve symptoms of
depression. It’s good to keep in mind that research
on the effectiveness of these herbs is often limited.
St. John’s wort
St. John’s wort is a flowering plant native to Europe.
It’s well-documented to improve mood in the short

term. In fact, research shows it’s on par with SSRI
medications for mild to moderate depression.
A word of caution
St. John’s wort should not be used with certain
antidepressant medications because it could
cause serotonin syndrome . Do not mix it
with:
citalopram (Celexa)
fluoxetine (Prozac)
fluvoxamine (Luvox)
nefazodone (Serzone)
paroxetine (Paxil)
sertraline (Zoloft)
Rhodiola
Rhodiola rosea is a flowering plant native to Arctic

European regions. It’s an adaptogenic herb,
meaning it helps your body adapt to stress.
So far, a small body of research suggests that

rhodiola may be effective for treating mild to
moderate cases of depression, though more studies
are needed.
A 2020 study even found that rhodiola was safe to

use in tandem with sertraline (Zoloft) and that it’s
effective for symptoms of major depressive
disorder.
Turmeric
What can’t turmeric do? This ancient Indian spice,

and its main active ingredient curcumin, seems to
cover a wide array of ailments, depression included.
While more research is still needed, several clinical

trials  have shown promising results for turmeric in
the treatment of major depressive disorder.
To date, no adverse effects have been reported in

any studies.
Saffron
Saffron is a rich crimson spice from Iran. It’s been

used medicinally since ancient times.
An older meta-analysis  of five studies found that

saffron was effective for treating symptoms of major
depressive disorder.
More recent research  shows that a dietary

supplement of saffron may be more effective than a
placebo in cases of mild to moderate depression.
One study  even found that saffron has equivalent

effects to therapeutic doses of antidepressant
medications like imipramine (Tofranil) and fluoxetine
(Prozac).
There are no known negative drug interactions for

saffron, though you shouldn’t take it if you’re
allergic to olives.
Chai hu
Chai hu is a flowering plant that’s been used in

Chinese Traditional Medicine (CTM) for more than
2,000 years.
Research  suggests that the herb’s antioxidant

activity is responsible for its antidepressant effect.
A recent systematic review  of 42 studies found

that chai hu is safe and effective, particularly for
those with post-stroke depression or postpartum
depression.
Maca
Maca comes from a plant native to Peru. It’s typically

ground up into a fine powder.
In 2015, a small study  found that maca reduced

depression symptoms in postmenopausal women.
Recent research on rats shows that maca can have

an antidepressant effect while increasing learning
and memory.
Techniques and exercises for

depression
To support your treatment, there are several
lifestyle modifications you can make.
Exercise
Research shows that exercise can be effective in

reducing symptoms of depression, due to the
release of feel-good neurochemicals, like
endorphins.
Depression symptoms can make it hard for some

people to get motivated to lift weights or do
vigorous physical activity. Some other movement
ideas include:
bicycling
dancing
gardening
swimming
walking
Meditation
A large body of research suggests that meditation

can reduce symptoms of depression and anxiety,
among other mental health conditions.
Some studies show that it’s even on par with or, or

effective than, physical exercise.
Studies  suggest that positive results can be

sustained well after 6 and 12 months, if you keep up
with the practice.
Yoga
Research  shows that yoga can improve symptoms

of depression and anxiety. In fact, some studies
suggest the more times a week you do it, the better
you may feel.
Note that some research has shown that yoga may

not be an appropriate stand-alone treatment for
therapy-resistant depression.
You may find it helpful to try free YouTube yoga

instructions like Yoga with Adrienne at home, or
book a restorative or yin yoga class at a nearby gym
or studio.
Psychedelic therapy
There is growing support behind psychedelic
therapy for the treatment of depression, anxiety,
PTSD, and other mental health conditions.
The psychedelics most commonly used for drug-

assisted therapy include:
ayahuasca 
LSD 
MDMA 
psilocybin, found in “magic mushrooms”
A small 2017 study showed positive outcomes for

treatment-resistant depression. After two doses of
psilocybin in a therapeutic setting, the majority of
the study participants still had reduced symptoms of
depression 3 and 6 months later.
A small 2020 study  of 24 participants with major

depressive disorder found that psilocybin provided
“large, rapid, and sustained antidepressant effects.”
A 2021 study of 164 participants noted a marked

improvement in symptoms of depression, anxiety,
and stress, such as rumination.
An important note on legality

Psychedelics are still illegal in the majority of
states and countries around the world. There
are some exceptions in clinical settings. To
locate an upcoming study near you, refer to
the Multidisciplinary Association for
Psychedelic Studies (MAPS).
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Foods for depression

Due to something called the gut-brain axis, research
shows that a healthy diet is linked with reduced
symptoms of depression.
Vitamins and minerals linked with lowered

depression can be found in a variety of ingredients.
These include:
citrus fruits for vitamin C

dark chocolate for magnesium
eggs for niacin
fish for omega-3 fatty acids
leafy greens for calcium
nuts for zinc
poultry for vitamin B12
seeds for folate
Research  shows that probiotics like kimchi,

kombucha, miso, sauerkraut, and yogurt may also
help improve symptoms of depression.
Many studies on the Mediterranean diet, in

particular, show reduced symptoms of depression,
anxiety, and stress.
This lifestyle emphasizes whole, unprocessed,

nutrient-rich foods including:
ancient and whole grains
fruits
lean cuts of meat of fish
nuts
olive oil
seeds
vegetables
Natural remedies and medication for

depression
For those with moderate to severe depression,
between 40% and 60%  of people experience
improved symptoms with the use of
antidepressants.
Natural remedies are a bit trickier to measure 

since the evidence relies on self-reporting, there
are more variables, and more research is needed
across the board.
In either case, your symptom relief will depend on

how severe your symptoms are.
Keep in mind that some supplements, like St. John’s

wort , can have negative interactions with
medications.
Always speak with your doctor before you add a

new element to your self-care regimen.
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Let’s recap
Depression is complex. There’s no one-size-fits-all
treatment. What works for one person may not work
for you.
An integrated approach — like talk therapy,

medication, lifestyle changes, and natural remedies
— may help you improve your symptoms.
If possible, consider a diet of whole, unprocessed,

nutrient-dense food to get the most vitamins and
minerals working for your mind and body.
You may also want to incorporate a regular

meditation practice, exercise, or yoga.
Most importantly, try not to lose hope. With the right

treatment plan and some patience, depression is
manageable. You are not alone and healing is
possible.
Last medically reviewed on August 3, 2021
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DEPRESSION Quiz Symptoms Causes Treatment

What Are the Cognitive

Attention Learning Executive function

Depression can have both physical and

Depression does more than deplete your energy

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Cognitive remediation therapy (CRT) may be able to

CRT involves training individual cognitive skills so

Depression can cause physical changes as well as