Background
Review
Cognitive symptoms during depression
Cognitive function/domain | Complaint | Impact on everyday life | Report of patient | Exploratory questions |
---|---|---|---|---|
Attention | Loses track of thoughts Cannot pay attention Difficulty concentrating | Cannot absorb information during conversation, watching a movie, or reading Cannot concentrate on tasks Lack of motivation | “I can’t concentrate” “It seems as if I don’t pay attention to anything” | Is it difficult for you to read a magazine or to work with data at your workplace, or pay attention to tv or in a conversation? |
Memory | No short term memory Forgetfulness Cannot count | Does not remember everyday tasks Needs lists and notes Feels old Loses or forgets things At the workplace feels embarrassed and stupid | “I forget everything” “I forget tasks, dates, meetings, and it is especially inconvenient at my workplace” | Does it happen that you can not find your keys, you do not remember names, or what you need to buy, or you lose track of tasks to do at home or work? |
Executive functions | Procrastination and delaying No self-confidence Inability to decide Cannot deal with more than one thing simultaneously | Not enough self-confidence for decisions Is afraid and anxious because of consequences Avoids making decisions, is anxious because of decisions and delegates them to others Procrastination | “I can’t decide in anything” “I don’t dare to decide” “I can’t make up my mind” | Is it difficult for you to make decisions at home or at work? Does it require a big effort to start or complete tasks at home or work due to this? How does this influence your everyday life? |
Psychomotor speed | Brain is foggy Slowed movement Tiredness, lethargy | No energy The smallest task takes a long time Feels slowed down, and feels brain is not working Cannot think | “My brain feels blocked” | Do you feel your thinking is significantly slowed down? |
Cognitive distortions and logical fallacies | |
---|---|
Dichotomous/all or nothing thinking | Absolute and black-and white thinking, refusing anything which includes any minor imperfections |
Overgeneralisation | Generalization based on a single experience of failure, perceiving a single negative event as an endless series of failures |
Negative filter/selective abstraction | Designating the whole situation as negative based on a single negative detail, disproportionate attention to negative details and ignorance for positives |
Discounting positives | Successes, accomplishments and positive characteristics do not count |
Jumping to conclusions | Negative conclusions in the absence of evidence; supposing without any basis that others will react in a negative way, the person continuously expects things to end badly |
Magnification/minimization | Arbitrary and disproportionate maximization of own faults and negative events, arbitrary and disproportionate minimization of good characteristics or events |
Emotional reasoning/logic | Reasoning based on emotions, treating negative emotions as facts, and drawing conclusions based on them |
“Should” statements | Formulating expectations as primary motives, criticizing self and others with should and must not statements |
Labeling | Identifying self with own mistakes, applying these labels instead of admitting and acknowledging own mistakes |
Personalisation and blame | Holding self responsible for something the person has no control over or something the person is not responsible for, or blaming others ignoring own role |