Today we discuss the "chicken or the egg" mental processes that seemingly influence and maintain the life-corrupting experiences of depression, while making willful recovery near-impossible.
summary
The conversation details the complexities of cognitive depression, emphasizing that it is not a choice but a state influenced by brain behaviors. Explicit and overgeneralized memories, negative interpretation of ambiguous events, poor inhibition of processing, irrelevant working memory contents, and deficient emotional regulation strategies resulting from all of the above paint the picture. We highlight the challenges of self regulation during cognitive depression and the added effects of self-beratement.
takeaways
- Brain behaviors can create and sustain a state of depression; this is not a choice.
- Verbal memory is more negatively slanted in depressive spells.
- Over general and under-detailed memories are shown to interrupt depression patients.
- Mental processing demonstrates a bias towards negative material; disengagement and elaboration are affected.
- Depression does not cause negative hypervigilance, but negative attention is sustained.
- Inhibition of processing and clearing of working memory contents are decreased with depression.
- Without the ability to clear working memory of irrelevant information, functionality declines.
- For all these reasons, effective emotional regulation tools (reappraisal) are hard to implement during cognitive depression.
keywords
cognitive depression, explicit memory, overgeneralized memory, interpretation bias, inhibition, working memory, processing elaboration, emotional regulation, self-beratement, brain behavior
Cog Dep Part II
And we continue! Returning to
Cognition and Depression: Current Status and Future Directions
Ian H. Gotlib, Jutta Joormann
Annu Rev Clin Psychol. 2010
To better understand the mechanisms of cognitive depression. To comprehend the brain, as it automatically makes our emotional and life experience. To increase compassion for ourselves and others, because we’re all trapped in these neurons.
So, we have at least one less thing to feel uncontrollably negative about.
Last time we discussed the neural network nature of depression; the manner in which one single stimulatory event, even, can instantaneously light up complex thought and emotional patterns related to past experiences with depression. Kicking us into the pit, once more, as a whole unit rather than a step by step transition. Like we’re on the unfortunate end of a foot in the movie 300.
Which might explain why you can’t encounter a particular song or smell or human being without suddenly skinnydipping in clinical levels of depression.
And to continue that conversation, let’s address some deeper theories of cognitive depression onset, maintenance, and relapse. Starting with a so-assumed penchant for perceiving and remembering everything negatively.
Gotlib and Joormann say:
BIASED PROCESSING OF EMOTIONAL INFORMATION IN DEPRESSION
Cognitive models of depression posit that depressed individuals exhibit cognitive biases in all aspects of information processing, including memory, interpretation, and perception and attention (Mathews & MacLeod 2005). While these theoretical predictions are straightforward, the empirical results are not. For example, a current controversial question concerning cognitive theories of emotional disorders is whether there are, in fact, negative biases in memory, interpretation, and attention in depression.
Let’s find out.
Is depression about biased recollections?
MEMORY
Preferential recall of negative compared to positive material is one of the most robust findings in the depression literature. Matt et al 1992 found that people with major depression remembered 10% more negative words than they did positive words. It should be noted, however, that memory biases are found most consistently in free recall tasks, and may be restricted to explicit memory.
Note there, they said “may be restricted to explicit memory.” And, fascinatingly, the other hand…
Watkins (2002) reported that, across studies, no bias is found in depressed participants when the encoding and/or the recall of the emotional material depend purely on perceptual processing.
Taken together, these results suggest that when the memory is associated with WORDS – when it is semantic or verbal in nature – a negativity bias may exist. But when the memory is sensory-based (perceptual), no negativity bias was found. Which runs counter to what one might expect from the old information about depression.
I’m making a new college course right now, so it’s top of the mind to share with you that cognitive word processes are also associated with more disturbing anxiety, memory fragmentation, and PTSD. The verbal nature of the human mind may be the asshole, whereas our visceral, implicit, experiential memories seem to be less negatively affected and affective.
But, that said, recall the “like-elicits-like” rule of brains. When we’re in a negative state, we retrieve (and only have access to) memories that are similarly valanced.
Meaning the potential memory problems don’t stop with words. Once depressed, depressing recollections are the norm. And also, we can get struck revisiting particular memories repetitively.
They say:
Depression is associated not only with enhanced recall of negative events, but also with the recall of rather generic memories, despite instructions to recall specific events.
And this is where we hear about “over general memories.” In behavioral science, generalization means a behavior is “lacking specificity; it’s abundantly applied to situations which may not be appropriate.” The same is true here. These are recollections that lack detail and accurate activation, but come up often.
Williams (1996) proposed that over general memory is a form of emotion regulation. That is, individuals attempt to minimize negative affect attached to distressing memories by blocking access to details of such memories or by retrieving these memories in a less specific way.
Research has demonstrated that over general memories are associated with difficulties in problem solving, with deficits in imagining specific future events, and with longer durations of depressive episodes.
In sum… depression is associated not only with increased accessibility of negative material, but also with the recall of over general memories.
This might help explain why your mind revisits a scene or period of time, often, intrusively, distractingly… but perhaps without full context… when depressed. And why depressed people can sound like broken records. And how those words, themselves, may be causing a bottlenecking negative slant to all other memories. And how these automatic brain behaviors cause downstream functionality disturbances.
But, these negative memory biases still don’t explain everything. So lettuce ask:
Could depression also be about biased interpretation – cognitive-emotional skewing - of events?
There is consensus that anxious individuals favor negative interpretations of ambiguous stimuli and often do so in tasks that indicate that these biases operate on an automatic level. Results have been much more equivocal (ambiguous) regarding whether depression is characterized by similar automatic biases in interpretation.
Butler & Mathews (1983), for example, presented clinically depressed participants with ambiguous scenarios and found that, compared to nondepressed participants, depressed individuals ranked negative interpretations higher than they did other possible interpretations.
So, just as is the case with PTSD – a comorbid disorder – when presented with uncertainty or the unknown, a depressed brain is more likely to predict negative qualities, events, or outcomes.
But remember, human brains are expertly terrible at anticipating the future. Especially when it comes to our own emotional responses. Per the research, we are “remarkably poor” executors of emotional forecasting. And we base our predictions on what has happened already.
Meaning, again, once we’re in a negative state, we assume everything will be negative. Which is simply how the brain functions. And once more doesn’t explain the full depths of cognitive depression.
So, we ask… If depression is not all about memory or interpretation, could depression be due to biased attention? What we allow or encourage ourselves to perceive?
Numerous investigations using a number of different tasks have provided evidence in anxiety disorders for biased processing of subliminally presented anxiety provoking stimuli (e.g., Bradley et al. 1995, Mathews et al. 1996). Strikingly, few studies to date have found similar biases in clinically depressed participants
Importantly, using an emotion Stroop task, Bradley et al. (1995) found that only patients with GAD who were not comorbid with depression exhibited biased processing for negative words; GAD patients who were also diagnosed with depression did not differ from the control participants.
This suggests that anxiety alters our attentional absorption of events, as we discussed earlier this year. But depression combined with anxiety, somehow, isn’t evidenced to have the same effect.
The brain exerts extra processing power when presented with negative material when the individual is anxiety-ridden. Shockingly, based on everything you’d expect, the brain doesn’t necessarily show the same attentional bias towards negative stimuli when depressed.
At least… not initially. Let’s look for more clues about the effects of depression on attention.
Empirical findings that depression is associated with faster identification of mood-congruent material or a faster orienting toward negative stimuli are mixed.
Importantly, there is empirical evidence to support these predictions. These findings suggest that depression is associated with a selective bias for negative information, but that this bias does not operate throughout all aspects of attention. Depression appears to be characterized by problems with disengagement from negative stimuli.
Taken together, research evidences that anxiety causes rapid, immediate, orienting towards potentially negative material that begins in pre-cognition. Anxiety, in other words, holds hands with negative hypervigilance.
Depression, in contrast, causes a mind to HANG ON to potentially negative material. It might not immediately predict and orient towards the unpleasant stimulation, but once that information has been perceived, the brain won’t let go. At this point the attentional bias towards negative substrate can be measured.
Which explains why I call depression “gloomy hands” – they grab you and can’t quit. And also brings us to our next topic.
What’s going on with the mind’s “stop signal” and why doesn’t it ever come?
INHIBITION AND COGNITIVE CONTROL
Overriding prepotent responses and inhibiting the processing of irrelevant material that captures attention are core abilities that allow us to respond flexibly and to adjust our behavior and emotional responses to changing situations. Difficulties disengaging attention from negative material may reflect deficits in inhibitory control that are associated with depression.
Executive processes must selectively gate access to WM, shielding it from intrusion from irrelevant material, and must also discard information that is no longer relevant. Increased interference from irrelevant representations has been proposed as a source of low WM capacity (Engle et al. 1999) and has been found to characterize various populations, including older adults (Hasher et al. 1991), children with attention deficit disorder (Bjorklund & Harnishfeger 1990), patients with obsessive-compulsive disorder (Enright & Beech 1990), and patients with schizophrenia (Frith 1979).
There is emerging evidence that depression is characterized by difficulties in the inhibition of mood-congruent material that could result in prolonged processing of negative, goal-irrelevant aspects of presented information and thereby hinder recovery from negative mood and lead to the sustained negative affect that characterizes depressive episodes.
In particular, the observation of negative automatic thoughts and ruminations about negative information in depression leads to the hypothesis that there is a valence-specific inhibitory deficit in depression in which inhibition is selectively reduced for negative stimuli.
In other words, the ability to halt a thought pattern is halted, allowing the brain to continually carry on with its negative focus.
These findings indicate that depression is associated with inhibitory impairments in the processing of emotional material, specifically, with difficulties removing irrelevant negative material from WM… reflecting the strength of the residual activation of the contents of WM that were declared to be no longer relevant.
In sum, the literature… does not indicate that depression is associated with biases in all aspects of information processing; rather, it suggests a very specific difference between depressed and nondepressed individuals in cognitive functioning.
Depression is not necessarily characterized by a general cognitive deficit or by a high level of alertness in the processing of negative material. (However) Once negative material has become the focus of attention.. depressed individuals are prone to elaborate on it and have difficulty stopping or inhibiting the processing of this material.
You’re not a “negative Nancy” or “Debbie Downer”… until life gives you reason. At which point the brain has difficulty disengaging and redirecting attention elsewhere. Which impairs working memory and daily functioning.
So, lastly for today, if depression includes biased elaboration of negative material only once it has been started… how does this effect emotional regulation?
COGNITIVE BIASES AND EMOTION REGULATION IN DEPRESSION
There is evidence both that depression is characterized by difficulties disengaging from negative material and that difficulties in disengagement are related to impaired emotion regulation.
… More frequent use of certain (emotional regulation) strategies (e.g., emotion suppression, rumination, catastrophizing) and less-frequent use of other strategies (e.g., reappraisal, self-disclosure) are related to symptoms of depression and anxiety (Garnefski & Kraaij 2007).
Given depressed people’s difficulties in disengaging from negative material, their ability to use attentional deployment as a regulatory strategy is likely to be impaired.
As we’ve discussed, attention and inhibition of attention are corrupted by depression. It’s not as simple as “just disengaging,” “willfully forgetting,” or authentically “choosing to look on the bright side,” because the mind won’t allow it to happen.
Reappraisal is also an important emotion-regulation strategy.
Individual differences in cognitive control… can influence a person’s ability to reappraise events. Biases in attention and memory (which, we’ve learned, are characteristic of depression once they’ve been kickstarted with negativity) may lead to inflexible and automatic appraisals that make it difficult to use deliberate reappraisals of situations to regulate emotions.
Meaning, depressed individuals can’t stop their attention and recollection from spinning around negative events in order to open up emotional neutrality or cognitive capacity within their working memory. And therefore they can’t take on new perspectives of those events. They can’t process them differently. They can’t find emotional relief within those altered narratives.
The mind, instead, returns to negative memories – especially those defined verbally – achieves and sustains a similar emotional state, this causes attention to shift towards similarly weighted stimuli, and then the mind’s processor (working memory) spins between those negative feelings, observations, and recollections without an internal “stop” sign being presented. Which comes with the opportunity cost of having alternative, more positively valanced, feelings, observations, and recollections. Which reduces the emotional regulation tools available to the sufferer while trapping them in a dark dungeon of the mind.
And this is how cognitive processes develop and deepen depression. Without the conscious desires of the individual having the power to override the negatively framed experience they become stranded within.
SUM
In sum, depression is characterized by a specific pattern of biased processing of emotional material that includes increased elaboration of negative information, difficulties disengaging from negative material, and deficits in cognitive control when processing negative material.
Because the experience of negative mood states and negative life events is associated with the activation of mood-congruent cognitions in WM, the ability to control the contents of WM is likely to be critical in differentiating people who recover easily from negative affect from those who initiate a vicious cycle of increasingly negative ruminative thinking and deepening sad mood.
Which is where we’ll pick up next time, as we investigate a cognitive process we’ve barely touched upon so far.
The role of rumination in depression.
From there, we’ll talk about what we can do about all of it. Applying these findings to real life, based on the suggestions of clinical treatments and academic research.
Til then, remember…
You’re not choosing to be depressed.
Even without a chemical imbalance, the brain’s behaviors can select and sustain this state for you.
And with precious few working memory resources available, due to the inappropriately lingering negative material consuming them, it’s not easy to function, let alone carry through with emotional regulation tools, once under the spell of cog dep. So committing additional attention to self-beratement is only tapping you and trapping a Fucker further.
Hail yourself. I’ll talk to you soon. Cheers. And take gentle care.