Depression is one of the most frequent psychological disorders today, reaching prevalence rates in Spain of up to 4 percent in the general population, according to the 2006 ESEMeD study. This is especially relevant since it has been estimated that,In our country, the annual expenditure for cases of depression amounts to more than 5,000 million euros, which is why it becomes a problem of not only a health, but also an economic and social nature.. And to all this we must add the fact that along with depression, other anxiety disorders and alcohol consumption tend to appear in up to 40 percent of cases.
Among the best known symptoms of depression we find a state of mind characterized by sadness, the presence of anhedonia (inability to enjoy things), loss of appetite, feelings of guilt, thoughts of death or suicide and the well-known ‘distortions cognitive factors’, which lead the depressed patient to interpret reality in a negative and unrealistic way.
However, in recent years the number of investigations aimed at studying the neuropsychological problems present in major depression has increased. According to Hanna Snyder of the Department of Psychology and Neuroscience at the University of Colorado,depression appears associated with alterations in what is called ‘executive functions’. These capabilities are what allow us to respond flexibly to the environment and make appropriate decisions.aimed at achieving certain objectives, especially in novel situations. Among the aforementioned ‘executive functions’ are the ability to update information to focus on the relevant at all times, the inhibition of automatic responses (such as when it is necessary to adjust behavior to new situations), working memory, which allows us maintaining and manipulating different data simultaneously (such as when reading a book), the ability to plan an activity, and verbal fluency (such as the ability to generate words that begin with a certain letter). As Snyder concludes,patients with major depression would show significant alterations in all of them, although the degree of severity of the depression, as well as the type and amount of medication play an important rolein these cognitive alterations.
Among the conventional treatments for depression we find antidepressant drugs and psychotherapy, which are aimed at modifying both the mood and the pattern of thought of the patient. However, few are the interventions aimed at addressing the neuropsychological alterations in depression, despite the fact that it has been described that these failures in intellectual functioning could be maintained even when the depression has already subsided.
Executive functions play an important role in a multitude of daily activities, and can even be fundamental when it comes to benefiting from psychotherapeutic interventions that require the patient to be able to keep different ideas in their mind, to be flexible in their ideas and to cope successfully meet the demands of everyday life. For all these reasons, it seems interesting to develop training programs that help improve these cognitive abilities, and that prepare patients to get the most out of their therapies and their lives.
Marisa Fernández, Senior Neuropsychologist, Unobrain.
