ADHD or Depression? When Memory Fails, How to Tell the Difference

Have you ever walked into a room and completely forgotten why you were there? Or struggled to remember a conversation you just had yesterday? If you're dealing with ADHD or depression, these moments might be more than just occasional lapses.

But how do you know if it's your ADHD, your depression, or something else entirely? This is the mystery I'm talking about today. I'm Doctor Tracey Marks, a psychiatrist, and I make mental health education videos.

Today's topic is based on a question from one of my mental wellness community. Live question and answer sessions. Here's the question summarized.

I have ADHD and depression. I'm currently depressed and my memory is horrible. How can I tell the difference between memory problems stemming from ADHD and depression and worse?

How do I know it isn't dementia? This is an excellent question that touches on the close relationship between attention, mood, and cognitive function. Let's break this down step by step.

First, you have to understand that ADHD, depression, and memory issues often overlap and interact in complex ways. This can make it challenging to pinpoint the exact cause of cognitive difficulties, but there are some distinguishing features that can help us understand what's going on. Let's start by looking at ADHD and its effects on memory.

Attention deficit hyperactivity disorder primarily involves difficulties with attention and focus, but it also significantly impacts what we call working memory. Working memory is an executive function, and it's your ability to hold and manipulate information in your mind for short periods. With ADHD, it's common to have working memory deficits.

This can look like forgetting instructions, losing track of tasks, or losing your keys. Struggling to keep multiple pieces of information in your mind at the same time. These problems are present to some degree most of your life beginning in childhood, because that's when ADHD starts.

It's a neurodevelopmental disorder, meaning it affects how your brain develops. Your symptoms and childhood may not be as impairing for you as they are in adulthood. Because of the increased demands that you have as an adult, the chances are at a minimum, you had some noticeable symptoms in childhood.

The second issue with information processing from ADHD is trouble filtering out distractions and ignoring irrelevant details. Does this situation sound familiar? Someone is sharing a long story with you that has a lot of details, and when they finish, you're like, I have no idea what you just said.

The person says, well, what part did you get? And you say, just the last three words. This happens because you can get overwhelmed with all the extra stuff and not be able to recall anything.

You might feel like that about this video. The point here is that these problems can look like memory problems when they're actually an issue with attention and information processing. If you don't pay enough attention to the information, it won't be encoded in your mind and you won't be able to recall it later.

Now let's turn to depression and its impact on cognition. Depression is a mood disorder that affects not just your emotions, but also a wide range of cognitive functions. These cognitive effects of depression are sometimes referred to as cognitive fog or depression related cognitive impairment.

Back when I was in residency, almost 30 years ago now, we called it pseudo dementia, when someone with depression had a lot of cognitive impairment. That term has fallen out of favor today, as we understand more about the connection between cognition and depression. Let's break down some of the key areas affected.

First, there's concentration and attention. When you're depressed, your ability to concentrate is often impaired. This difficulty focusing can lead to problems with encoding new memories.

Depression can slow down your thinking process. People often describe feeling their thoughts feel like they're moving through molasses. Similar to ADHD, depression can affect executive functions like organization, follow through, initiating tasks, and working memory.

Here's where depression symptoms separate from ADHD symptoms. Depression can make you less flexible. In other words, it can be harder to adapt to changing situations or shifting between tasks or thought processes.

Depression affects what we call verbal fluency. This is where it's hard to find the right words to express yourself. And then depression can dampen your ability to feel motivated or experience pleasure from activities, which in turn affects how you engage with tasks and information.

These cognitive effects can vary in severity and don't affect everyone with depression, in the same way as depression improves with treatment. These cognitive symptoms typically improve as well, but they can improve at a slower rate than the mood symptoms. So a key difference between depression related memory issues and those seen in ADHD is that depressive symptoms, including the cognitive ones, are episodic.

They tend to improve as the depression lifts, but the symptoms you have with ADHD are persistent and don't just show up when you're depressed. Another important distinction is how motivation and interest affect your memory. With ADHD, you may struggle to remember boring or routine tasks, but have excellent recall for topics that you find interesting.

This is sometimes called hyperfocus. With depression, you don't get that variability based on interest. You can be generally uninterested or unmotivated for most things.

Now let's address the concern about dementia. It's natural to worry about more serious cognitive decline, especially if you're experiencing significant memory problems. However, there are several key differences between the memory issues in ADHD or depression and those seen in dementia.

First, dementia is typically a progressive decline in multiple cognitive domains. This means it affects not just memory, but also areas like language problems solving and spatial skills. On the other hand, ADHD and depression generally don't impact language skills or spatial reasoning.

Spatial reasoning involves the ability to understand and manipulate visual information in your mind, such as mentally rotating objects or navigating through space. Here's an example. Someone with dementia might get lost in their own neighborhood or have trouble finding their way around the familiar store.

These are things we don't see with ADHD and depression. Second, dementia usually affects recent memories more severely than long term memories, at least in the early stages. People with dementia might forget recent conversations or events, but clearly remember things from years ago.

And ADHD and depression don't have that pattern. Third, dementia often affects daily living in a way that ADHD and depression usually don't. People with dementia might struggle with familiar tasks like managing finances or following recipes, which isn't characteristic of ADHD or depression.

Age is also an important factor to consider. While early onset dementia does exist, it's rare before the age of 65. If you're younger and experiencing memory issues, it's much more likely related to ADHD, depression, or other factors like stress or sleep problems.

Now that we've discussed the differences, let's talk about strategies for improvement. The first step is always to treat the underlying conditions for ADHD. This might involve medication to improve focus and cognitive behavioral therapy to develop coping strategies or executive functions.

Skills training for depression A combination of antidepressant medication and psychotherapy is often effective. There are also cognitive strategies that can help with memory issues regardless of the cause. And these include external aids like calendars, reminders, and to do lists.

Breaking down tasks into smaller, manageable steps. Creating routines and habits to reduce cognitive load and using mnemonic devices or visualization techniques to improve your recall. A word about mnemonics.

These are memory aids that can significantly enhance your ability to retain and recall information. And there are several types of mnemonics, including acronyms like Homes to Remember, the Great Lakes, Huron, Ontario, Michigan, Erie, and superior to Acrostics, which are sentences where each word starts with the letter that you need to remember. Like every good boy does, fine to help you remember the notes of the treble clef.

If you're a music person, number three rhymes for the method of low key, also called the memory palace technique. Five imagery associations and six chunking. Let's highlight two of these techniques.

The method of low key and chunking. The method of low key, also known as memory palace technique, is a visualization tool. It involves associating information with specific locations in a familiar place.

For instance, to remember a grocery list, you might imagine milk on your front porch. Eggs placed in cushions on the couch and bread on the coffee table. When you need to recall the list, you mentally walk through your house, seeing each item in its place.

This method takes advantage of your spatial memory skills, and can be surprisingly effective for remembering ordered lists or complex information. Next is chunking. This is a technique many of us use without realize it's a formal memory aid.

Chunking involves breaking larger pieces of information into smaller, more manageable chunks. For example, we often remember phone numbers as three chunks like (212) 555-7890, rather than ten separate digits. Chunking works because our brains are better at remembering smaller groups of information by organizing them into meaningful units.

We reduce the cognitive load on our working memory, making it easier to process and recall the information later. You can apply chunking to various tasks like organizing your to do list and the categories dividing study materials into related concepts, or breaking down long numbers into smaller groups by consciously using techniques like the Method of Loki chunking or other Mnemonic, you can significantly improve your ability to remember important information. Helping to combat memory difficulties associated with ADHD or depression.

And don't hesitate to reach out to your health care professional about your concerns. Health care providers have access to diagnostic tools and expertise that can help differentiate between these conditions and provide appropriate treatment. And although it can be scary to experience memory problems, especially when you're already dealing with ADHD and depression, it's important to remember that these issues are treatable.

The memory problems associated with ADHD and depression are typically not permanent or progressive like those seen with dementia. I hope this was helpful for you. Watch this video for more on working memory.

Thanks for watching today. See you next time.