Depressed or Anxious? Paying Attention Could Be the Key to Recovery

Source: Photo by Kamaji Ogino on Pexels

Have you ever wondered why someone in the grip of depression can’t seem to remember anything nice that happens, however important it was?

I had a client who had no memory of passing an important exam with distinction. He was in depression when he received his results and it didn’t stick in his mind, he said.

Sometimes this happens because, in depression, people inadvertently filter out what doesn’t fit with their mood, homing in only on whatever feeds the miserable story they are currently telling themselves. But there is another reason, and it can give us a steer for how to start turning things around.

Maybe you have at some time cajoled a depressed friend or relative into going for a walk with you, knowing that exercise elevates mood: how could they fail to have their spirits lifted by such a lovely day? So you walk in the countryside, and it is green and lush and you admire the clouds scudding across the blue sky and comment on the birds singing in the hedgerows. Perhaps you both look into a stream and you point out gleaming little yellow fish visible in the sparkling water.

And then, a day or two later, you comment on the walk and they remember nothing about it. The images are crystal clear in your own head, yet seem to have departed from theirs. Is it that depression has robbed their memory? Well, here’s the thing. It is likely that they can’t recall that day because they never made a memory out of it in the first place.

Lisa Genova is a Harvard-trained neuroscientist and author of the highly acclaimed novel Still Alice (about early-onset Alzheimer’s), among others. She explains in her latest engrossing book, Remember, "Your memory isn’t a video camera, recording a constant stream of every sight and sound you are exposed to. You can only capture and retain what you pay attention to."¹

It is the paying of attention that is key. Yes, your friend may have seen the clouds scudding across the blue sky, the lush green grass, and the gleaming yellow fish, and heard the birdsong, but they didn’t pay attention to any of it. They saw and heard – the sensory information would have passed through to the correct areas in their brain. But that is not enough. Our hippocampus, the brain structure in the brain that makes our memories, cannot form a lasting memory from sensory information without, as Genova terms it, "the neural input of attention." When we don’t pay attention at the time, whatever we sensed is lost.

You have probably had occasions when you put your keys down somewhere and moments later couldn’t for the life of you remember where you put them – because you were thinking about something else and so weren’t paying attention at the time. Similarly, depressed people are likely to be distracted by the constant negative self-talk in their heads. They aren’t paying attention.

This is why it can be valuable to coax someone who is depressed into being fully present on a pleasant occasion. Ask questions which demand their attention: "What colour would you call that flower?" "Look at that little dog carrying that huge stick! Do you think it finds it heavy?" "Mmm, I can really taste the coconut in this ice cream – can you?"

Once you have helped someone who is depressed to create and embed a memory, you can later encourage them to recall it, when they are down: "remember that day we went to the countryside…?" And bring up some of the moments from that day which you had guided them to participate in. It all helps to break the depressive negative trance in which "nothing good ever happens to me".

Paying attention can help with anxiety, too. The medial prefrontal cortex is the area of the brain with a major role in maintaining focused attention, but anxiety commandeers it to search for threats – even, or especially, non-existent ones. In this way, anxiety slants what we pay attention to, skewing our perceptions of the world and the ways we respond to it.² So, again, an important part of the solution is to learn to stay mindful, and pay attention to what actually is around us, without judgement.

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How we look at the world alters what we find in it. As Dale Carnegie, the once-famous developer of self-improvement courses, put it: "Two men looked out from prison bars. One saw mud; the other saw stars."

Let’s engage the brain in helping us notice – and remember – what serves us best.