So thank you everyone for coming to listen to our talks today.
And thank you Lisa for letting me share some bits and pieces of my recent research.
So as Lisa introduced, the title of my rather short talk today is ‘Sometime I get lucky
and forget Depression, Memory and Negative Bias’.
And most specifically I would like to focus on the following three questions.
How do people who suffer from depression remember self-related events from the past?
What is the relation between the intensity of depressive symptoms and the memory?
And also are there any benefits of memory distortions in depression?
The title, and at the same time the inspiration for this talk, comes from one of my patients.
I used to work as clinical psychologist on the psychiatric ward, and one day I met this
extraordinary man called Zdzislaw.
He was 49 years old, of a very gentle character, kind, polite, always smiling, and making friends
with nearly everyone on the ward including doctors, nurses, psychologists, occupation
therapists and obviously other patients.
Literally there wasn’t anyone who wouldn’t like Zdzislaw.
He always had something nice to say to people, and he had a rare ability to make nearly anyone
laugh.
At the same time Zdzislaw suffered from a very rare psychiatric disorder called Korsakoff
syndrome, which cutting long things short meant that his autobiographical memory was
holier than a saint.
Zdzislaw lived hundred percent in the present moment and had absolutely no recollection
of any past events, including the key events from his life such as his childhood, his wedding,
his mother’s death, but either he didn’t remember what happened even a few minutes
ago, who he spoke to, what did he do, or even how old he was.
The one and only thing that Zdzislaw did remember, surprisingly, about himself was his own name.
One day I spoke to him asking how he was feeling, and he replied ‘I'm fine.
I know everyone here expects me to be miserable because of my poor memory, but look at them.
They remember their lives very well and it seems to hurt them.
They tell me they suffer from depression, and so they ask me about my life, and I tell
them I can’t remember anything from my life, and then they ask why’s that?
So I reply it is because I'm very lucky.’
So this conversation has given me lots of food for thought.
So far I had been considering good memory as a sign of health, and I have been pursuing
memory distortions as undesirable burdens associated with other mental or physical difficulties.
Meanwhile looking at Zdzislaw and listening to his words, made me realise that perhaps
in at least some circumstances it might be more beneficial not to remember.
My patient was a living proof of such case.
Therefore I spent some time investigating online resources dedicated to the idea that
to remember less might mean to live more stress free.
I have learned that especially in the recent years with the growing number of people diagnosed
with depression, the popular interest in the possibility of erasing memories has become
significant.
A variety of scientific and pseudoscientific medicines publish their views about a bright
future for those who want to stop ruminating their painful past.
Many of them sound a little scary at least, promising to use, for example, laser and gas
techniques to delete your own memories and implanting new ones.
This discovery made me a little confused, so I decided to do some more research in order
to check what exactly is the relation between suffering from depression and the way we remember
things.
Most of psychological books on depression mention this or other sorts of memory problems
usually related to memory loss as one of the illness related cost.
However, only few describe what exactly happens to our memory once we suffer from depression.
Memory problems in depression are listed next to such issues as sadness; anhedonia which
is inability to feel pleasant emotions; apathy – it’s a sort of feeling of being washed
out of all emotions; negative bias in judgements which is overly negative view of oneself and
reality; social withdrawal leading often to loneliness; also insomnia – the sleeplessness;
and anxiety.
Of course this list goes on and on; these are only a few of most commonly described
symptoms of depression.
So what happens to our memory when we suffer from depression?
Is it that we remember less?
Is that we remember simply less things?
Is it that we find it hard to learn?
Is it that we remember only certain events but not the others?
And what is the relation between our self-related memories and the way we feel?
At this point some people may wonder why are such questions important or relevant in the
first place.
Here I point some out of many reasons why the issue of memory problems in depression
might be worth asking.
To find the right answers could mean to understand better how the human mind works, and by offering
a more balanced view of cost and benefits of depression could help to battle the stigma
of mental health.
It could also provide new tools for therapeutic practice, especially in depression and dementia
management.
Let’s now take a look at the empirical evidence telling us what are the possible links between
depression and memory.
So the strain of psychological studies starting from 1977 by two psychology students, Alloy
and Abramson, and still ongoing, investigating the accuracy of beliefs in the people with
and without depression, found out that the people who suffered from low mood and mild
forms of depression often remember certain things and events better, more accurately,
than healthy people.
It turns out that the things that people with depression remember more accurately relate
to the subject own lives.
This includes for example, the amount of material that has been learnt, the time that has passed
whilst doing certain activity, or the type of feedback which participants received.
But it also includes past events from their personal life such as a number of disagreements
they had with these causes, how often they felt misunderstood by the family members,
or how many times the failed or succeeded in their romantic lives.
It turned out that health people usually overestimate the frequency of positive events and underestimate
the negative ones.
And what does empirical research tell us about memory in people who suffered from most severe
forms of depression.
Here it turns out that in this case memory problems affect people in a significantly
more serious way.
The studies which we reviewed link severe depression to substantial memory loss, sometimes
even leading to dementia.
This was more common in older age, but occurred throughout the wide age range.
For example, the study by Burt and colleagues shows that self-related memories are subjected
to memory loss in depression more than in any other mental illness including schizophrenia.
However, severe depression certainly doesn’t strip us of all our self-related memories.
Therefore it seems plausible to ask what do we remember in severe depression.
Here the most of researchers agree affected people remember self-related past events in
an overly negative way and have poor recall of positive events.
More specifically it means that in severe depression our memories are affected by negative
cognitive bias.
We tend to interpret our past in an overly negative way more negative than it is warranted
by the objective data.
At the same time we seem to ignore the positive aspects of self-related memories and tend
to focus on explosively negative traits of ourselves.
We ruminate our past failures and misfortunes as well as expect more bad events to happen
to us in the future.
The most common cognitive errors are based on generalisation and are related to memory
distortions in depression, and include the following beliefs: my childhood was nothing
but pain; all my life so far has been a series of disasters; nothing really wonderful has
ever happened to me; I haven't done anything worthy or constructive with my life; people
in my life kept hurting me all the time; I had no control over my life at all; everything
that happens to me is my own fault.
Obviously such negatively biased thinking counts for both psychological and epistemic
costs such as anxiety, lower mood, social withdrawal, feelings of unworthiness, lack
of hope for the future, and among the epistemic costs we can find erroneous interpretation
of reality, misleading conclusions, and poor self-knowledge.
So in the presented context it seems plausible to ask whether in certain cases the loss of
memory in severe forms of depression might be psychologically adapted.
In other words, is that what we remember hurts and is our self-related past memories affect
our wellbeing to a significant extent.
Then memory loss in depression seems to come as a relief for many as it protects our self-esteem
and psychological wellbeing.
Perhaps then this is what Zdzislaw had in mind when he said ‘I get lucky and forget’
or ‘I'm happy because I don’t remember’.
To sum up, we can say in some contexts of depression, a psychologically and epistemically
costly condition such as memory loss may both have psychological benefits by contributing
to better psychological wellbeing, and have epistemic benefits by allowing the subject
to acquire other true memories mediated by psychological benefits.
This will happen when, for example, improved psychological wellbeing supports access to
other less painful memories and help constructing narrative identity of the person.
Coming back to Zdzislaw, after two years of regular everyday exercise of his short term
memory, it started to improve.
It was possible mainly because of his positive attitude and eagerness to achieve new targets.
It is especially significant because the short term memory in people with Korsakoff syndrome
is usually the most affected area of the functioning and hardly ever improves.
So in my talk I hope I managed to show at least to some extent that the relation between
depression and memory is more complex than it might be thought, and it’s not limited
to simply depressed people remember less and being poorly psychologically as a result.
Although depression and dementia might often be related, especially in older age, sometimes
the loss of memory might also play an adaptive role of supporting personal coherence and
wellbeing.
Thank you.