home
RSS
June 21st, 2011
10:23 AM ET

Can depression cause inability to focus?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Tuesdays, it's Dr. Charles Raison, an associate professor of psychiatry and behavioral sciences at Emory University, and an expert in the mind-body connection for health.

Asked by Rachel from Southern California

I am a college student, recently diagnosed with depression, and am taking steps to figure out if I have ADHD because of a tremendous inability to focus and retain information. It is almost like, when I'm trying to focus on something someone says, it slips right through me like water.

I am curious to know what prospects I have of gaining my cognitive abilities back if I start taking Lexapro or other antidepressants. If these are going to impair my ability to concentrate and focus even more, then I am not sure how to weigh the cost-benefits of taking them, because I am in school.

In short, are antidepressants more helpful or hurtful to my cognitive functions? Can I look forward to reversing the concentration and memory retention problems I am currently undergoing?

Expert answer

I am very sorry to hear about your situation. College is tough enough without having to struggle with depression.

When most people think of depression, the first things that come to mind are sadness, a loss of enjoyment in life, and perhaps that great dark sense of foreboding and fear that so often accompany the disorder.

And while these are all very painful, and central, parts of the condition, other symptoms of depression can be at least as damaging, and you are struggling with one of those: trouble concentrating.

So the first thing you should know is that the problems with focusing and remembering that you are experiencing are classic depressive symptoms and therefore may not be indicative of ADHD (attention deficit hyperactivity disorder).

It's pretty easy to figure this one out. Did you always have trouble concentrating and remembering things? If you can clearly answer yes to this, then you may have ADHD that preceded your depression. This would not be surprising - it appears that ADHD in childhood is a risk factor for a variety of psychiatric disorders in adulthood.

On the other hand, if your problems with concentration and memory only began with the start of your depression, then they are almost certainly depressive symptoms that will resolve when your depression is fully treated.

Let me answer your question about Lexapro (escitalopram) by assuming that your memory and focus problems are symptoms of your depression and not related to any pre-existing ADHD.

In this case the surest way to resolve these issues is to get rid of your depression, and to do so as quickly as possible. If you take Lexapro and it resolves the depression, it will also greatly improve your ability to focus and remember things.

Note that this does not appear to be a direct effect of the antidepressant, but rather results when the antidepressant resolves the depression.

Antidepressants don't improve memory or concentration, per se. But anything that makes your depression go away will fix your cognitive difficulties precisely because they are part of the depression.

A final comment: Don't forget that antidepressants are not your only option. Many studies show that certain types of psychotherapy (including cognitive behavioral therapy, behavioral activation and interpersonal psychotherapy) work as well as antidepressants.


soundoff (32 Responses)
  1. Dystopiax

    We need a new designation upon earned academic degrees – perhaps O.Rx. – to indicate with assistance of Medications. It was not necessary to do this centuries ago at Dartmouth, Princeton, and William & Mary where all the students were deliriously happy and focused.

    June 21, 2011 at 10:55 | Report abuse | Reply
    • Steve

      Right, because suffering from clinical depression isn't bad enough – we also need to have a big, black mark on our diploma for battling through it and graduating.

      June 21, 2011 at 11:10 | Report abuse |
    • Clearly not an alum

      Besides being insensitive, your comment is also inaccurate. First, centuries ago? Really? Yes, I'm sure that you have evidence of the happiness and focus of colonial college students (and not just some, but ALL). Second, should there also be a designation for diabetics to indicate that they earned their degree with the aid of modern medicine? Or is your criticism limited to mental illnesses? Finally, ever noticed how most people that we consider genius suffered from mental illness?

      June 21, 2011 at 13:41 | Report abuse |
    • Trolls

      Please don't feed the trolls.

      June 21, 2011 at 15:37 | Report abuse |
    • EventHorizon

      In partial defense of the seemingly indefensible, there is rampant ADHD drug abuse as "study aids" in colleges. Try googling "college adhd drugs" or looking up adderall on wikipedia (specifically the "performance-enhancing use" section). It seems some use Nootropyl (aka Piracetam) to boost academic performance as well.

      I've also heard misuse is not unheard of among scientists, researchers, professors, etc. I cannot remember where I heard it so don't quote me on that one.

      June 21, 2011 at 18:35 | Report abuse |
    • Nicole

      How on earth does one being on medication have anything to do with their ability to earn a degree? Would you rather they flunk out and wallow in their illness and live off the government? I would rather someone reconize they have a problem and get the help they need whether it is medication, therapy, or a combination of both so that they can lead a normal life and reach their goals. I have dealt with this illness since I was 15, and I know how challenging it can be to deal with life when depressed. Those who have never been there don't understand.

      June 21, 2011 at 21:28 | Report abuse |
    • Michael

      Dear Rachel,

      ADHD is basically a problem with your prefrontal cortext–the part of your brain that is involved with concentration. When you try to concentrate your prefrontal cortext does not function as well. Depression can also cause an inability to concentrate.

      If you have ADHD, the problem is many of the antidepressants work by increasing how seretonin (a brain chemical) is used in your body. This can decrease the ability of the prefrontal cortext to function.

      Welbutrin is one antidepressant that does not work on seretonin. It works on dopamaine, which helps the prefrontal cortext to focus.

      Depression is a tricky thing. There is more than one type and each responds to different classes of antidepressants. I would look up Dr. Daniel Amen books. I think they are right on. By the way, most of what I said is based on his books. Beware that antidepressants have a withdrawl period when they are not taken and must be gotten off very carefully. The withdrawl symptoms are similar to the problem symptoms themselves. Best to deal with both the root and the symptoms by working through things rather than just medicatioin alone. Joseph Glenmullen is a good author that talks about the dangers of medication.

      May 13, 2013 at 11:18 | Report abuse |
  2. Kim

    The symptoms described are also symptoms of hypothyroid, which causes depression, slow thinking, low energy, and a host of other problems. The challenges described don't have to be attributed to depression or ADHD; they could be from something else entirely.

    June 21, 2011 at 11:57 | Report abuse | Reply
    • CalgarySandy

      You are assuming that his doctor is an idiot and did not do the check that is always done by good doctors before calling it Depression.

      June 21, 2011 at 16:09 | Report abuse |
  3. GDK in DFW

    It is a vicious cycle for me, the medication lessens my anxiety and keeps me from focusing on my situation / unhappiness / hopelessness - but it also makes me incapable of concentrating on my job as a database application developer. Either I take the medicine and I lose the 'gloomies' (and miss my deadlines) or I skip the meds, the anxiety kicks in and I finish my assignments (for fear of being fired) – but then become the social pariah due to my 'gallows point-of-view'.
    The medicine also allows me to deal with the anxieties of dating, but makes consumating that relationship troublesome due to rampant flaccidity – and if that problem gets sidestepped, the inability to climax lessens both partners' satisfaction. If only I could get all the 'good' without and equal does of the 'bad'

    June 21, 2011 at 14:00 | Report abuse | Reply
    • D

      Maybe try a different antidepressant? Good luck to you.

      June 21, 2011 at 14:18 | Report abuse |
    • AGuest9

      D, if only it were that easy. They make you stay on meds that destroy your thoughts, ambitions and desires, and are unwilling to change them for months at a time – on top of what you have aready lost to the depression in the first place. By then, a job/family/home, or in this case an entire semester, is lost.

      June 21, 2011 at 14:59 | Report abuse |
    • BeenThere

      If you have ADD in addition to your anxiety and are taking an SSRI or SNRI, what you're experiencing is typical. The medication is boosting circulating serotonin, which helps anxiety/depression, but lowers circulating dopamine (which occurs in a "seesaw" relationship with serotonin – if one is boosted, the other goes down). Less circulating dopamine means less ability to focus, concentrate, organize, and remember. Some folks in this situation are helped by switching to Wellbutrin, which has some dopamine-boosting properties, or the addition of an ADD med to their antidepressant.

      June 21, 2011 at 15:34 | Report abuse |
  4. djj

    How about before jumping to ADHD drugs, the patient try treating the depression? If recently diagnosed, I doubt any therapy or treatment for the depression has had time to work.

    June 21, 2011 at 14:09 | Report abuse | Reply
  5. erich2112x

    I really believe that........hold on, let me go read the article again.

    June 21, 2011 at 14:15 | Report abuse | Reply
  6. Fuyuko

    I think modern living creates an inability to focus. With the advent of so many electronic distractions it is quite easy to get sidelined or distracted. there was an article about how younger people have less attention spans... And I know it is true. Of course if you are anxious or depressed these issues will intensify. Changing diet, removing stimulants and sugar and adding a vigorous workout of at least 1 hour a day will help in addition to traditional meds and therapy.

    June 21, 2011 at 15:54 | Report abuse | Reply
  7. L

    errr... truly depressed people don't ask these questions...

    June 21, 2011 at 16:11 | Report abuse | Reply
    • chad

      exactly.. If you are actually depressed you know how screwed up your focus abilities are and there is no need to ask a doctor about it.

      June 21, 2011 at 16:27 | Report abuse |
  8. chad

    The answer to her question doesn't require a medical professional.... YES!!!!!

    June 21, 2011 at 16:26 | Report abuse | Reply
  9. Richard

    One responder repeated the "chemical imbalance" myth propagated by the drug companies. There is no proof that low serotonin has anything to do with depression. Why take antidepressants when they do no better than placebos in most studies and have side effects like weight gain and low libido. These effects might make you more depressed. Why not increase your exercise ((a proven antidepressant) and take fish oil pills ( mood enhancing qualities among other benefits) and see a therapist to help with your emotions and problem solving. Drugs should be the last resort and only taken for short periods of time due various "withdrawal syndromes" when stopping their use.

    June 21, 2011 at 17:23 | Report abuse | Reply
    • fuyuko

      I think if anti-depressants work for some people, why not take them? Iook, if they help people who am I to say what they should take or not take?

      June 21, 2011 at 19:24 | Report abuse |
    • Jamie

      Um.. with Celexa I'm just peachy and productive. A month without Celexa and I'm paralyzed and near suicidal. The profound shift that occurs from this drug can absolutely not be replicated by a freakin sugar pill. Thanks though.

      June 21, 2011 at 21:02 | Report abuse |
  10. jackcash

    Yes,

    depression can affect one's attention......absolutely.Been there, trust me.....

    June 21, 2011 at 18:15 | Report abuse | Reply
  11. Sunny

    Dear College: Go to a reputable psychiatrist for your medication (not a primary care physician), see a psychotherapist (one you're really comfortable with otherwise it's pointless, so keep looking if you have to) then a healthy diet, some regular exercise, adequate sleep, and family and friends for company and support (believe it or not, this is critical). Vitamin supplements can be very helpful, but be careful you're taking only what you need. For some people keeping a journal to write your heart out can be a great help also. Like your studies, this is an investment in you. Depression is serious, but treatable. You're young and in school at the start of a great adventure. You have a lot to be thankful for. Count your blessings and write them in your journal. Good luck and God bless! Been there too!

    June 21, 2011 at 18:58 | Report abuse | Reply
  12. Sunny

    Dear College: Sorry, I didn't answer your question outright! Yes, focus is a problem. If you see a good physician (psychiatrist) for your medication he will be able to address this during your initial meeting. All the other suggestions work together to help you focus. Good luck again

    June 21, 2011 at 19:05 | Report abuse | Reply
  13. Jamie

    Yes. Absolutely it can. I've taken celexa for years with marginal results but when I described my inability to concentrate in detail to my Dr. he reccomended trying adderall. I know the bad rap it has but the results were day and night. I can tackle whatever comes at me now.

    June 21, 2011 at 20:59 | Report abuse | Reply
  14. Margo Zargo

    I was going to leave a comment but I forgot the gist of the article I just read. I don't think that the antidepressants that I take are the cause, but stress and anxiety are really memory killers.

    June 21, 2011 at 21:18 | Report abuse | Reply
  15. WhatsAllDaFussAbout

    Are you breathing? Do you blink 31 times instead of 32 times a minute? Do you urinate alot? Sometimes? Not enough? Have you stopped growing? Do you eat anything other things that will obviously kill you? If you answered yes. Or no. Or maybe so to any of the following you might be depressed!

    Seriously I was depressed most of college and I think environment and the behavior of others plays a huge role. Especially if your family environment is troubled compared to those outside your family you perceive as having a better upbringing. Also even if others came from a poorer background seem unphased by their experience it can cause you to doubt yourself and question how you are handling your own negative environment, which can make you more depressed for feeling unable to match up and better yourself.

    Unfortunately regards of what anyone says your issues are your issues alone and you have to somehow get through it. People will only go so far to offer "help" so don't the idea that any help is good help.

    June 21, 2011 at 21:44 | Report abuse | Reply
  16. Angela

    FYI some antidepressants made me forget whether or not I actually took the antidepressant. So make sure you develop a system for remembering this fact (I placed medications I had taken on the right side of my tv!). Be proactive in assessing whether antidepressants work. Sometimes it was hard to tell that I was becoming apathetic or finding it hard to find words or realizing that I was confused. It sounds strange but some antidepressants will make you too sedated to realize what's going on. Also, remember that some psychiatrists are better than others and if one pescribes medications that do not seem to be working, move on to another. Try to find a psychiatrist that is teaching in addition to practicing since they will tend to approach your depression from a combined research and experience-based approach. Remember, no doctor will canre more about resolving your depression than you will so be proactive in assessing whether you medication is working. I find that asking yourself the following questions are crucial:

    1) Has my motivation improved or do I feel sedated and unmotivated all the time?
    2) Do I feel well-rested after 8 hours of sleep or do I wake up feeling like I never slept? Am I sleeping for an ungodly number of hours?
    3) Has my sadness or frequency of crying spells decreased?
    4) Am I gaining an uncomfortable amount of weight? Remeron will imitially do this but it will go away after a month or so.
    5) Am I still forgetful and having poor cognitive function?
    6) If I hear a funny joke, do I actually feel the chemical response I would normally feel after hearing a funny joke? Some antidepressants will numb your emotions and you won't realize this because you will still have the automatic response of laughing but not "feel" it inside.
    Ask yourself these questions after being on medication for 4-6 weeks. Again, some anti-depressants will cause sedation and complacency. As smart as I was, it took me months to realize that some antidepressants were doing this to me. I know I've mentioned a lot of bad stuff but again the Wellbutrin (150 mg) +Remeron (15 mg) and Adderall (20mg XR) (Ritalin did not work for me at all! so again keep assessing!) has brought me back to 75% of the cognitive functions I had before which is not perfect but am hoping the rest will come back after I fixed all of the other financial and academic issues my depression caused. Best of luck and don't give up on finding the right medication.

    June 22, 2011 at 05:44 | Report abuse | Reply
    • Jesus

      I am depressed, I know this. My main proelbm is that I have two parents in denial about my condition. I also have Aspergers, a side effect of which is having extreme difficulty in discerning my emotions. Ergo, I can't really talk about feelings because it is unbelievably frustrating to figure them out.I have also been emotionally abused my whole life, so it's next to impossible for me to actually talk to someone about my proelbms.I'm at the point of wanting to end my life. I'm so confused.

      September 14, 2012 at 00:15 | Report abuse |
  17. joanieb

    Probably a silly question but have to ask it. Can antidepressants make you feel depressed? I have been taking fluoxetine for a couple of years or more, originally described for fibrymalgia. Having gone through the menopause the doctor thought I may as well stay on them as I was feeling a bit down. I'm not sure if they are the answer though. Any thoughts on this would be appreciated. Thanks.

    June 22, 2011 at 06:37 | Report abuse | Reply
  18. Pankaj Manocha

    Dear Rachel,
    Sorry to hear about your situation. I understand college can be tough and challenging at times. There are lots of things you can do before you start on antidepressants. I will try to incorporate some life style changes as to counter this problem including exercise, meditation, maintaining "to do list" for every day, week and month and doing one thing at a time. Use of alarms, repeated reminders, and use of calendars can be really helpful.
    In short as expert mentioned antidepressants are not the only options. Literature has shown that Behavioral therapy along with life style changes have done wonders for the people. I hope this might be helpful. Stay strong and good luck.

    July 12, 2011 at 21:38 | Report abuse | Reply

Post a comment


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.