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Changes in Cognitive Skills

Symptoms of Bipolar Depression - Part 5

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Updated June 27, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Cognitive skills are the patterns of thinking that allow us to perform tasks. They include processing speed, short-term and long-term memory, concentration and decision making. Problems with these skills can have a profound effect on behavior. In fact, these symptoms - difficulty concentrating, indecision, memory problems and disorganization - may be the among the ones first noticed by co-workers and supervisors because of the way they affect on-the-job performance.
  • Inability to Concentrate
    This can take two forms. It may be that no matter how hard you try, you simply cannot focus - on the task at hand, on a book you're trying to read, on the lecture you're attending, on the recipe you're following. Or it may be that your attention wanders without your being aware of it until someone points it out to you, or you suddenly notice you've been staring at the same page of your book for 20 minutes. Both can be embarrassing and frustrating. In either case, the inability to concentrate is an important condition to be noted.

  • Indecision
    What to wear to work today? Which of three projects has priority? What's the best day to choose for a doctor's appointment? What should you make for dinner? In a state of depression, making even simple decisions can become a major undertaking, and more difficult decisions can become impossible. When indecision is accompanied by anxiety, being confronted by the necessity of making a choice can even lead to hysteria. People tend to think of a depressed person as being quiet and withdrawn, but if that person is backed into a corner, it can result in an emotional explosion or collapse.

  • Problems with Memory
    Memory problems primarily occur as a result of poor focus - that is, because of difficulty concentrating, you simply didn't hear something that was said to you and so don't recall it later. But many cognitive processes become slower and less effective in depression, including memory.

  • Disorganization
    Disorganization is not exclusively a symptom of depression, nor is it necessarily a disorder. And it is perfectly possible for a manic or hypomanic person to be unorganized, but in that state such a person isn't likely to be bothered by it and may, for example, know just where a particular item is in spite of having his belongings in a state of chaos.
As with all the depression symptoms we've covered, recognizing these symptoms is a key element in knowing when to get help. For example, if you are always indecisive, even when manic or hypomanic, indecision likely won't be an identifying characteristic of depression for you - unless you react to it differently depending on your mood. If you can laugh it off when hypomanic, but are filled with anxiety about it when depressed, you have a personal marker for your own depressive episodes.

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