Mental health disorders are one of the top 10 causes of disability worldwide. In 2019, the World Health Organization (WHO) stated that 1 in every 8 persons was living with a mental health disorder. This means that someone you know (relatives, co-workers, or friends) could be dealing with one mental health challenge or another. Mental disorders significantly impact all aspects of living.
What has cognition got to do with it?
Some symptoms of mental disorders are familiar. If asked to name a few symptoms, you might mention excessive crying, deep feelings of sadness, sleeping too much or not at all, poor judgement, or difficulty concentrating, and you’d be correct.
Cognition is one dimension of mental health that is often affected in people with mental health challenges, but this important connection is often missed. Cognition refers to the mental processes that allows humans to acquire knowledge through our senses and experiences.
Cognition includes mental processes like memory, decision-making, reasoning, attention, planning, language, comprehension, visuospatial function, judgement, and perception. |
When any aspect of cognition is affected or impaired in any way, it is called a deficit. Difficulty learning new things, having trouble remembering information, and speech difficulties are all forms of cognitive deficits. Cognitive deficits are sometimes present in the two most common mental health disorders, anxiety, and depression. And the manifestation can be subtle. Consider a teenage student finding it difficult to pay attention in class or remember what they have learnt that day. Can this be due to unrecognized depression?
What about the employee who prepared for weeks to present at the board meeting only to forget the punchline and faint on D-day? Can this be due to situational anxiety? The answer in both scenarios is yes. In other scenarios, the link between mental health and cognitive deficits is easier to identify, such as in someone who is addicted to a “hard drug” like cocaine or a prescription medication like Tramadol, an opioid analgesic. Post-traumatic stress disorder (PTSD), schizophrenia, and autism spectrum disorders are examples of other mental health conditions known to affect cognition.
Why good management is important
Cognitive deficits need to be managed not only to improve the quality of life and functionality of affected persons, but also because of the huge social and economic costs if not corrected. Lost productivity from depression and anxiety alone is estimated to cost the global economy about $1 trillion every year! A significant proportion of the economic loss is due to cognitive deficits that affect job performance, decision-making, and so on. Unfortunately, less than 5% of governments’ budgets for health go to mental health.
On their own, cognitive deficits are not disorders or illnesses. They are an indication of an underlying mental or physical health condition. |
The first step to managing cognitive deficits is recognizing that there is a deficit, but this is not as easy as it sounds. People with mental health conditions may not recognize a cognitive deficit, so it's important to be your brother's keeper. If you notice something is off with someone you know, say something.
A health professional can help identify the affected areas of cognition as well as any underlying conditions that may be responsible for these deficits. Assessment also helps to provide a baseline by which changes to cognitive functioning can be monitored.
Cognitive deficits can be mild, moderate, or severe. For instance, memory issues can range from difficulty remembering names to an inability to recognize one's loved ones. |
Many options in the treatment toolkit
There are several proven management strategies to improve cognitive deficits in mental health patients. These strategies may be pharmacological, psychological, or lifestyle-focused.
Easing the way with medication
Pharmacological management of cognitive deficits may involve the use of medication such as anti-psychotics, mood stabilizers, stimulants, and antidepressants to treat the mental health condition causing the deficits such as anxiety, schizophrenia, ADHD (attention deficit hyperactivity disorder), and depression. Stimulants can improve attention while anti-psychotics can reduce the intensity of delusions and hallucinations.
The role of psychological therapy
The different forms of psychotherapy go by big names like cognitive behavioural therapy (CBT), psychoeducation, and cognitive remediation therapy. They are delivered by professionals with special training. The proof is in the pudding as psychological therapy can be very helpful. CBT is especially effective for improving mood disorders like depression. Its key focus lies in identifying unhelpful behaviours and thought patterns and replacing these with positive and helpful thought patterns and behaviours.
Cognitive remediation therapy restores and improves cognitive functions through a variety of techniques such as repetition, role-play, modeling and activities such as word searches, puzzles, and dexterity games. Psychoeducation provides the person and/or caregivers with adequate information about the present deficits, any underlying disorders, and how best to manage them.
There is no one-size-fits-all management (treatment) approach because cognitive deficits are often complex and may result from many different factors. Treatment strategy may involve more than one method. |
Some individuals with cognitive deficits may benefit from occupational therapy. Occupational therapy is concerned with equipping individuals with basic daily skills such as cleaning, eating independently, brushing, and washing up while improving cognitive functions like problem solving.
Improving cognitive deficits through daily habits
Daily habits shape our lives. What we eat, how often we exercise, the hobbies we indulge in, and the quality of sleep we get all have powerful effects. Similarly, the day-to-day experiences and cognition of persons living with mental health disorders can be improved through key lifestyle changes.
Regular exercise increases blood flow to the brain and can help to improve problem-solving ability, attention, and memory.
A Mediterranean diet may be protective against cognitive decline. This diet is based on whole grains, vegetables, fruits, olive oil, beans, nuts with moderate servings of dairy products, poultry, and fish. Mental stimulation is also essential for optimal cognitive health. Puzzles, reading, writing, playing music, partaking in active conversations, and playing card/board games are activities that are mentally engaging.
In summary…
Cognitive deficits are often an indication of an underlying mental health disorder. The deficits can range from being barely noticeable to affecting a person’s ability to perform basic, everyday functions. Management programs must be tailored to fit each individual’s unique profile in order to help them live the best version of their life.
This article was sponsored by Fidson Healthcare PLC
