I was diagnosed with a major depressive disorder 10 years ago and have had to endure debilitating lows, feelings of worthlessness and physical pain that has left me bedridden.
If these symptoms weren’t bad enough, my ability to think, plan and, sometimes, speak have been impaired so much that I’ve contemplated giving up work and claiming unemployment benefits.
The dreaded ‘brain fog’ is one of the most distressing and glossed-over symptoms of depression. We’re all sluggish first thing in the morning, but a strong cup of coffee and a hot shower are usually enough to jolt our brains into action and take on daily tasks.
But some of us remain trapped in a seemingly never-ending battle for mental clarity.
In medical terms, what people like me experience is called a ‘Mild Cognitive Impairment’ and can be accompanied by depression, as well as a range of negative emotions such as anger and worry.
When I first started noticing that things weren’t quite right, it felt as though my stream of thoughts had been suddenly switched off. In mine and many other cases, brain fog comes on suddenly and can be intensely frightening.
The first time it happened, I was working part-time at a local discount store doing a stultifying job as a shop assistant and cashier, which required little in the way of high-level thinking. To while away the hours, I would practice Mandarin, a language I’d acquired a few years earlier working as an English teacher in rural Henan.
Although I’d been diagnosed with Major Depressive Disorder about two years before, I hadn’t experienced any cognitive impairment. But, whilst lifting boxes in the store’s warehouse, it became intensely difficult to recall basic words that had previously come very easily to me.
Initially I dismissed it as a mental block, putting it down to my inadequate breakfast of coffee and biscuits. But as the day went on, the difficulties remained and, when I was summoned to the shop floor, they began to reveal themselves more plainly.
Working on the till, I made mistakes and struggled to keep up as the queue grew longer and ever more impatient. As I scanned goods and took money, I found myself under and over-charging customers, and they became irate about being given the wrong change.
Eventually, I voluntarily came off the till and admitted to my manager that I wasn’t feeling myself. A little bemused, she agreed to let me return to the warehouse.
Later in the staff room, my colleagues gossiped, as they often did, about topics ranging from Brexit to their summer holidays on the Algarve. Despite wishing to join the discussion, I was unable to speak any words or put them in any coherent order.
I think some of them realised something was a bit off, as they were looking at me in the hope of getting a response. But even though I wanted to contribute, my mind was failing me, drawing blank after blank. It was a surreal and slightly scary feeling.
After several days of this, I decided to quit my job and rest up, putting my inability to think properly down to overwork and insufficient self-care. I spent time in nature, avoiding electronic devices and anything that might be overstimulating, and eating a junk-free diet rich in fruit and vegetables.
A week of clean living, however, was not enough to kickstart a recovery. Falling ever further into despair, I became ill several weeks later with a severe depressive episode and end up admitting myself to a local psychiatric ward for two months.
Even though I’ve consulted my GP a few times about this, stressing just how debilitating and frustrating my symptoms are, they haven’t been able to suggest any treatment
Although I’d received therapy and medication before, this was my first time I’d checked into a mental health unit. I found myself barely able to talk to the other patients, preferring to stay in my room and only making an appearance during mealtimes.
After a few weeks inside, I finally plucked up the courage to speak to the friendly-looking young man I’d sit with at dinner. Unlike me, he was admitted against his will after a psychotic episode and his illness was much more severe than my own.
But like me, he was stumbling on his words, suffering from memory lapses and struggling to think. Despite this, we managed to find common ground and were able to bond – I found simply being in the company of someone going through something similar to me comforting, even if our conversations were stilted.
Over a year has passed since my hospital visit and brain fog still causes me to suffer in silence. There are times when I’m effortlessly loquacious, speaking in detail about topics that interest me, and times when it’s hard to even remember my phone number or, perhaps more embarrassingly, a friend’s name.
I’m not alone in experiencing this. An estimated 90% of patients with depression experience cognitive impairments, which include difficulty concentrating and memory loss.
But even though I’ve consulted my GP a few times about this, stressing just how debilitating and frustrating my symptoms are, they haven’t been able to suggest any treatment. And, as my MRI scan showed no physical evidence of neurological pathology, I’ve hit a brick wall in terms of treatment.
It’s a similar experience to fellow depression sufferers I’ve spoken to on internet forums.
Mild Cognitive Impairments need to be recognised as a major aspect of depression and those struggling with it must be referred to a cognitive behavioural therapist who can help them cope with the symptoms.
I’m currently trying my hardest to keep my life in some semblance of order. I now mainly freelance in my preferred field of written translation, which means I can take my time and avoid potentially difficult interactions with people.
And much to my family’s astonishment, I’ve relocated to Kuala Lumpur, Malaysia – so, if my brain isn’t quite working properly during a conversation, I can always attribute it to being a bumbling foreigner!
More must be done to understand Mild Cognitive Impairments and their relationship with depression. It’s only when science discovers the underlying physical causes of the disorder that those of us who experience it will be able to get the support we need.
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