Young people with depression should be reassured that their poor concentration and memory are often part of the illness and don't mean they're "dumb", says an expert in mental health.
An Australian study has revealed widespread cognitive functioning difficulties among teens and adolescents with depression.
The findings, published in the journal Neuropsychology Review, have prompted calls for a rethink on how depression is treated in the young.
Dr Kelly Allott at Orygen, the National Centre of Excellence in Youth says traditional cognitive behavioural therapy or talking therapy might not be as effective because they require high levels of cognitive ability.
If a young patient is unable to engage or focus properly in a therapy session then this can feed into the depression and enhance their sense of worthlessness, said Dr Allott.
Many study participants reported walking out of a therapy session and within a minute had forgotten everything that was discussed, she said.
"When they experience not being able to remember conversations or not being able to focus on what's going on then it actually makes them feel worse about themselves and feeds into their depression even more," she said.
"It's kind of like a continuing spiral."
For the study, researchers at Orygen and the University of Melbourne reviewed 23 previously published research papers that looked at cognitive functioning in young people with depression.
The research review found "significant" cognitive difficulties were common among young people aged 12-25 years who had depression compared to those without the mental illness.
They included maintaining attention, recalling verbal and visual information and verbal reasoning - and they appeared to be heightened for those on anti-depressants.
Dr Allott doesn't suggest ditching CBT or talk therapy altogether but says the sessions may need to be modified, for example making them shorter.
Instructions for taking medication should always be written down.
Simply educating young people with depression about the cognitive symptoms associated with the illness is critical, said Dr Allott.
"Highlighting that this is a part of depression and it's not who they are, can give them a sense of reassurance and hope about their recovery" she said.
