Mental Health

Introduction to Cognitive Health

Cognitive health is the ability to think, learn, and remember clearly. It is the ability for information management, logic, perspective, judgment, and wisdom.

Age-related declines in brain health can be normal, therefore steps should be taken to maintain or improve brain health while aging. Apart from brain disorders, levels of mental ability slowly change with age. They can make multitasking, focusing and paying attention difficult for extended periods of time. Inherited genes, lifestyle and dietary choices can greatly influence how you age mentally.

What are cognitive disorders?

Cognitive disorders are a group of mental health diseases, which mainly affect learning, perception, memory, and problem-solving. They can be caused by head injury or the degeneration of the brain with aging. However, they may also develop due to substance abuse and other causes. Their treatments may vary depending upon their exact type.

  • Traumatic Brain Injury: It is caused by head injury, which leads to torn, stretched, bruised or swollen brain tissue. Therefore, oxygen may not be able to pass to the brain cells and there may be bleeding also. It can cause temporary or permanent effects.
  • Hypoxic injury: Failed suicide attempts such as hanging, near drowning, are the main causes of hypoxic injuries. This generally affects a large area of the brain instead of very particular areas.
  • Brain tumors: They can be very dangerous. They can be either cancerous or noncancerous. Their cause is largely unknown.
  • Degenerative conditions:
    • Multiple sclerosis: In this condition nerve cells die when the myelin is removed. Myelin is a fatty coating which acts as a plastic insulation on electrical wiring.
    • Parkinson′s disease: It is caused by the loss of cells in various parts of the brain, which includes an area that forms dopamine. This leaves people less able to direct or control their movement.
    • Alzheimer′s disease: Its causes are not fully understood. However, genes are thought to play a chief role in its development. There is no cure for this condition.
  • Stroke & other vascular diseases: A stroke occurs on the disruption of blood supply within the brain. Arteries in the brain are either blocked, broken or start bleeding that prevents oxygen and nutrients from passing to the brain cells.
  • Infections: They can injure the brain and even result in death very quickly.
  • Epilepsy: It involves the frequent short episodes of abnormal electrical activity in the brain that leads to uncontrolled convulsions and unconsciousness, or a momentary loss of awareness.

Usually, cognitive disorder is caused by genetic and environmental factors:

  • Inherited traits: People, who have mental illness in their blood relatives, usually develop cognitive disorders. Certain genes can increase the risk of developing a brain disorder.
  • Environmental exposures before birth: Cognitive disorders are generally linked with the exposure to environmental stressors, inflammatory conditions, alcohol or drugs while in the womb.
  • Brain chemistry: When the neural networks involving neurotransmitters(brain chemicals that carry signals to other parts of your brain and body) are impaired, the function of nerve receptors and nerve systems change, resulting in depression.

Cognitive disorders can start at any age. However, they mostly begin in the earlier life. There are some factors that may increase the risk of developing cognitive disorders including:

  • Having a blood relative, with a cognitive disorder
  • Stressful life situations
  • Traumatic experiences, such as being assaulted
  • Use of recreational drugs or alcohol
  • Having few healthy relationships
  • A previous mental illness
  • An ongoing chronic disease such as diabetes
  • Brain damage due to serious injury
  • Being abused or neglected as a child

To diagnose your condition your doctor may do:

  • Physical exam: The doctor will try to find out the physical problems which can cause your symptoms.
  • Lab tests: These tests may include a check of thyroid function or a screening for drugs and alcohol.
  • Psychological evaluation: The doctor will talk to you about your symptoms, thoughts, behavior, and feelings.

The most common diagnostic imaging tools for the diagnose of cognitive disorders are CT, MRI, and PET scans.

Your doctor may also study the fluid from your brain and spinal cord to find bleeding in the brain, infection, and other abnormalities.

There is no sure way to prevent cognitive disorders. However, following these steps can help:

  • Pay attention to warning signs: Consult your doctor in case you notice any changes in yourself and how you feel. Take the aid of your family members to observe the warning signs.
  • Get routine medical care: Do not skip the visits to your doctor especially if you are not feeling well.
  • Get help when you need it: Do not wait till the symptoms get worse. It will be hard to treat cognitive disorder at a later stage.
  • Take good care of yourself: Take enough sleep, eat healthily and do a regular physical activity to minimize the risk of mental illnesses.

The treatment of cognitive disorder depends upon its type and severity. In several cases, combinations of treatments work.

  • Medicines: Psychiatric medicines cannot treat cognitive disorders but they can significantly improve symptoms. They can also help make other treatments more effective.

    Some of the most commonly used classes of psychiatric medicines are:

    • Antidepressants: They are used to treat depression, anxiety, and some other conditions. They can improve symptoms such as hopelessness, lack of energy, sadness, and difficulty in concentrating.
    • Anti-anxiety medicines: These medicines are used to treat anxiety disorders. They may help decrease agitation and insomnia.
    • Mood-stabilizing medicines: They are most commonly used to treat bipolar disorders. Sometimes they are used with antidepressants for the treatment of depression.
    • Antipsychotic medicines: They are usually used to treat psychotic disorders like schizophrenia.
  • Psychotherapy: Psychotherapy involves talking about your condition and relevant problems with a mental health provider. This therapy helps you to learn about your condition and your moods, feelings, behavior, and thoughts. Therefore, you can learn to cope stress management with the insights and knowledge you gain.
  • Brain-stimulation treatments: These treatments are sometimes used for depression and other brain health diseases. They are usually used when medicines and psychotherapy do not work. They include transcranial magnetic stimulation, electroconvulsive therapy, and vagus nerve stimulation.

Following lifestyle changes can help to manage the cognitive disorders:

  • Stick to your treatment plan: Be regular with your treatment plan and do not skip your medicines even if you are feeling well.
  • Avoid alcohol and use of the drug: Avoid the use of alcohol or recreational drugs. You can take the aid of support group or your doctor if find it challenging.
  • Stay active: Exercise can help you to manage the symptoms of anxiety, depression, and stress. You can choose any type of physical activity as gardening, walking or swimming.
  • Avoid making important decisions when your symptoms are severe: Do not make decisions when your symptoms are severe because you will not be able to think clearly.
  • Learn to adopt a positive attitude: Take the help of stress management techniques such as relaxation methods to adopt a positive attitude.
  • Eggs. The protein and nutrients in eggs help kids concentrate,
  • Yogurt
  • Greens
  • Fish
  • Nuts and Seeds
  • Oatmeal
  • Apples and Plums

Fish is an excellent source of vitamin D and omega-3s, which protect the brain from declining mental skills and memory loss. Salmon, tuna, and sardines are all rich in omega-3s. Sixty percent of our brain is made of the omega-3 fat DHA, which comes from algae and fish.

The brain is one of the organs in the body with the highest level of lipids (fats). Omega-3 fatty acids are important components of nerve cell membranes. DHA, in particular, is involved in various nerve cell processes. Omega-3 fatty acids from fatty fish in the human diet may be effective in the prevention of stress and other disease conditions including depression, and dementia.

Following are some of the cognitive disorders that can be managed with the intake of omega-3:


In a review of evidence of omega-3 fatty acid in depression, four of seven trials showed significant improvement of depression with at least 1 g/day of EPA. Results from a trial have also shown therapeutic benefits with omega-3 fatty acids in depression during pregnancy. In a Finnish study, the risk of depression and suicidality was much lower in those who frequently ate fish.

Bipolar Disorder

Scientists in Taiwan compared omega-3 supplementation (10 capsules per day, each containing EPA 440 mg and DHA 220 mg) with usual treatment in patients diagnosed with a major depressive disorder for a duration of eight weeks and concluded that omega-3 PUFAs could improve the short-term course of illness. Patients on omega-3 supplementation experienced a significantly greater decrease in the Hamilton Depression Scale score than did those in the control group. In another clinical study of 30 people with bipolar disorder, omega-3 fatty acids (EPA and DHA 9.6 g/day) in addition to usual treatment for four months could maintain mood stability; also, patients experienced fewer mood swings and recurrence of either depression or mania than those who received a controlled drug.


Preliminary clinical evidence suggests that people with schizophrenia experience an improvement in symptoms when given omega-3 fatty acids. Omega-3 fatty acids reduce the antipsychotic drug requirement in first-episode patients with schizophrenia and may be an effective adjunct to antipsychotics. But, a recent study observed no additional benefits of EPA supplements than placebo in improving symptoms of schizophrenia.

Attention Deficit/Hyperactivity Disorder

Children with attention-deficit/hyperactivity disorder (ADHD) may have low levels of EFAs including EPA and DHA. In a clinical study of about 100 boys, learning and behavioral problems (such as temper tantrums and sleep disturbances) were more common in boys with lower omega-3 fatty acid levels than those with normal omega-3 fatty acid levels.


A child diagnosed with autism who received 540 mg of the omega-3 fatty acid daily in the form of EPA for four weeks experienced a complete end to his previous anxiety about everyday events as reported by his parents and clinician. His overall quality-of-life was also improved. In another trial, most parents of 18 children with autism who had been given fish oil supplements for six months described improvements in overall health, cognition, sleep patterns, social interactions and eye contact. A recent trial reported reduced hyperactivity and reduced stereotypy (repeated movements like hand-flapping) in children who received 1.5 g of fish oil per day, as compared to children who received placebo.

Eating Disorders

Omega-3 fatty acids have also been researched in eating disorders such as anorexia nervosa. In a pilot study of EPA supplementation in the treatment of anorexia nervosa in seven young patients, three recovered and four improved.


Omega-3 fatty acid supplementation may have an inverse relationship with the risk of dementia and cognitive decline. People who have diets rich in fish would have a significantly lower risk of dementia and Alzheimer’s disease. Omega-3 fatty acid supplements may slow cognitive decline in some patients with very mild Alzheimer’s disease, though they do not appear to affect those with more advanced cases. A study by researchers at Tufts University in Boston found that people with the highest blood levels of DHA had a 47% lower risk of developing dementia and a 39% lower risk of developing Alzheimer’s. The study analyzed the blood of 899 men and women with an average age of 76. All participants were free of dementia at the beginning of the study and underwent neuropsychological testing after giving their initial blood sample. In patients with mild cognitive impairment, a significant improvement in the cognitive portion of the Alzheimer’s disease Assessment Scale (ADAS-cog) was noted.

According to research, the last three months of pregnancy are a crucial time for pregnant women to take fish oil supplements, as the baby′s brain experiences a growth spurt during that time, which continues through the first few months of the infant′s life. The evidence is increasingly accumulating about the benefits of high omega-3 fatty acid content in the fish oil supplements during pregnancy. These healthy fats are beneficial to the brain development of a healthy baby while in the womb. A baby while in the womb and as newborn depends entirely on the mother for omega-3 fatty acids as they cannot produce these fatty acids. Hence, the maternal omega-3 status during pregnancy is critical for the omega-3 status in the newborn because these nutrients are key building blocks for the brain and the nervous system. Yet, many pregnant women lack the important omega-3 fatty acids in their diet. Therefore improving maternal omega-3 status throughout pregnancy and lactation ultimately benefits the infant.

Fish oil supplements taken during pregnancy help in the proper development of a baby′s brain and IQ, improve eyesight and lead to fewer behavioral problems later in life.

A recent study also shows improved hand-eye coordination and greatly improved comprehension in children whose mothers were given either high-dose fish oil or olive oil during pregnancy. The researchers based their findings on 98 pregnant women, who were either given 4 g of fish oil supplements or 4 g of olive oil supplements daily from 20 weeks of pregnancy until the birth of their babies. High cord blood levels of omega-3 fatty acids at birth (from fish oil) were strongly associated with good hand-eye coordination, while low levels of omega-6 fatty acids, found in many vegetable oils, were not.

Maternal intake of omega-3 fatty acids during pregnancy and lactation may be favorable for the later mental development of children. Children whose mothers received DHA supplementation during pregnancy and lactation scored better in mental processing tests carried out at four years than children whose mothers received placebo. Intake of DHA by the mother (but not infant intake) positively correlated with the mental processing ability of the children. Hence, optimizing DHA status of expectant women may offer long-term developmental benefits to their children.