Why Small Decisions Feel So Difficult: Dr. Sanjay Gupta’s coronavirus podcast for May 27

During the pandemic, many people are struggling to make even the smallest decisions. Why does choosing what to eat for dinner or what to watch on TV suddenly feel impossible? CNN Chief Medical Correspondent Dr. Sanjay Gupta and neuroscientist Daphna Shohamy explain that we may need to look inside the human brain for the answers.

You can listen on your favorite podcast app or read the transcript below.

Dr. Sanjay Gupta: What movie should I watch tonight? Should I take my kids to the park? Where should I order takeout from?

These are some of the small, mundane decisions many of us used to make easily — before the pandemic.

But now, with so much uncertainty about the coronavirus and what the future will hold, even these seemingly insignificant decisions can feel time-consuming, even overwhelming.

But why? Why is it happening to so many of us right now and what we can do to cope with it?

To find the answers, we may have to travel to one of my favorite places: the human brain.

I’m Dr. Sanjay Gupta, CNN’s chief medical correspondent. And this is “Coronavirus: Fact vs. Fiction.”

Daphna Shohamy, professor of psychology, Columbia University: I finished a book and I was deciding what book to read next.

Gupta: Daphna Shohamy is a professor at the Zuckerman Mind Brain Behavior Institute at Columbia University.

Shohamy: And I felt very stuck with this very, very simple decision. It was a decision, you know, I make all the time but never feels difficult. And suddenly it felt difficult in ways that were unfamiliar. A simple decision like what to read suddenly mattered a lot and really sort of brought up all of the uncertainty that we’re facing in so many areas of our lives right now.

Gupta: So she ended up doing what a lot of us would do. She gave up.

Shohamy: I ended up going with The New Yorker [laughs].

Gupta: And it raises the question: Why are these decisions so hard right now? Shohamy thinks we first have to understand what’s going on in the brain when we make routine decisions. That’s been her area of research for years. And the area of the brain that it involves is kind of surprising.

Shohamy: And the name of that brain region is the hippocampus.

Gupta: The hippocampus is shaped kind of like a sea horse, and it’s located roughly behind your ears, toward the center of your brain. And it is usually associated with the act of remembering, not decision-making.

Shohamy: For years, most of us in the field have really thought of the hippocampus as only a part of the brain that’s important for memory. What we’re discovering in the last several years is that part of the brain that’s important for memories actually plays a really important role in decision-making.

Gupta: Shohamy recently collaborated on a study that looked at how patients with damage to the hippocampus made decisions.

Shohamy: We asked patients with memory loss to make a series of very simple decisions like between Kit Kats and M&M’s or between pretzels and potato chips. And we had them make these sorts of decisions over and over again. We saw that they take two to three times as long to make these decisions than healthy people do.

So they’re really struggling to come up with the evidence from memory, it seems, that would help them make that decision. So all that suggests that there’s really something special about having to make decisions based on internal evidence, based on our own internal preferences. That’s really when we need to draw on memory to kind of make predictions about the future.

Gupta: So you may be wondering, how exactly does memory play a role in decision-making?

Shohamy: The brain basically makes a prediction. Every time we have to make a decision, the brain predicts which decision will lead to a better outcome. And that decision is based on what actually happened in the past.

Gupta: For example, take a simple choice, like ordering at your favorite restaurant.

Shohamy: If I order this dish from this menu at this restaurant, which I’ve been to 50 times in my neighborhood, my brain has learned the likelihood that I will enjoy one dish over the other and it can make a quick decision based on that calculation from the past.

Gupta: But this may surprise you: The brain can use your memories even when you’re considering dishes you’ve never tried before.

Shohamy: The brain makes those relatively new decisions by basically extrapolating from the past into the future. And that it does so, in large part, by basically imagining what’s going to happen next. Leaning on everything it already knows, even if it’s not directly related, but just sort of tangentially related.

Our brain takes that information, kind of imagines a scenario in the future. What is this dish likely to taste like? Does it have components that look familiar to me that I can imagine whether they’ll work well for me together or not? Did I see someone at the table at another restaurant eating something similar and they looked like they were enjoying it?

So when we have to predict about the future, what we will like and what we will enjoy and which decisions will be leading to good outcomes for us, we sort of use all this imaginative capacity of the brain to make predictions, even about things that we’ve never experienced before.

Gupta: And that brings us to right now. We’re all experiencing new dilemmas every day during this pandemic. And that means your brain has to work extra hard. I have heard it called “decision paralysis.”

Shohamy: And I think part of the difficulty that we’re feeling in making decisions now has to do with a signal from our brain that’s saying, “No. You brought up that memory? That is not the right memory. Keep searching. You need more evidence. This isn’t enough.”

And I think that’s part of this sort of feeling of decision fatigue, that every decision suddenly feels exhausting because we keep on searching for the most relevant information and it’s not always there at all.

Gupta: But many of the little decisions people are struggling with right now are things they’ve actually dealt with thousands of times in the past. Shohamy says that even if these choices are familiar, the uncertain environment in which you’re making these choices is brand new.

Shohamy: I think what the current situation is really highlighting is just how much context matters for the decisions we make. And that even when we think we’re making the same decision, like what to make for dinner or which book to read, when the context changes, it’s not the same decision anymore because we are trying to adapt our decisions to a particular context.

So that’s, I think, really something that many of us are facing is we don’t know exactly what’s going to happen tomorrow, next week, next month. And we’re all forced to make decisions in that state of uncertainty and to just rely on what we do know, which is not good enough.

Gupta: It’s important that we understand the role memory plays in our own decision-making, so that we can make sense of our choices. And the choices of others, even our government leaders.

Shohamy: In a decision-making position, a person will be influenced in the decisions they make, for a whole group of people, by their own individual memories. There’s actually studies that show that different leaders and policymakers at different stages of history lean different ways in their decision-making partly based on world events that happened when they were in their late teenage, early 20s.

Gupta: Now you might be thinking: It’s not so reassuring that our leaders are relying on their teenage memories to make decisions. Memories can, after all, be pretty flimsy things. They can be misrecalled. They can be inaccurate. But Shohamy says that’s not necessarily a problem for good decision-making. In fact, it might even be a benefit.

Shohamy: If you think about memory as a function to serve decision-making, then you don’t want memory to be 100 percent accurate. You want memory to be flexible and you want it to be biased. You want it to be biased by the elements of your experiences that are most relevant for your future. It probably doesn’t matter so much what you had for breakfast three weeks ago. You can forget that.

But maybe it matters a lot what you had for breakfast on the day before you found out which colleges you got into. And so what look like errors in memory are actually the features of memory that allow it to be flexible and useful for future decisions.

Gupta: Of course, everyone’s experience during this pandemic is going to be different. And some people are actually finding decision-making right now to be easier.

Shohamy: Having no freedom and no decision-making can be easier in some way. We do not have to deliberate. I was talking about this with one of my daughters the other day because she was saying she doesn’t have to decide which of her friends to go to, which party to go to, what to do on a Saturday afternoon, because the options are really reduced.

And for many people, that reduction in options, I think, can feel like a burden that’s lifted.

Gupta: There’s a lesson in here I think for everybody. If you find yourself paralyzed by a small decision, it may help to try to restrict your options by focusing on fewer factors.

Shohamy: I think an important thing to do in that moment of indecision, especially with small decisions, is to sort of choose a dimension that matters to you and to help yourself kind of pull out of it. Like you might just be able to say to yourself in the toothpaste aisle, “I’m just gonna go with a color my kids like and then I’m just gonna use that.”

Instead of trying to include all relevant information in this one small decision, remind yourself that it’s OK to focus on one dimension and just use that. And to find a dimension that helps you kind of break the tie.

Gupta: I think the most important thing: If you are struggling with decisions these days, Shohamy wants you to know that’s normal.

Shohamy: I struggle with making decisions. So I find myself trying to not let the difficulty of the decision-making process itself be taken too strongly as an indication that something’s wrong.

It’s difficult because things are different. But that’s not a problem. That’s just the way our brains work to bridge the gap between what was and what will be.

Gupta: This is a normal — perhaps even essential — part of how our brains work.

It’s an indication that our brains are searching for relevant information and memories to fill in the gaps in our knowledge.

I notice it myself all the time. As simple as choosing a tie in the morning, what I’m going to have for lunch, whether I’m going to go for a run or a bike ride, whether I want to take a nap or watch ridiculous television. Those were decisions that usually took me just a few seconds, and now sometimes I just find myself struggling.

This pandemic is an uncertain time for all of us. But we’re all in it together. And a lot of us are going through the same thing — even our brains.

We’ll be back tomorrow. Thanks for listening.

If you have questions, please record them as a voice memo and email them to asksanjay@cnn.com — we might even include them in our next podcast. You can also head to cnn.com/coronavirus and sign up for our daily newsletter, which features the latest updates on this fast-moving story from CNN journalists around the globe. For a full listing of episodes of “Coronavirus: Fact vs. Fiction,” visit the podcast’s page here.