Dementia & Depression: How to Combat the Difficult Combination

For those living with Alzheimer’s disease and other forms of dementia, the chances of experiencing depression are significantly higher than their cognitively healthy peers. Out of the estimated 5.4 million people with Alzheimer’s, approximately forty percent suffer from depression and its debilitating symptoms. That equates to just over 2 million seniors struggling to deal with the burdens that both of these diseases cause.

“As if memory loss weren’t enough to contend with, depression often presents as dementia’s unwanted side effect,” says Tuscan Gardens^® of Venetia Bay’s Community Relations Director Nancy Clanton. She has witnessed this difficult combination in the memory care residents in the Venice, Florida community. “Usually, depression occurs in the early and middle stages of Alzheimer’s, when symptoms are beginning to present themselves and the individual has to learn to cope with the cognitive changes they’re experiencing.

“In this time, it can be hard to look to the future with hope or excitement, and depression can creep in as a result. In some cases, medications can cause depression, too. No matter how or why mental illness originates, it’s vital to recognize and address its symptoms in order for those with the disease to improve their quality of life.”

Detecting Depression in Your Loved One

If you have a loved one with memory loss and are concerned about their mental and emotional health, paying close attention to their mood and behavior can help you to determine whether and when to talk to their doctor. According to the Alzheimer’s Association, common symptoms to look for include:

• Social isolation or withdrawal
• Fatigue or loss of energy
• Disruption in sleep
• Agitation or slowed behavior
• Disruption in appetite (unrelated to other medical conditions)
• Irritability or aggression
• Loss of interest in hobbies or activities
• Impaired thinking or trouble concentrating
• Feelings of worthlessness, hopelessness or excessive guilt
• Apathy
• Recurrent thoughts of death or suicide

Some of these symptoms are related to both Alzheimer’s and depression. For example, a person’s difficulty in concentrating could be due to their cognitive decline. Your loved one’s doctor or a psychologist can help determine what’s causing their symptoms and whether or not they are depressed.

Diagnosing depression in a senior with dementia takes a slightly different approach than it would for someone else. Dr. Esther Oh describes these differences in her case study, “Depression in Patient with Dementia,” published by John Hopkins Medicine. Dr. Oh explains that depression in a patient with dementia won’t necessarily present with the typical symptoms of an otherwise healthy person. Someone with dementia is more likely to experience irritability, fatigue and agitation as symptoms, rather than the typical feelings of hopelessness, loss of interest or intentional social withdrawal. Dementia patients with depression are also less likely to express suicidal thoughts or actions.

Usually, depression is diagnosed if a patient has been experiencing a depressed mood or extreme apathy, along with two or more of the symptoms listed above, for two weeks or longer. In the case of someone with memory loss, the person may not remember feeling depressed or may deny claims of their symptoms. Professionals will more likely rely on the observations of the person’s family members or primary caregiver to determine whether or not the person is depressed.

Possible Treatments for Relief

If your loved one is diagnosed with depression, their doctor may prescribe an antidepressant if their symptoms are severe. However, this type of medication is used with caution for patients with dementia, as it may interfere with other medications they may be taking.

Fortunately, there are many possibilities in practice to treat depression holistically. As their caregiver, you can do a lot to help your loved one as they deal with dementia and mental illness. For example:

• Help them find a support group for people with early-stage Alzheimer’s who are learning to cope with their diagnosis. If a group setting isn’t ideal, help them schedule counseling sessions.

• Create a predictable daily routine, utilizing the time of day they’re at their best for the most difficult tasks.

• Encourage and help them to exercise each morning.

• Help them participate in or socialize with the things and people they enjoy the most.

• Celebrate every success, big or small, and find other simple reasons and occasions to celebrate.

• Acknowledge their sadness. Let them know that you understand their feelings are legitimate, yet continue to express hope that they’ll feel better soon.

• Nurture them with soothing activities, their favorite foods and pleasant experiences.

• Find ways to help them contribute to the family, recognizing and thanking them for their contributions.

• Reassure them that they will not be abandoned.

• Let them know that they are loved – not because of their abilities, but as the person they are, have been and always will be to you.

We Can Help You Carry the Burden 

“Dementia and depression are a lot to deal with alone,” says Clanton. “Relief seldom comes for either you or your loved one without support. At Tuscan Gardens of Venetia Bay, we’re want to help both of you experience the best of life’s moments, despite the burdens brought on by Alzheimer’s disease and memory loss.

“Our community not only offers specialized memory care for those who need it, but we offer support groups and educational activities for families and loved ones as well. If you or your loved one could use some help dealing with depression or the hardships of dementia, our friendly, highly trained associates are standing by to help you along your caregiving journey.”