Depression and Dementia

Double-Whammy! Depression & Dementia

By LORI L. DIEROLF

It may not surprise you to hear that according to the National Institute of Mental Health, nearly 7% of American adults — an estimated 17 million people — will have at least one major depressive episode in their lifetimes.

But did you know that 20% of people over the age of 65 have been impacted by depression? And, the age group with the largest number of suicides in the U.S. is men over the age of 75?

In fact, 20% of all suicides in this country are committed by people over the age of 65, yet only 1 person out of 10 gets help for their depression, despite the fact that more than 70% of these individuals had seen their doctor within one month of their deaths.

Depression is toxic to the brain, and it is three times more common in older adults living with dementia than those without dementia. Neither depression nor dementia is a normal part of aging, yet about half of all individuals affected by Alzheimer’s disease or another form of dementia will experience significant symptoms of depression at some point in their illness.

When an individual has dementia, it can be extremely difficult for care partners to recognize the symptoms of depression in that person. This is partly due to the fact that the behaviors common in depression can be viewed as “normal” for a person with dementia.

Individuals living with dementia are also less able to describe

their own feelings or identify their own symptoms because they already have an impaired ability to communicate.

What makes it even more difficult is the fact that symptoms of both illnesses are very similar. Shared symptoms include feelings of loneliness, forgetfulness, difficulty concentrating, social withdrawal, change in sleeping and/or eating habits, apathy, and loss of interest in activities.

Untreated depression in persons with dementia can have a real impact on their quality of life. It can increase the rate of their cognitive decline and cause progressive difficulties with their daily living skills.

This, in turn, can cause a need for more dependence on care partners and further loss of independence. Depression can also cause loss of interest in taking part in and enjoying activities. It can lead to increased anxiety, agitation, and changes in mood.

There are several options available to treat individuals diagnosed with dementia and depression, including medication, counseling, therapy, and behavioral interventions.

It is important to understand the cause of the depression in order to determine the most appropriate treatment. Generally, there are multiple factors at play, and every person is different, so certain interventions may be more effective for one person than for another.

A number of nonpharmacological approaches have shown success in treating depression in those with dementia, including improving their cognitive function and increasing their physical abilities. The benefits of these non-drug approaches also include avoiding chemical side effects and drug interactions.

While there is no “one-size-fits-all” activity to treat every person’s depression, here are some nonpharmacological suggestions for alleviating the symptoms in those with dementia:

Support groups can be very helpful, particularly in the early stages of dementia when individuals are aware of their diagnosis and want to take an active role in seeking help or helping others. It can be especially encouraging to hear how others have learned to cope, which can help ease feelings of loneliness. Individual counseling may also be an option for those who may not feel comfortable in group settings.

Predictable routines can foster the feeling of control and give an individual something to look forward to during his or her day. This also enables the person to schedule activities for times when they are feeling their best.

Purposeful activities can enable individuals to make a contribution. Find activities the person enjoys or make a list of places he or she likes to visit, and do these things frequently. Suggestions include listening to music, sitting on a swing, and walking in the sunshine (which may increase the mood-elevating serotonin levels in our brains!).

Exercise and other physical activity can increase energy levels, improve sleep and appetite, and impact a person’s selfesteem. This can include anything from light stretching exercises to working in the garden to pushing around the vacuum.

Social interaction provides those with dementia the opportunity to express feelings and emotions and offers that human connection that can increase a person’s self-confidence and sense of purpose. Being connected to others — including pets — may allow them to maintain a more positive outlook, as well.

If you suspect that you or someone you care for may be exhibiting symptoms of depression, it is important to get an assessment by a medical professional. For those living with dementia, an accurate diagnosis and appropriate treatment can have a critical impact on the individual’s quality of life. Lori L. Dierolf is the president of Open Door Training & r Development.She holds several certifications as a dementia care educator and can be contacted through her website, www.OpenDoorTraining.net.