Coping with depression

Recognising the symptoms of depression in someone with dementia may not be as easy as you might expect. 

Many of the symptoms of depression are the same as those of dementia, (and Alzheimer’s disease in particular), and it is not uncommon for people to think they have to just put up with depression as an inevitable part of the disease. This is just not correct however.

Treatment is available AND is proven effective. It can significantly improve quality of life for both the patient and their carers.

Depression is very common among people with dementia, particularly in the early and middle stages of the disease. Estimates suggest that the figure could be as high as 40% so making yourself aware of what to look out for and the possible treatments available is an important step towards seeking help when, and if, needed.

Signs of Depression

• Apathy
• Loss of interest in activities and hobbies
• Social withdrawal
• Isolation
• Trouble Concentrating
•  Impaired thinking

While a diagnosis of dementia can lead to intense feelings of sadness, hopelessness, fear and even guilt, the cognitive impairment caused by the disease often makes it difficult for the person to articulate these feeling adequately. The symptoms of the depression can therefore all too easily easily be masked by the dementia.

The Alzheimer’s Association issues this advice which is helpful in deciding when to seek help:

“For a person to be diagnosed with depression in Alzheimer’s, he or she must have either depressed mood (sad, hopeless, discouraged or tearful) or decreased pleasure in usual activities, along with two or more of the following symptoms for two weeks or longer:

• Social isolation or withdrawal
• Disruption in appetite that is not related to another medical condition
• Disruption in sleep
• Agitation or slowed behaviour
• Irritability
• Fatigue or loss of energy
• Feelings of worthlessness or hopelessness, or inappropriate or excessive guilt
• Recurrent thoughts of death, suicide plans or a suicide attempt”

Treatment for Depression

People with depression, whether they have dementia or not, are not able to think themselves out of the condition by sheer force of willpower, so simply telling them to “Snap out of it” or “Cheer up”, is not going to help. Support, reassurance and medical help are all required.

Making an appointment to see your GP is an essential first step. This will allow you to explore the options for drug medications, counselling and complimentary therapies that may prove beneficial.

The most effective treatment is likely to involve a combination of medicine, counselling, and gradual reconnection to people and activities that bring happiness.

Ways for Carers to help

• Seek out local support groups – These can be a huge source of help both for the person with dementia and their carer. It can be a huge source of comfort to know that you are not alone in dealing with this and there are others in a similar position. They provide a valuable source of information and access to other services and support available locally. Groups can provide fun and meaningful activities geared specifically to those with memory and cognitive problems, and are a great way of maintaining social contacts.
• Acknowledge the person’s feelings and frustrations while continuing to express positive messages about how you hope they will feel better soon.
• Plan a predictable daily routine. This can provide reassurance and help schedule activities the person finds challenging at the time of day they are best able to cope.
• Make a list of activities, people and places the person enjoys. Try to visit/incorporate these more frequently into your diary.
• Find ways the person can contribute to family life and remember to recognise his/her contribution.
• Plan in regular exercise, particularly in the mornings, as this can be a fantastic mood enhancer.
• Provide lots of reassurance the person will not be abandonded.
• Celebrate small successes and occasions.

Depression is not inevitable and should definitely not be suffered in silence. Help is available so speak out.