Identifying Depression in Someone with Alzheimer's
Updated: Feb 12, 2019
Depression is common among those with Alzheimer's, especially during the early and middle stages. This post examines the symptoms, diagnosis, and treatment of depression in someone with Alzheimer's.
Symptoms of Depression
It is estimated that 40% of those with Alzheimer's suffer from significant depression, but it can be difficult to identify because dementia can cause some of the same symptoms. In addition, Alzheimer's makes it difficult for the person to articulate any feelings of sadness, hopelessness, guilt, or depression. These are symptoms common to both depression and dementia:
Loss of interest in activities and hobbies
Depression in someone with Alzheimer's doesn't always look like depression in someone without Alzheimer's. Here are some ways that depression in a person with Alzheimer's may be different:
May be less severe
May not last as long and symptoms may come and go
The person with Alzheimer's may be less likely to talk about or attempt suicide
If you are a caregiver and see signs of depression, discuss them with your loved one's primary physician. Proper diagnosis and treatment can improve well-being and function.
There is no single test to diagnose depression. It usually requires a thorough evaluation by a medical professional, especially since side effects and medical conditions can cause similar symptoms as depression. A typical evaluation includes a review of the person's medical history, a physical and mental examination, and interviews with family members who know the person well.
It may be helpful to consult a geriatric psychiatrist who specializes in recognizing and treating depression in older adults. You can ask your doctor for a referral. For a person to be diagnosed with depression in Alzheimer's, he 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 2 weeks or longer:
Social isolation or withdrawal
Disruption in appetite that is not related to another medical condition
Agitation or slowed behavior
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
The most common treatment for depression in Alzheimer's involves a combination of medicine, counseling, and a gradual reconnection to activities and people that bring happiness. Telling someone with depression to "cheer up" or "try harder" is not helpful. Depression cannot be cured by sheer will. It requires a lot of support, reassurance, and, at times, professional help.
Getting appropriate treatment for depression can significantly improve quality of life
You can treat depression in Alzheimer's with or without medication. If you choose a non-drug approach, support groups can be helpful, especially in a group of people with Alzheimer's who are aware of their diagnosis. Counseling is a good option if the person with Alzheimer's doesn't like groups. You can also make a list of activities, people, or places that the person enjoys and schedule these things more often. Acknowledge the person's frustration or sadness and provide reassurance that the person is loved.
If you choose to treat depression in Alzheimer's with medication, there are several types of antidepressants. Be careful that the medication doesn't cause interactions with other medication. Make sure to ask about the risks and benefits, what type of monitoring is needed, and what follow-up is needed.
Source: Alzheimer's Association