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Dementia and Depression: What Happens When You Have Both Problems

If you or a loved one are dealing with dementia, the struggle with symptoms can be heartbreaking. And you might not recognize that someone with dementia might also have depression. It’s important to recognize that depression may be part of the picture. Even though dementia and depression are two separate conditions, they can happen at the same time.

We talked to Ganesh Gopalakrishna, MD, a geriatric psychiatrist (one who specializes in treating older people) with Banner Alzheimer’s Institute, to learn more about what happens when a person with dementia also has depression. Read on to understand what you need to know when caring for a loved one.

Here’s what these conditions can look like:

  • People with symptoms of dementia will have memory loss or memory problems and trouble thinking and doing daily activities.
  • People with common symptoms of depression will feel sad and hopeless. They may not want to take part in activities they used to enjoy. They might cry, have trouble concentrating, think about suicide or have trouble showing their emotions.
  • Depression can look a little different in people with dementia compared to others. Instead of having the typical symptoms, they might be irritable or have trouble managing frustration.
  • Some symptoms happen with both conditions. They include social withdrawal, anxiety, trouble sleeping, feeling tired (fatigue) and trouble concentrating. 

And each condition is linked with the other. “People with depression tend to be at higher risk of dementia. Also, people with dementia are at high risk of having depression,” Dr. Gopalakrishna said. 

People with dementia can be depressed because they are facing the challenges of trouble with thinking and losing their independence. And depression in dementia can make dementia get worse more quickly.

Many people living with dementia today have experienced difficult times and were raised by parents who lived through the Great Depression and World War II. They may not feel comfortable talking about emotional pain or mental health conditions. So they may complain about physical pain as a way to express their emotional distress. When this happens, a health care provider usually can’t confirm a medical condition as the source of their pain.

Dementia and apathy

People with dementia often also have apathy. That’s when they can be unmotivated and not want to do things they used to enjoy. Caregivers and family members may think that signs of apathy are signs of depression. But there’s a difference between apathy and depression.

With both mood disorders, people feel uninterested in doing things and unmotivated. They might not have much energy. However, people with depression may feel sad or hopeless, while people with apathy don’t feel many emotions.

“People with dementia often experience apathy and that can be distressing, usually more for the caregiver than the patient,” Dr. Gopalakrishna said. A mental health professional can help you figure out whether a condition is apathy or depression.

What to do

If you notice symptoms of dementia, depression or both in yourself or a loved one, don’t try to figure it out on your own. You’ll want to see a health care provider. Dementia isn’t just a normal part of aging.

An expert can assess symptoms to figure out what’s causing them and make recommendations. You may want to work with professionals who specialize in geriatric care (care for older people), dementia and mental health.

Generally, a professional will rely on reports from family members and caregivers to diagnose dementia. That’s because it can be hard for people with dementia to express their feelings and thoughts.

A lot of different conditions might cause dementia, including Alzheimer’s disease, frontotemporal dementia and Lewy body dementia. It’s also possible to have more than one cause, called mixed dementia.

A mental health provider can make a depression diagnosis. You may want to see someone who specializes in dementia for a diagnosis of depression.

Both of these conditions can have a big impact on your or your loved one’s quality of life. And the impact can be stronger when they both happen at the same time. When you recognize and treat depression along with dementia, your well-being may improve, and you may be better able to cope with dementia’s challenges.

Treating dementia and depression

Your or your loved one’s care team will want to create an individualized treatment approach. Psychotherapy (counseling) and medication can help with treating depression. Your provider will want to make sure whatever depression treatment is chosen doesn’t interfere with any dementia medicines being taken.

You’ll need to be patient because it can take time to see results from medication. Your doctor may also want you or your loved one to consider electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS). “These are very effective interventions,” Dr. Gopalakrishna said.

To manage dementia and depression, you’ll need to focus on physical, emotional and psychological well-being. Activities that bring joy, social connections and physical activity can all help improve quality of life. These things can reduce triggers that lead to depression symptoms.

If you’re a family member or caregiver of a loved one who has dementia, pay close attention to the person’s behavior, mood and well-being. You can share what you’ve noticed with health care providers.

“Observe, report and talk to your provider about your concerns,” Dr. Gopalakrishna said. Open communication is important. That way, you can be sure everyone is clear on all aspects of the person’s well-being.

The bottom line

People with dementia may also have depression, and it can be hard to recognize the symptoms of the two conditions. While they each have separate symptoms, they also have symptoms that overlap.

If you’re concerned about dementia or depression in yourself or someone you care about, be sure to talk to a health care provider. It’s tough to manage these conditions. An expert can help, so your or a loved one’s quality of life is as high as possible.

If you would like to connect with a provider who can help you navigate depression and dementia, reach out to Banner Health. 

Other useful articles about dementia

Alzheimers Disease and Dementia Caregiving Behavioral Health Depression Senior Health