The link between dementia and depression

Key points:

• The symptoms of depression and dementia can be very similar, making it hard to diagnose
• 20 to 30 percent of people with dementia have depression
• Loss is a big component of depression, which is why it is not surprising many people with dementia develop mental health conditions

But something that falls to the wayside is the toll a dementia diagnosis can have on an individual’s mental health or how dementia can lead to depression and anxiety as the condition progresses.

Whilst there will be a lot of uncertainty and information to take in, keeping physically and mentally healthy, and continuing activities you love to do is great for promoting and supporting your wellbeing.

It’s important to regularly check-in with your doctor and have loved ones around you who can notice when something is not right.

​Signs of depression

Many older people can develop depression as they age, which usually is instigated by a loss of independence, mobility, lifestyle or connection with others.

A person diagnosed with dementia who has a mental health issue can be hard to spot, because symptoms of depression and anxiety can be very similar to the signs of dementia.

An individual may not be able to differentiate between what is considered “normal” for their condition or if they have developed depression or anxiety.

Chief Executive Officer (CEO) of Dementia Australia, Maree McCabe, says that depression among people with dementia is very common and it is difficult to diagnose because of how depression mimics the symptoms of dementia.

She says around 20 to 30 percent of people with dementia develop depression but often aren’t diagnosed by doctors.

“Often family members who know the person well will detect some of these symptoms that may arise. Some people with dementia may not have had issues with apathy or issues with sleep or issues with feeling sad. When they do arrive, it really is important to get them checked out,” explains Ms McCabe.

“For people that know their loved ones well, they’re the best ones to be able to identify it. And even the person themselves may say, ‘Look, I just feel like I have lost my mojo, I don’t feel like doing anything.’

“They may be showing something that has not been a feature of their dementia [previously]. So symptoms that arise that are inconsistent with what has previously been displayed is really important to get checked out.”

For example, depression usually involves impairment to memory or preoccupied thoughts, which are both symptoms of mental health conditions and dementia.

Even sleep disturbance, feeling apathetic, inference in eating patterns, mood swings or not wanting to do anything are signs of dementia or depression.

Ms MsCabe says it can also be a case of doctors diagnosing an individual with depression when in reality they have dementia, or vice versa.

What causes depression for people with dementia?

Depression is usually associated with loss for people that have the condition and for people with dementia it can be a very similar reason.

Ms McCabe says, “It can be loss of self-esteem, it can be loss of a loved one, it can be loss of independence, it can be a loss of environment if you have to move into residential aged care, or, the loss of being close to loved ones.

“There is always loss associated with [depression]. Certainly with dementia, there are lots of experiences of loss that a person with dementia is confronted with.

“It could be that [a person with dementia] is aware they are struggling with memory. It may be that they are confronted with the fact that dementia is a terminal illness. It is the second leading cause of death in Australia after heart disease, and the leading cause of death in women.

“That is extremely confronting, it is a progressive disease, people will get worse, and that is very challenging. And one of the things that is also confronting with people who have a diagnosis of dementia is it is profoundly isolating.”

Dementia Australia often hears from people with dementia that they feel isolated from friends and family after a diagnosis.

Those friends and family who always used to visit, now stop visiting; this can make a person feel socially isolated and rejected, which can have a huge effect on someone’s self-worth.

Ms McCabe adds that dementia is very much an invisible disability, which is why it is so challenging to deal with.

“What people can’t see, they often don’t understand, and what they don’t understand, they often fear, and what they fear, they avoid,” explains Ms McCabe.

“So you can see the cycle people can get caught up in when a loved one shares they have a diagnosis of dementia. It is also the heartbreak of families seeing their loved ones deteriorate.”

Treatment for depression

The first step you should always take when it comes to mental health is to visit your General Practitioner (GP) or doctor, who will be able to determine if there needs to be a medical intervention, such as medication, or if the depression is mild and can be handled differently.

Ms McCabe suggests exercise as a great way to assist with mood regulation and also helps keep your mind occupied with other thoughts.

This also means keeping a person with dementia engaged with activities or hobbies they enjoy is important.

“It’s really important to keep them active, engaged in enjoyable activities and socialising. Doing things with family, friends and loved ones is a really important part of reducing the change of social isolation and assisting somebody to get back in touch with the things that they love, the people that they love and doing things that they love,” says Ms McCabe.

Counselling is a great way to get assistance. A counsellor will be able to use different therapy techniques to help or can provide an independent ear to hear their worries.

There are medical interventions that may assist, such as antidepressants, but these should only be prescribed by a medical professional.

Antidepressants can be hit and miss for certain people, so it is important to keep a log of how medication may be helping the individual with depression.

Lastly, Ms McCabe says if anyone has concerns around the mental health of a person with dementia, to contact the National Dementia Helpline on 1800 100 500. The advisors can assist callers and point people in the right direction if a loved one with dementia is suffering from depression.

What activities do you find lift your mood? Tell us in the comments below.

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