BEHAVIOURAL AND PSYCHOLOGICAL PROBLEMS IN THE CASE OF ALZHEIMER’S DISEASE: DEPRESSION

Many people with dementia become depressed. This can be the result of a realization, usually early on in the course of the disease, that the brain isn’t working as it should be. Sometimes it happens for other reasons and occasionally an apparent dementia can, in fact, be depression. There is a difference between being depressed and feeling miserable. A person who is depressed will usually be withdrawn and unhappy, will speak, act, and think slowly. This can affect the daily routine and interest in food, and is sometimes associated with early morning awakening with difficulty in getting back to sleep. Some people with depression experience mood swings, and are much happier in the evening than they are when they first get up in the morning.

If depression is present against a background of dementia, it can be difficult to realize that the increased impairment in the sufferer’s intellectual ability is the result of depression rather than of a worsening of the dementing process. If you ever have any fears that the sufferer has depression, it is best to ask the doctor for advice. He should be able to help, even is he has to refer the sufferer to a psychiatrist for a more expert assessment.

The presence of depression will often mean that the sufferer requires even more love and support. If he or she is given medicine for the depression, this may actually cause a worsening of the memory for a while and may have other side-effects. It is important that you ask the doctor to let you know what you should be looking out for, and also important to decide whether the treatment seems worthwhile. In some patients, anti-depressants just make the situation worse. Nevertheless it is often necessary to undertake a few weeks’ trial of treatment, just to see whether there is any improvement.

One very important thing not to forget is that one mustn’t expect someone with depression to ’snap out of it’. A person with normal intellectual function can’t manage this and it is even less possible for someone with dementia. Depression is an illness that has a physical basis to it and is not just an attitude of mind. It has to be regarded in the same light as other medical illnesses that are more clearly due to physical abnormality.

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