Alzheimer’s: Depression – What the Caregiver Can Do?

It’s not uncommon for most people to feel inexplicably sad at varying times in their lives. But depression is a serious mental illness that can impair the way you function. As much as 9.5 percent of the population or nearly 19 million people suffer from a depressive illness every year. Depression is considerably more common among die elderly and affects approximately 20 percent of people over the age of 55. Left untreated, the condition can have devastating consequences and destroy a person’s career, family life, and other relationships, and cause enormous pain and suffering.

In the elderly who have Alzheimer’s, depression is even more prevalent, especially among people in the early stages of the disease who are aware of their condition. These people may be feeling depressed because of their diminished capacities for remembering, thinking, and participating fully in life. They may be saddened by their growing dependence on others and their loss of freedom.

They may feel intense loneliness from having Alzheimer’s and feel isolated from others who are not sick. At the same time, their brains are undergoing some of the same chemical changes that can cause depression, namely a reduction in serotonin, a neurotransmitter in the brain responsible for mood that is associated with feelings of happiness. But not everyone who has Alzheimer’s develops a concurrent case of depression.

It isn’t always easy to determine whether you’re experiencing a short-lived bout of sadness or a serious case of depression. After all, most people suffer from an occasional case of the blues, and learning you have Alzheimer’s is certainly enough to make even the most jovial person feel sad. According to the National Institute of Mental Health, there are some telltale signs of serious depression:

• Persistent, sad, anxious or empty mood.

• Feelings of hopelessness and pessimism.

• Feelings of guilt, worthlessness, and helplessness.

• Loss of interest or pleasure in hobbies and activities you once enjoyed, including sex.

• Decreased energy, fatigue, and feeling slowed down.

• Difficulty concentrating, remembering, or making decisions.

• Insomnia, early awakening, or oversleeping.

• Appetite changes or fluctuations in weight.

• Thoughts of death or suicide, or suicide attempts.

• Restlessness or irritability.

If you have five or more of these symptoms every day for at least two weeks, and they begin to interfere with your daily living, you should be evaluated for depression.

Treating depression in people who have Alzheimer’s can help alleviate the symptoms. In the early stages of the disease, you may want to participate in psychotherapy. You may also consider talking to your doctor about taking anti-depressants, such as a selective serotonin reuptake inhibitor (SSRI), a class of medications that have been found to reduce depressive symptoms in patients with Alzheimer’s.

These medications work by blocking the removal of serotonin, in the synapses, or gaps between the nerves. Inadequate amounts of serotonin, as well as other neurotransmitters such as dopamine and norepinephrine are often the cause of depression. In recent years, these drugs have become enormously popular as the medication of choice for treating depression. In addition, you might consider discussing your feelings with a trusted friend or loved one, such as your caregiver.

What the Caregiver Can Do

If you sense that your loved one is suffering from depression, encourage her to talk to you about it. Simply by listening and acknowledging her feelings, you can help her cope with her sadness. You might also encourage her to talk to her physician, a social worker, a clergy person, or a mental health professional who might be able to help her work through her difficult feelings. But as the disease progresses, avoid any formal therapy or group therapy, since this kind of treatment requires the person to remember and process information.

Be careful not to give false encouragement, like suggesting she “get over it,” or “snap out of it,” or trying too hard to cheer her up. Such statements may diminish the severity of her depression and only compound her feelings of frustration of not being able to get over her sadness.

To help brighten the mood, try engaging your loved one in her favorite activities. Playing music, doing simple arts and crafts, or watching a favorite video can provide a lift for sinking spirits. Minimize her despair by avoiding tasks or activities that are less familiar or giving her things to do that require a lot of concentration. Tasks that have become overwhelming will only serve as reminders of her dwindling capacities.

Help your loved one remain socially engaged, too. Being among friends can sometimes help lessen the depression and distract your loved one from his sadness. But avoid subjecting him to large gatherings, which may be too overwhelming and tiring. Instead, invite only one or two close friends to come over for some quiet conversation.

Finally, if you think your loved one needs medical attention for her depression, don’t hesitate to seek out her doctor for help. There are numerous anti-depressant medications today that can make a big difference in her mood. Just because someone has Alzheimer’s doesn’t mean she needs to live with depression as well.

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