Depression & dementia: The unseen pain (Part II)

Nov 18, 2019

Depression & dementia: The unseen pain (Part II)

Depression & dementia: The unseen pain (Part II)

Posted in : Living with dementia on by : Giulia Melchiorre

What to do when someone with dementia faces depression

Depression is more common than you might think in dementia. Read our previous blog to understand depression in dementia: what it is, its causes, symptoms and impact. Now, let’s look at treatment options.

There are multiple treatment options but the choice depends on what causes the depression. Often more than one thing causes depression. Causes of depression can include a combination of internal (mind & body) and external (environmental & social) factors. This will be different for each individual. Therefore, the right treatment for a person should be decided with the support of a doctor. They can help identify treatments that address their needs.

What can you do?

If someone is experiencing mild depression, things like guided self-help, activities, a support group and lifestyle changes should be considered. 

1) Guided self-help

Guided self-help means learning about techniques that can help the person with dementia manage their symptoms. There are several apps, online courses & tools that are accompanied by therapists, as well as workbooks that can be effective. 

2) Staying active

Being active and encouraging the person to stay involved in activities they enjoy is very  important. If the dementia is making it difficult to take part, try and adapt the activities to their abilities so they can still stay involved. It will help if family, friends and their community know and better understand the person’s condition, allowing them to help adapt as needed.

3) Lifestyle

Support groups can be helpful at the early stages of dementia. It can be therapeutic to talk about one’s feelings in a group of people who can relate. It can also help reduce social isolation and feelings of loneliness. 

Lifestyle changes can also have a positive impact and improve their quality of life:

  • Encouraging healthy habits i.e. eating nutritious food, staying hydrated, exercising, being socially active 
  • Minimising stress by keeping days organised and simple with consistent activities 
  • Adapting the home to help maintain involvement and independence 
  • Getting fresh air and sunshine (if weather permits)

4) Talking therapies

Another option are talking therapies, which involves talking about how the person feels. This is usually done by a healthcare professional who helps the person express their negative thoughts and feelings and help address them. Doing this for a few weeks is seen to be beneficial. Cognitive behavioural therapy (CBT) is a type of talking therapy, involving 12-20 sessions with a therapist. In CBT the therapist helps identify behavioural patterns that lead to the negative thoughts and combat them. 

It is important to note that, talking therapies might not be as effective if the person with dementia struggles to communicate, remember things or stay attentive. However, the doctor will try tailoring this therapy to support them as much as possible. 

If someone is experiencing moderate depression, they might be recommended some of the above options together with antidepressants. Other options to consider are complementary therapies, like massage or bright light therapy that can be used in addition to conventional medical approaches. 

5) Medication

As mentioned in the previous blog, the changes in the brain that lead to depression are complex, but can be summed up as a chemical imbalance in the brain. This means that there are not the right levels of different chemicals available. This imbalance causes changes in mood, perception, and how we experience our day-today life. Antidepressants, as the word suggests, counteract these chemical changes, which can help the brain function like it used to. This may have been suggested as a treatment option for the person living with dementia and depression, especially if the depression is severe or other options haven’t worked.

Things you should know about antidepressants:

  • There are different types of antidepressants
  • People respond differently to antidepressants. While a type  might work for one person, it may not work for another – be patient to find the one that works 
  • They are usually taken for 6 months but might sometimes be prescribed for longer
  • The doses are gradually increased. This means starting off with a really low dose to help identify which one works for the individual
  • It can take time for the effect to be seen. Sometimes it can be several weeks before someone experiences the benefits. This is because antidepressants are not as effective for people with dementia when compared to someone who doesn’t have dementia. 
  • Side effects (i.e. headaches, nausea) are usually experienced in the beginning as the body get used to the medication. If side effects persist the doctor will tend to change and try another one
  • When it comes time to stop taking the medication, people might struggle to stop and  experience withdrawal symptoms and anxiety. That’s why doctors tend to slowly wean people off the medication. 

If someone has been prescribed medication or is seeing their therapist, you should encourage them to continue with the treatments, even if improvement feels slow at first. Depression isn’t something that dementia brings along. It is something that can be treated if given the right attention and support, helping to improve quality of life. 


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