Can depression be a sign of dementia?

Depressed Senior Woman Sitting OutsideDepression can affect our memory, and it can result from not being able to do the things that were once easy for us, as in the case of Alzheimer’s or dementia. Depression can result from a number of factors and it often appears differently in different people

Some people are able to hide the fact that they are terribly depressed. I did. I tried to put on a happy face during my husband’s illness, but inside I often felt as though I was dying. Following the recent suicides of Kate Spade and Anthony Bourdain, we have to remind ourselves that we usually don’t know what is happening inside someone else’s head.

Before my husband was diagnosed with younger-onset Alzheimer’s disease he was withdrawn and depressed. I didn’t know what exactly what was going on, and he was unable to articulate how he felt. I eventually realized that he was depressed because the things that were once effortless for him to do, such as driving around town or figuring out how much tip to leave in a restaurant, had become difficult.

Alzheimer’s and depression often occur simultaneously, which often makes it difficult for physicians to make a diagnosis without further testing. According to James M. Ellison, MD of the Swank Memory Care Center, Christiana Care Health System, approximately half of individuals affected by Alzheimer’s disease will experience clinically significant depressive symptoms at some point.  Depression can occur during any phase of the illness.

Symptoms common to Alzheimer’s and depression

  • Loss of interest in things that were once enjoyable
  • Memory issues
  • Sleeping too much or too little
  • Social withdrawal or isolation
  • Impaired concentration
  • Eating too much or too little
  • Crying, feelings of hopelessness, despair
  • Unmotivated
  • Lack of energy, lethargy, apathy
  • Irritability
  • Thoughts of death or suicide

A case of the chicken or the egg: which came first, Alzheimer’s or depression?

Some health professionals think that depression can put one at greater risk for Alzheimer’s. There is also a belief that depression is a symptom of Alzheimer’s. In any case, physicians feel that a person with dementia who is depressed can experience a quicker cognitive decline and need to rely more on caregivers.

What to do?

8 natural ways to combat depression.

Antidepressants may not work as well with people who have Alzheimer’s and are depressed. Before resorting to antidepressants and other drugs,  try these options:

  1. Provide a safe and calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.
  2. Get some physical exercise every day; even just a 20 minute walk helps tremendously.
  3. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn
  4.  I gave my husband Ginkgo biloba for depression (and also took it myself). It helped right up until he was in late stage Alzheimer’s. One word of advice, not all brands are efficacious, so pick one carefully. Also note that it takes about 6 weeks to notice an effect. This is a typical difference of taking a pharmaceutical versus a natural remedy.
  5. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.
  6. Omega-3 fatty acids are rich in DHA, the major unsaturated fat in the brain. This long-chain fatty acid provides the necessary fluid quality to the membranes of the nerve cells so that electrical nerve impulses can flow easily along the circuits of the brain. One study found that Alzheimer’s patients given an omega-3-rich supplement experienced a significant improvement in their quality of life.
  7. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group, or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.
  8. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. Studies have indicated that sleep deprivation can increase risk of dementia and Alzheimer’s disease. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Dealing with a loved one’s things after their death

 

Wohnungsauflösung

I confess. I am attached to my material possessions. It’s very important to me that I live in a beautiful environment and that means being surrounded by beautiful things. I have had the good fortune to inherit lovely things from my deceased in-laws. Their various art collections grace my walls and I enjoy them. But actually, at this stage in my life I would prefer to live more simply in a small, uncluttered home where I don’t need an alarm system to provide peace of mind that my beautiful things will be forever guarded and safe.

Now that my mother has passed away I have more beautiful things. But this time around, as I weathered the storms of her many health crises I was able to think about the things I would like to keep and visualize what it would actually be like to clear out her apartment. I contemplated the reality of having to face the thankless task of going through her top drawer and disposing of her most intimate things: eye glasses, hearing aids, medications, bras, and underwear. I think this exercise helped me to get through the actual tasks required after she died.

Creating a safe space for family

I invited my adult children, my brother’s wife and their daughters, my mother’s sister and husband, and a few cousins to my mother’s apartment the day after she was buried. Since everyone lived at least a thousand miles away, the “farewell party” had to be expedient. Most people were flying home that afternoon.

I asked everyone to browse through the things I had laid out on the couch and the many items, including a collection of paper weight and Lladro figurines, that were displayed in two large glass showcases. Next, we took turns choosing what we would like to take home as a remembrance of our mother, sister, grandmother, and cousin. It worked beautifully because my mother’s family happens to be one of the most “normal” families I know. No one fights, everyone gets a long–usually. And that’s how it went without petty arguing or bickering.

But my mother had a will in which she specifically indicated that I, the only daughter, was to inherit her jewelry. A couple of years before she passed, we went through her jewelry together and picked out pieces for her granddaughters and daughter-in-law. And then I found four small pinky size rings with various precious stones that were perfect for her four little great granddaughters. The will made this task easy.

Many years ago, when my mother-in-law died it wasn’t as easy. One family member got greedy which led to some bitter feelings. The key is to make a plan ahead of time. Encourage your loved ones to designate in a will who they want to inherit valuable and sentimental items.

10 tips for making a difficult, emotional process a little easier

  • Consider how much time you have. Do you need to vacate the apartment or house in one week or one year? Personally, I am glad that I had a time limit of one week. Even though the job was exhausting, I’m glad to have it behind me. Dragging it out month after month would seem to me to be even more exhausting, both physically and emotionally.
  • Get help! My aunt, her daughter and my partner, who stayed with me for the entire week, helped tremendously. I could not have done it without them. After everyone pulled out the items they wanted, it was easy for my helpers to go through things and determine if they could be sold or if they should be donated.
  • Find a non-profit agency such as Goodwill to pick up a truckload of furniture. I was shocked when several very nice pieces of furniture were rejected because of a stain or slight crack. These non-profit groups have become very picky, so be sure to ask on the phone if they will accept imperfect furniture pieces. Set a time for pick-up and ask if the items need to be disassembled before pick-up.
  • Bring miscellaneous items such as pots and pans, dishes, books directly to a non-profit organization in order to clear the space for when the bigger items are picked up, if you have the time and energy.
  • Nursing homes and continuum care facilities sometimes have a “store” on the premises that accepts used items. They often are eager to accept artwork and medical supplies such as wheel chairs, walkers, commodes, etc. If not, give these to someone in need. You might even find a neighbor on the same floor as where your loved one lived.
  • Take photos of photos to save money and space. My parents kept dozens of photo albums from their many trips. I shipped home some albums that included family life cycle events and gatherings. My brother, however, wanted all the travel albums. Instead of spending a fortune on shipping heavy albums, I removed the photos and put them in shoe boxes. My daughter took photos of the special family photos to archive.
  • Keep important papers: insurance policies, birth certificates, car titles, etc.
  • Don’t stop and read every letter or card that you ever sent your loved one. Box them up and bring them home to read when you aren’t as emotional.
  • Do not flush medications down the toilet! They get into the water supply. Boulder County’s website says: Pour liquid medications over cat litter or other absorbent material, and seal it in a plastic bag before placing it in the trash. Fill pill containers with household glue, remove all personal information from the container, and place it in the trash after the glue has dried. Cut trans-dermal patches into small strips, place them in a container, and add glue or mix them with coffee grounds or used cat litter. In some areas, you can bring medications to the fire or police station.
  • Don’t feel guilty about getting rid of stuff. The objects meant a lot to your loved one. But your memories are not contained in the favorite necklace your dad gave to your mom. Your dad’s favorite golf clubs that he won several trophies with don’t hold the same meaning for you. Your spouse’s slippers are old and ratty and it’s time to get rid of them. As we reminisce and go through our loved one’s material possessions, it is a good time to start downsizing our household and to think about our own mortality and how we want to live the rest of our life. The memories of celebrating your loved one’s life will always be held close to your heart. As you go through their items, remember the saying “You can’t take it with you.” It might just help, at least a little.

“Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn contains a treasure trove of information on how to stay connected with your loved one, keep calm, improve immunity, reduce stress and feel happier and healthier. Plus, it includes 20 healing modalities that the caregiver can do alone or with their loved one. Available wherever fine books are sold and on AmazonBarbraCohn__