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Low mood and depression

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approaches to dementia care, research, symptom reduction

There is a strong link between mood and dementia. People who have previously suffered with depression have a higher likelihood of developing dementia and depression is also linked with a faster rate of deterioration in those living with dementia.

Dementia is unique in the way it affects every aspect of an individual’s life and the concurrent presence of depression can add further torment and troubles to an already challenging condition. In the earlier stages of dementia, low mood and depression are relatively common. The reason behind this is multifactorial and thought to be a combination of an increased susceptibility to a recurrence of past depression, insight into one’s condition and prognosis having an effect on mood, and directly due to the various pathophysiological changes of the brain that happen with dementia.

Fortunately, having depression alongside dementia doesn’t mean the depression is simply left untreated. In fact, there are many treatments available for those suffering from depression. This will be tailored to an individual and depend on the severity of the depression and dementia. The biggest challenge though is identifying the low mood in the first place. Communication limitations can make this challenging and signs can be misconstrued as being generally part of the dementia.

Initially, non-pharmacological approaches are considered best. This may include behavioural approaches which teach the main caregiver behavioural strategies to alleviate the depression in the person they care for, mainly involving improving and increasing the number of pleasant events and activities provided by the caregiver for the sufferer. Additionally, support groups can be of great benefit in managing depression, as well as being invaluable assets in their own right to the everyday life of an individual living with dementia. Self-help, for those with more insight into their situation, can also be of benefit and involves activities and techniques a sufferer can do alone to boost their mood and take some time out for themselves. Talking therapies are effective methods of treating those suffering with moderate depression, in particular cognitive behavioural therapy. This involves the individual understanding and addressing the links between their thoughts, feelings and behaviours, to create positive change.

Antidepressants do have a role in treating depression that is more severe or refractory to other therapies. There are a number of drugs with different mechanisms available and a range of different options may need to be trialled and withdrawn as appropriate because their efficacy can vary greatly from person to person. This can be a timely and difficult process, firstly as the drugs in question can take weeks to have any effect, and secondly as the measurement of their effectiveness treating depression in those living with dementia is often challenging due to the communication limitations.

Depression can place a heavy burden on the individual living with dementia as well as those close to them, adding to what is an already complex disease. There have been a host of studies exploring the links between the two diseases and potential therapies for when they occur together, however many are underpowered or provide inconclusive results and I believe it would be of great benefit to the lives of many individuals if more research were carried out in this area. Most importantly, I think it is vital that depression is diagnosed and managed well in those with dementia as tackling it can provide real benefit to the person’s quality of life. 

 

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