How to distinguish between dementia and depression

Posted: Friday, October 19, 2007

Donna, age 89, was in good physical health and had always been an active member of her community. She was very involved in her church, attended classes at the senior center, drove herself to the market and appointments, played bridge. But over the course of a year, she became increasingly confused and lost interest in her usual activities.

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Donna seemed very negative, alienating others from her, complained of stomach pain, had a poor appetite and lost quite a bit of weight. She could not concentrate; she couldn't read or or even follow a television program. She could no longer take care of herself so her daughters arranged for staff to manage her daily personal care.

Those around her, on a regular basis, assumed her condition was due to "normal" aging or some sort of age-related dementia. Fortunately for Donna, one of her daughters was a home health nurse who knew there could be many reasons for her symptoms and that the condition might even be treatable. Donna received a complete physical exam and was seen by a neurologist. One of her daughters arranged for a counselor to come and talk with her weekly to address her loneliness. A psychiatrist started her on medication for depression and anxiety. A couple months later, however, Donna was still miserable.

Her nurse daughter, Diane, learned from experience that medications can dramatically reduce symptoms within three to six weeks-and she didn't see this progress. Knowing that there are many different types of medications to effectively treat depression, Diane wrote a diplomatic letter to Donna's psychiatrist, suggesting that he try some of the other medications, which she listed. The psychiatrist took her suggestion and, within four weeks, a miracle happened!

Donna began to take pleasure in those things she had once enjoyed: watching the news, reading books, playing bridge, going to exercise class, even serving on committees. She enjoyed the company of others and had her quality of life back. In fact, with the help of her daughters, she celebrated her 90th birthday this past June with 150 friends she has known throughout her life!

Each year October is commemorated as Mental Health awareness month, and Donna's situation is certainly a testament to the importance of mental health awareness. What would have become of her had her daughters and physicians not advocated on her behalf? Depression is a biochemical disease of the brain and should be treated as a medical issue, like a cold, diabetes or the flu-something that can be successfully reversed or handled as positively as possible.

Mental illness in any form, including depression, anxiety or dementia, should not be considered a normal part of aging. Many older people and their families don't recognize the symptoms of depression, aren't aware it is a medical illness and don't know how it is treated. Yet, once diagnosed, 80 percent to 90 percent of depressed individuals can be helped.

With depression, a holistic approach works best. This could include counseling, physical activity, increased social contact, proper diet, taking care of other medical issues, addressing spiritual issues and more. Without treatment, depression can turn deadly and, at a minimum, negatively affect the remainder of one's life. Nils Dihle, licenced professional counselor at Southeast Senior Services, offers counseling for senior citizens and their family caregivers. For further information on mental health and seniors, contact Dihle at 463-6163.

• Marianne Mills is the Program Director of Southeast Senior Services which offers home and community-based services for older Alaskans throughout the region. SESS is a part of Catholic Community Service and assists all persons regardless of their faith.

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