By JUDD MATSUNAGA, Esq.
You may have just lost a spouse, close friend or family member. Or they (i.e., those bastards!) might have just taken your driver’s license away. If so, there’s a good chance you may be depressed (I would be). You can’t sleep. You feel irritable and restless. Foods you once loved look unappetizing. These are signs that you may be depressed. You are not alone. Over 19 million Americans suffer from depression every year.
While depression is not a normal part of the aging process, there is a strong likelihood of it occurring when other physical health conditions are present. For example, one-third of widows/widowers suffer depression in the first month after the death of their spouse, and one-half of these individuals remain clinically depressed after one year. Nearly a quarter of the 600,000 people who experience a stroke in a given year will experience clinical depression.
Depression is not just having “the blues” or the emotions we feel when grieving the loss of a loved one. The treatment of depression must be taken seriously. Telling someone who suffers from depression to simply “cheer up” or “snap out of it” is not helpful. Unfortunately, symptoms of depression are often overlooked and untreated when they coincide with other medical illnesses or life events that commonly occur as people age.
Did you know that primary care physicians fail to accurately recognize patients with depression over 50 percent of the time? This results in potentially decreased function and increased length of hospitalization. (Source: Mental Health America, Depression In Older Adults) This is a huge problem for seniors!!! Ignoring sadness or dismissing it as a normal side-effect of aging could allow potentially treatable memory issues to progress unchecked.
Fortunately, clinical depression is a very treatable illness. More than 80 percent of all people with depression can be successfully treated with medication, psychotherapy or a combination of both. Clinical depression is never a “normal” response; it is a serious medical illness that should be treated at any age. (Source: Harvard Health Publishing, “Depression: Early warning of dementia?,” Oct. 1, 2012)
According to Dr. M. Cornelia Cremens, assistant professor of psychiatry at Harvard Medical School, “I think older individuals are more in denial about having depressive illness. They’ll say, ‘Well, I’m 83 years old — who wouldn’t be depressed?'” Ignoring sadness or dismissing it as a normal side-effect of aging could allow potentially treatable memory issues to progress unchecked.
You’re also more likely to develop illnesses such as diabetes, heart disease, and cancer as you get older. These conditions can increase your risk for depression, and vice versa. Depression can make a chronic illness worse, says Dr. Cremens. The link between depression and dementia is even more significant considering that depression becomes more common with age.
Quite often, diseases will often mimic one another, yet have distinct differences as well. This is no different with depression and dementia. Both can display the same symptoms, from lethargy to confusion, yet they have notable differences that define them. One can even mask the other. Since geriatric depression and dementia share many similar symptoms, it can be difficult to tell the two apart.
There are several similarities in symptoms between depression and dementia. The two disorders can go hand in hand, sort of like a never-ending cycle. That is because so many people who have Alzheimer’s disease are also depressed, either due to their condition or some other cause. Those who suffer from both Alzheimer’s and depression often find it easier to deal with the changes caused by Alzheimer’s when they feel less depressed, says the Mayo Clinic.
Unfortunately, since depression is often confused with dementia, it goes untreated, e.g., “The loss of mental sharpness is just an unfortunate effect of aging.” The bad news is one study found that people who became depressed late in life had a 70 percent increased risk of dementia, and those who’d been depressed since middle age were at 80 percent greater risk. (Source: Archives of General Psychiatry, May 2012)
In other words, you can dramatically reduce your risk of developing dementia if you treat depression – that’s great news!!! So if you’re getting up in years and starting to see signs of depression or dementia, there’s a good chance that your “quality of life” can be improved with proper treatment. Depression is not a normal part of aging. It is a true medical condition that is treatable, like diabetes or hypertension.
Always have a doctor make an official diagnosis and never diagnose your loved one yourself. A misdiagnosis can be dangerous, as your senior loved one may be treated for the wrong illness. For example, if they have depression and are mistakenly diagnosed with dementia, then their depression will remain untreated, which can be devastating.
That being said, here are some guidelines for figuring out the difference between elderly depression and dementia that I found on www.seniorlifestyle.com:
Response: People suffering from geriatric depression notice and are worried about their memory problems. Those with dementia are unconcerned with or in denial about their symptoms.
Mood: People with elderly depression have a pervasively sad mood. People who have dementia are in a normal mood most of the time, and their mood often brightens with stimulation and support.
Memory: People with geriatric depression have difficulty concentrating and may even suffer occasional memory lapses. People with Alzheimer’s disease have trouble with short-term memory and storing new information, such as the recent visit of a close relative or what they ate for dinner.
Language and motor skills: Depressed people have normal language and motor skills, although they may speak slowly at times. People with dementia often experience apraxia – trouble remembering how to perform previously learned and routine motor activities.
According to the Alzheimer’s Association, the most common treatment for depression in Alzheimer’s involves a combination of medicine, counseling and gradual re-introduction to activities and people that inspire happiness. If depression is the problem, memory, concentration, and energy will bounce back with treatment. Even in some types of dementia, symptoms can be reversed, halted, or slowed.
Knowing you’re at high risk for dementia can also help you and your family prepare for it, so it won’t be as much of a shock down the road. Get treated and keep getting monitored by your doctors until your depression is under control. Depression is among the most treatable of mental disorders. Between 80 percent and 90 percent of people with depression eventually respond well to treatment. Almost all patients gain some relief from their symptoms.
Yet many people avoid getting diagnosed because of the stigma depression still holds for older adults. “Older people still have the idea that ‘I’m not crazy. I don’t want people to think I’m crazy,'” Dr. Cremens says. “If somebody appears to have the beginnings of dementia and they are depressed, it’s very important to treat their depression, and to treat it as aggressively as possible,” she adds.
Whether you’re concerned about a loved one or your own cognitive decline, regardless of the cause, it’s important to see a doctor right away. If depression is the problem, memory, concentration, and energy will bounce back with treatment. Even in some types of dementia, symptoms can be reversed, halted, or slowed.
In conclusion, if you have any signs of depression, or are concerned about your own cognitive decline (regardless of the cause), it’s important to see a doctor right away. By the way, in case you forget later, cut this article out and give it to your closest caregiver. If someone you know suffers from elderly depression or dementia, offer to go with him or her to see a health care provider to be diagnosed and treated.
Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.