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Why Is Depression Often Mistaken for Dementia?

“Where did I put my pills?” Memory problem in older adults is an alarming situation. For the person suffering the decline in their cognitive ability but also for the person’s family and caregivers.

Our first reaction in this situation would be to associate a lack of memory with early signs of dementia. While this intuition may be correct in some cases, lack of memory is not a sign of dementia but depression. Mistaken both ailments can lead to unsuccessful treatments and receiving the wrong type of care.

In this article, we will learn the similarities and differences between depression and dementia and understand these mental health conditions are mistaken. We will review their symptoms, warning signs, and some examples in which lack of memory may not be considered dementia.

We will provide you with helpful tools to address this situation, including receiving the type of help you or your elderly loved one needs.

Depression and Its Symptoms

woman with dementia

Depression is a mental health condition that affects around 4% of the world population (WHO, 2020). Many people have a limited view on depression as related to “feeling sad,” “not wanting to get out of bed,” or “being a pessimist.”

Depression is a complex mental health disorder that affects our standard capacity of thinking, feeling, and acting. In its severe cases, it may affect a person’s daily functioning, relationships, work performance and increase the risk of death to suicide. 

Adults or elderly who suffer from depression may experience several depressive episodes throughout their lives. Some of the more widespread warning signs include:

  • Frequent sadness or tearfulness.
  • Feelings of hopelessness and helplessness.
  • Lack of appetite or increased cravings for fatty, sugary, or salty food. 
  • Changes in sleeping patterns (insomnia or excessive sleep).
  • Lack of interest in most activities that were previously considered enjoyable.
  • Lack of attention and concentration.
  • Memory problems.  
  • Withdrawal from social interactions or not wanting to go out of the house.
  • Recurrent health problems, such as headaches, stomachaches, unexplained physical pains, or tiredness.  
  • Suicidal thoughts, planning, or attempts.

It is essential to keep in mind that most people may experience a few depressive symptoms without having a mental health disorder. Older adults are no exception. For this population, depression symptoms may be triggered by age-related life events, such as a crisis of identity after retiring, the death of a spouse or a long-time friend, receiving a physical diagnosis, losing the ability to live independently, spending too much time alone without contact with family or friends, among others.

Dementia and Its Symptoms

Dementia is not a disease but an umbrella term that describes a progressive decline in cognitive abilities because of the gradual death of brain cells. Although Alzheimer’s disease is the most common type of dementia, accounting for 60-80% of the cases (Alzheimer’s Association), other diagnoses are also included under this general term.

Different types of dementia include Parkinson’s and Huntington’s disease Vascular Dementia, Frontotemporal Dementia, among others.

Symptoms of dementia vary from person to person. The following are the most common symptoms:

  • Disorientation
  • Confusion
  • Short-term memory problems, even affecting daily activities (i.e., forgetting important appointments, turning off gas hobs or ovens).
  • Decline in language skills (i.e., forgetting words, familiar names, and ultimately, overall speech).
  • Changes in mood and behavior.
  • Impairing of problem-solving skills.

As opposed to the mainstream view, dementia is not age-related. Indeed, as we grow older, our brain activity may not be as high as it used to be in our 20s, 30s, or 40s.

This gradual reduction may cause us to forget things from time to time, like someone’s birthday, a phone number, or the name of the restaurant we visited last summer. This slight decreased in brain activity does not cause brain damage, as any type of dementia disease does.

Symptoms of Depression and Dementia May Overlap in Older Adults

As children, friends, or caregivers of older adults, we may start to perceive signs of depression in our loved ones and confused them for dementia. This is a common mistake that may lead to seek the wrong type of treatment or provide inappropriate care to the person. 

Depression and dementia are confused due to at least two reasons. First, as we mentioned above, dementia is incorrectly associated with the aging process. Second, both mental health conditions share similar symptoms, such as memory loss, lack of concentration to perform daily activities, and changes in cognitive skills and mood.

For a non-clinical eye, it would be challenging to distinguish both conditions. For a diagnosis of a type of dementia disease, the person needs to undergo a medical evaluation, which may include brain scans. 

One of the most pressing needs to find out whether an elderly loved one is experiencing depression or dementia has to do with finding the proper treatment. This is key in helping the person increase her overall sense of well-being, especially for older adults suffering from depression.

As we mentioned above, severe cases of depression may lead to suicidal attempts if the person does not receive professional mental help promptly.

“In Canada, suicide is the 12th cause of death among the elderly. Among the seniors who die of suicide every year, 80% are men” (Public Health Agency of Canada, report) 

Examples of Elderly Depression Resembling Dementia

Depression in the elderly usually manifests with a variety of symptoms, besides instances of memory loss. It is essential to look at the overall day-to-day functioning of our loved ones.

Here are a few examples of how depression may look like for this population:

  • “Since my husband died a couple of months ago, I am having a hard time concentrating and remembering things.”

The death of a spouse can elicit depressive symptoms such as the inability to concentrate on daily tasks. Lack of concentration often results in poor memory because the brain may be operating on automatic pilot without retaining any information.

In this case, lack of memory is probably not the result of brain damage (dementia) but a depressive state.

  • “Mom, where did you put the bills? —I don’t remember Kathy, and I simply don’t care. I just want to be left alone! Please go, I feel so tired…”

Notice that the older adult presents various symptoms that may fit with a diagnosis of depression. Indeed, the lack of memory and moody character may point toward early dementia. Still, other diagnoses, such as depression, need to be considered.

In this case, one may have to think whether the adult’s lack of memory reflects a brain disease or an increased sense of indifference and helplessness towards life? The lack of energy this woman is experiencing and her desire to isolate herself from her children may suggest that she is experiencing depression.

  • “I feel so frustrated that I keep forgetting if it is Monday, or Wednesday, or Saturday! Since I retired, every day looks the same.” 

While many people are looking forward to the day of their retirement, others may experience depressive episodes after the initial “vacation phase.” Many people find their life’s purpose in the professional careers they have built with so much effort throughout decades.

Transitioning to retirement may undermine their sense of worth and the meaning they give to life. For those older adults, jumping from working 10 to 12hrs a day to sitting every day on a couch to read the newspaper may cause a significant impact on their sense of self.

Adjustment to retirement can be particularly challenging for men who were raised to be the primary financial provider of the household or who occupied leadership positions in their organizations. 

What Can You Do?

Probably at this moment, you are wondering whether you or your aging loved one is having depression, dementia, or any other strange condition listed on the internet. That’s understandable! It is normal to feel puzzled trying to figure out the underlying cause behind our mental health symptoms.

There are two essential steps that you can take at this point.

First, take some time to further educate yourself on the signs of depression and dementia.

Second, seek professional help. Aging is not equivalent to living a life of misery and suffering. Least of all, in our current times when there are so many resources, therapies, approaches, and specialists available to support people as they grow older.

As Therapists, What We Can Do To Help?

As therapists, we recognize that one of the most powerful things we can offer to any person —regardless of their age— is the value of caring.

For us, caring means listening attentively, relating with compassion, and not judging anyone for speaking about their symptoms or life’s struggle. We believe that knowledge without caring does very little.

The practice of caring accompanied by clinical knowledge can be an excellent approach to help you live a more pleasant and meaningful life.

Now what?

You can book a free 15-mins phone consultation with us  to let us know how we may better serve you. In addition, you can review our team of registered counsellors and psychotherapists, who will be more than happy to help you thrive at this moment of your life. Thank you for taking the time to read and checking our services.

We hope you have a peaceful day! 

Picture of Pareen Sehat MC, RCC

Pareen Sehat MC, RCC

Pareen’s career began in Behaviour Therapy, this is where she developed a passion for Cognitive Behavioural Therapy approaches. Following a Bachelor of Arts with a major in Psychology she pursued a Master of Counselling. Pareen is a Registered Clinical Counsellor (RCC) with the BC Association of Clinical Counsellors. She specializes in CBT and Lifespan Integrations approaches to anxiety and trauma. She has been published on major online publications such as - Yahoo, MSN, AskMen, PsychCentral, Best Life Online, and more.

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