Is it Dementia or Depression?

If you ask the average person to compare dementia versus depression, they’ll probably say cognitive disorders are easy to tell apart. One is a down-in-the-dumps, melancholy mood change, while the other is characterized by disorientation, confusion, impaired judgment and generally, a patient with confusion.

But what if we told you it’s not so simple? 

Depression and dementia have many common symptoms. And while a grandparent may never confuse you with your parents because of depression, the characteristics of these two mental illnesses can be hard to sort from one another. 

Put simply, when asked whether someone — particularly an older person — is experiencing dementia or depression, it’s not always easy to tell the two apart.

Whether you’re concerned for the health and safety of an aging loved one or are becoming an aging loved one yourself, there are some key questions to ask when trying to determine whether a person is experiencing dementia or depression. 

It may be crucial for a healthcare professional to answer some of those questions (and ask more of their own).

But before you start making appointments with professionals, let’s look at the basics so you can make more informed decisions for yourself or your family.

Dementia and depression are both conditions you should understand in their most basic forms first, so here’s a brief breakdown of each.

What Is Depression?

Depression is a mood disorder characterized by down, hopeless, indifferent or melancholy feelings. It can affect your mental health, cause insomnia and even memory loss, and it can lead to problems with your weight and sleep cycles.

Over time, it can increase your risk of heart conditions and other potentially deadly diseases. People with depression may lose the will to perform daily activities, and their minds and bodies can decline as a result.

What Is Dementia?

Dementia, meanwhile, has a lot in common with depression — at least on paper. A person with dementia will see cognitive decline and struggle to perform everyday tasks, their behaviors may change, and they may lack insight into why these things are happening.

So when we ask why dementia and depression can look alike, the answer is because the symptoms frequently overlap.

It’s often hard to distinguish symptoms of depression from symptoms of dementia in older adults because intellectual decline and mental illness are common experiences of aging.

According to Harvard Medical School, depression in older adults can lead to a type of dementia called pseudo-dementia. This is essentially intellectual decline caused by a lack of energy or motivation that results from depression.

On its own, dementia is a pretty serious condition. But when it comes to your risk of depression, the most common forms of dementia are heralds of bad news. 

Experts believe depression can be a primary risk factor for the development of dementia later in life, along with traumatic injuries, family history and cardiovascular disease.

That risk factor often comes to fruition when certain types of dementia occur. Roughly 30 percent of Alzheimer’s disease patients experience depression concurrently. 

And 30 percent of people with vascular dementia also experience depression alongside the condition’s more common symptoms. Meanwhile, people with Huntington’s disease and Parkinson’s disease are at an even higher risk. Some 40 percent of folks with these conditions experience “sustained and disabling” episodes of major depression.

Dementia has a complicated and tightly interwoven relationship with depression, often exacerbating problems like social isolation and sadness. Depression is one of the symptoms of dementia, which confirms a clear cause-and-effect relationship. 

So yes, dementia can cause depression. But it’s not quite that simple, either.

A 2015 paper noted that people with any form of dementia have a “high incidence” of developing major depression and, likewise, that the occurrence of a major depressive episode is, in and of itself, a risk factor for developing dementia when it happens in elderly adults.

In other words, you’re awfully likely to see both happen if one happens — and it doesn’t really matter which one comes first when considering that risk.

Older depressed people can often be mistaken to have dementia, as we mentioned before, which is why depression is one of the most important differential diagnoses when a person exhibits signs of dementia.

Worse yet, a person showing signs of depression can make dementia harder to treat effectively. Experts say depression in elderly patients requires quick and early detection and prompt treatment to be manageable without serious consequences — which can be difficult when a person’s intellectual faculties are failing them.

And as you’re about to see, treating both conditions can require a lot of extra care in several forms.

According to experts, the goal of treatment for dementia and depression is to maximize the quality of life for the person experiencing these conditions. This means giving them tools to live and helping their brain function as normally as possible despite their circumstances.

Here’s the problem: treatments for depressed patients don’t always work as well when dementia is involved.

Selective serotonin reuptake inhibitors (SSRIs), for instance, are typically considered the first line of treatment for depression, but they’re not as good at treating mood disorders in older people.

So what do you do to treat these conditions? In the case of dementia, medications called cholinesterase inhibitors are regular medications that work to slow cognitive decline and cognitive impairment in patients with dementia. The behavioral symptoms of dementia can be treated with SSRIs, antipsychotics and anti-anxiety medications.

Types of treatment like memory training, exercise programs for physical activity and social programs are also essential for supporting someone with dementia, as are lifestyle improvements around sleep, caffeine use, alcohol consumption and therapy.

As for depression, treatments like antidepressants, therapy (especially cognitive behavioral therapy) and lifestyle changes are all highly recommended.

Reductions in caffeine and alcohol intake, antidepressants, better sleep hygiene and exercise are recommended for the management of both dementia and depression. This is arguably a sign that taking care of our physical bodies is just as important as taking care of our minds.

Real talk: dementia and depression are both serious conditions. They can ruin lives — and potentially take them — if not treated properly with the help of a healthcare professional. If you or someone you love is showing concerning signs of dementia or depression, get help for them as soon as possible.

Help can mean lots of things. It can mean treatment, therapy, medication and safe facilities where they can be assisted in their usual day-to-day activities.

In cases where someone has both depression and dementia, treatment can be life-saving. 

Not sure where to start? We can help. Our mental health resources are a great place to learn more about depression, depressive symptoms and the forms of treatment that are most effective in managing day-to-day symptoms. 

But don’t stop with words from the internet. Get a mental health provider involved in treatment today so the loved one in question has the best support available as soon as possible.