Depression is common among people with Alzheimer’s disease. It can be hard to know if someone with Alzheimer’s disease is depressed, because the two conditions often have many of the same symptoms.
When someone with Alzheimer’s disease is depressed, they may:
- Feel sad and hopeless
- Not enjoy their usual activities
- Not want to be around others
- Not feel like eating
- Have trouble sleeping
- Appear agitated
- Have less energy
- Be irritable
- Feel worthless
- Have repeated thoughts of death or suicide
If they’re confused about things like where they are or what time period it is, don't try to correct them. This could make them upset or scared.
Withdrawing from social activities is common for people with Alzheimer’s disease, but it isn’t usually serious. When they withdraw, they’re less active and may spend more time in a chair or in bed. They don’t want to take part in their usual routine. They stop taking part in activities they used to enjoy. Often, they feel sad and cry.
There are several things that can cause your loved one to withdraw. They may be depressed, or feel anxious when a social situation gets to be too much. They may be in pain. They may be sick or getting sick. They’re more likely to withdraw if they’ve had Alzheimer’s disease for a while.
Sadness and Crying
As Alzheimer’s progresses, your loved one may start to behave differently. They may feel sad and cry more often. Crying about little things is common in certain types of dementia because those little things affect areas of the brain that control emotions. Your loved one also might be remembering sad events, or be sick or worried about their health.
If your loved one cries all the time, they might be depressed. Try to find out what they’re feeling that makes them cry. Ask a question like “Can you tell me what is making you so sad?” If they can't tell you, remind them that you love and care for them. Keep in mind that they may not be crying because they’re depressed. Alzheimer’s often causes unexplained crying or strong reactions to everyday activities.
It might calm your loved one if they do something they enjoy, like eat a favorite food or smell their favorite smell, whether it’s flowers or candles. They can also pet the cat or dog, listen to music, or watch a favorite TV show. It can help to talk about important positive life events or favorite interests with them. You could also read to them or look at photos or videos. If they let you touch them, try holding their hand, touching their shoulder, or giving them a gentle massage.
Suicide in Older Adults
People over the age of 65 years have higher odds for suicide. Their loved ones often don’t realize they’re depressed, so they don’t help them get treatment. Things that make someone more likely to take their own life include the death or loss of a loved one, loneliness, illness, or pain.
The risk of suicide is highest if your loved one hasn’t had Alzheimer’s disease for very long (is in the early stages of the disease). The warning signs are different for different people, but include:
- Talk of death and suicide
- Greater use of alcohol
- Saving up medications
- A sudden interest in guns
- Making goodbyes
- A rush to make or change a will
If you think your loved one is at risk for suicide, there are some things you can do to help them.
- If they have had Alzheimer’s disease for a short time, find counseling or a support group for them.
- Keep guns, knives, and other sharp objects out of the house or locked away.
- Set up a routine.
- Plan hard or tiring tasks, like bathing, for times when they have the most energy.
- Help them get daily exercise.
- Make a list of their favorite places, people, music, and activities. Help them to do a favorite activity every day.
- Offer them their favorite foods.
- Remind them you love and care for them.
- Ask them if they’re thinking about death or suicide.
- Stay away from large groups of people or certain places if these upset your loved one. If you can’t do this, comfort them by talking to them or by touching them gently if they’ll let you.
- If your loved one says they have repeated thoughts of death, or if they talk about suicide, call a doctor or counselor right away.
Medication for Depression
Ask your loved one’s doctor about antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs). Be aware that these medications may not be as helpful for people with Alzheimer’s, especially if they’re just mildly depressed. This might be because chemicals in the brain that cause depression are different in people with Alzheimer’s disease. It could also be that your loved one’s depression results from things that drugs can’t fix, like social isolation.
Medications for depression can cause problems like confusion, falls, dizziness, and other side effects. They sometimes prevent other medicines from working the way they should. Try other things to help your loved one before trying medication, and talk to a doctor about the possible side effects.
Taking Care of Yourself
It’s normal to feel frustrated when you’re caring for a loved one who’s feeling sad and crying. If you can, try to take a break during the day. If you’re worried about leaving your loved one alone, ask for help from a family member, a trusted friend, or your local Area Agency on Aging or Alzheimer's Association chapter.