People with dementia often have emotional symptoms such as depression and anxiety. These symptoms may be a direct result of the neurological changes caused by the illness. They can also be the person’s reaction to the awareness of change in his ability to function as he once could. In addition, depression and anxiety can be a symptom of another illness entirely or of medications used to treat it.

By keeping the person with AD physically healthy, you will be also helping him to maintain a positive emotional balance. Illness and pain, though sometimes unavoidable, can lead to a depressed and anxious mood. It is important to consult the person’s doctor to find out whether there is a physical illness that might account for a sudden change in mood or other emotional symptoms.

A person in the early stage of Alzheimer’s disease may still be able to express feelings of sadness, loss, hopelessness, or even to say that she feels depressed. Symptoms of depression include a loss of interest in activities and hobbies, not wanting to be with people, and irritability. There may also be some physical symptoms such as change in appetite, fatigue, and sleep problems, although these may also be symptoms of another medical condition. It is not easy to separate out the symptoms of Alzheimer’s from those of depression and a person may have both illnesses.

As with any depressed person, it is not helpful to tell him “get with the program,” “cheer up, things could be worse” or to “try harder.” It is best to respond by providing more emotional support and meaningful activities and including him in family life as much as possible.

Symptoms of depression in people with Alzheimer’s disease sometimes seem to come and go, unlike the cognitive (ability to think) problems that get worse over time. But if your efforts to relieve his negative mood do not work, he should be evaluated by a psychiatrist who specializes in the care of the elderly with dementia. An antidepresssant medication may help the person in your care feel better, but as with all medications, should be checked regularly to ensure that the drug is still helping and is not causing unacceptable side effects. Strong emotions are a normal part of long-term illness. Counseling and support groups are a very helpful way of dealing with these feelings. If the person with dementia is depressed and needs therapy, ask the primary care doctor to give you the name of a therapist.