How can I tell if behavior is related to depression or dementia?

1 answer | Last updated: Mar 27, 2017
A fellow caregiver asked...

My mom is in her eighties, and has had some health issues over the past few years. She, now, stays in the bed most of the time, although she can still walk, with difficulty. And, she has fought severe depression most of her life. (She is and has been on meds for a long time.) However, lately, my mom will go from talking non-stop - lots of repeating - to being angry, to being very depressed.

I can talk to her on the phone and she's "fine" - talks non-stop, usually complaining, but is in a decent mood, to criticizing me the next time we talk and telling me I'm criticizing her because I told her to not be so negative or to not complain so much. She then tells me how much I'm like my dad (who is trying to take care of her with much of the same problem I'm having) and that I "worship him and he can do no wrong, but she's always wrong". She will also become fixated on something and worry non-stop about whatever it is. There have been several of these incidents. I can't talk to my mom, anymore, for the most part, like we used to.

On the other hand, she knows what's going on in the world, politically, and can talk about basic things. I haven't noticed anything really bad in the memory dept., as of now. I am so tired of being told I'm being disresptful, just for disagreeing with her or correcting something that she is wrong about. I may sound frustrated, at times, but I can't help it. She fusses about my dad nonstop, too. I am an only child, have young kids, and a full-time job, and I have been terribly down because of this problem. What do I need to do?

Expert Answers

Brenda Avadian, brings knowledge, hope, and joy to family caregivers for loved ones with Alzheimer's and dementia. She cared for her father with Alzheimer's and helps families one-on-one and in groups. She is the author of eight books, including the pioneering memoir "Where's my shoes?" My Father's Walk through Alzheimer's and the Finding the JOY in Alzheimer's series. She presents vivid, compelling, and funny keynotes to both professional and family caregiving audiences.

These are just some of the struggles we encounter when loved one's depression or dementia causes off behavior.

From what you describe, it is likely a combination of both depression causing dementia-like symptoms, and the dementia aggravating her ongoing struggle with depression.

You may want to have her medications reevaluated.

Our bodies change as we age and the medications that worked for so many years may no longer affect our bodies the same. The kind of medication may no longer work as effectively or the dosing may need to be changed.

Another reason may be due to the type of dementia she has.

The range of her behaviors could be indicative of frontal temporal dementia (FTD) that involves more behavioral symptoms and is often mistaken for dementia. Another form of dementia could be Lewy body dementia (LBD).

A geriatric physician or neurologist can best diagnose which form of dementia your mother has while also addressing the balance of medications she's taking.

Until then, understand that she is likely afraid of what is happening to her.

Wouldn't you be? I would. Even a "normal" person may struggle to cope with such symptoms but adding severe depression to the mix makes it even harder for your mother to cope.

Try to agree with her, redirect her attention to more favorable topics, and just be there for her. Making sure she's accurate may not be as important at this time in her life as making her feel comfortable and that you support her. It's hard, especially, when you're trying to balance life with your own responsibilities"”work and children, while being there for your parents.

Try your best. This is all you can do.