How exactly is depression treated in people with dementia?

My sister suffered from depression, so much so that initially the specialists thought she had "depression induced pseudo-dementia." They put her on Trintellix, which is considered beneficial as an antidepressant for people with dementia. Within 8 weeks, her depression was gone; unfortunately, her dementia was not. She was diagnosed with Alzheimers. For the next 30 months, until her death, she lived with us. We kept her on a daily dose of Trintellix. She was never again depressed and was actually filled with joy and laughter. I would strongly suggest that you have your Mum evaluated by a geriatric psychiatrist as soon as possible for possible anti-depressant drug management.

Best of luck. Finding the right Doctor who can support you through this awful time is so very critical!

Have you tried Googling what you can do to help a grieving family member cope, and doing some of those things? Grief can manifest in a variety of ways regardless of age.

Bcause I'm not familiar with Australia's system, I read a few of the comments. In one, you responded that you've considered taking her to emergency where she would be evaluated.
DO THAT!

If you feel you need some kind of excuse, tell them you are concerned that she has a urinary tract infection. UTIs can mimic psychiatric symptoms. If you need a physicial medical excuse, use that and get her care ASAP.

Cappuccino42: Dementia cannot be rationalized; perhaps your mother is not able to fully state why she feels down because her brain is broken. While she may try, perhaps she's so burdened with the illness of dementia that depression is adding another VERY conflicting layer to her ill health. Hugs sent during this most difficult of times.

A Geriatric Psychiatrist can evaluate your mum's mental state and offer medications that are created to treat depression, grief, schizophrenia if it's indicated and help both of you find an appropriate placement where ongoing issues can be treated (perhaps a psychiatric hospital).

Professional advice is needed here so that you and mum can move forward in your lives. You may want to get a grief therapist for yourself as you have lost loved ones too.

I practice Mindfulness Meditation to help keep my challenges in check and not let any one issue drive me to the brink.

I'm not a doctor, but a gerontological social worker. My thoughts are that if your mom is not on any psych meds, that's a possible help for her. The delusions and such she's experiencing could be vascular dementia, combined with depression. Those two are linked as they both are brain related, obviously. She may have initially started having small strokes and now there are areas of her brain that are misfiring. If she has dementia and is not in good shape, it does also seem that the cholesterol medication is no longer a good idea. Many doctors and publications like to take people off statin meds when they reach 75 or certainly 80, as the side effects might not be helping her cognitive abilities. If there is a social worker who can work with you, while you translate, they may be able to help, and the idea of taking her to the ER is always a possibility, as you will at least get a brief evaluation. Ideally, you'd like a geriatric psych nurse or physician to evaluate her for medications, along with trying some calming behavioral methods to help soothe and reassure her. So difficult!! Sounds like you are doing a lot along those lines already, but the videos suggested (Teepa Snow) may have other suggestions.

My stupid doctor think every thing can be fixed with a pill.

Your poor mom has been through a lot.

Aging is depressing enough without loss of loved ones.

My mom had similar behaviors when she was over medicated. (Many medications have side effects of dementia-like confusion, depression, suicidal thoughts, etc. Although you have nor written anything about suicidal thoughts, the self-criticism you have witnessed may be a lighter version.)

If your mom is already taking several medications, that may explain why her doctor is unwilling to prescribe more.

Check first to ensure any medications are being taken according to instructions (at properly spaced times). It seems like your mom is probably getting help rather than going into the pillbox herself, but regardless, make sure the medications are stored out of reach.

Has she undergone any changes (like weight loss) that could be affecting the way her medicine impacts her?

You don’t need to be a doctor or pharmacist to go through this following exercise. Chart out each medication, vitamin, and supplement with name, class of medication, purpose, dose, recommended dosage for domeone her weight, side effects, warnings snd potential interactions. Get this information from the internet.

When I went through this exercise with my mom’s medications I leaned she was being prescribed medications for conditions that had resolved and for problems that were annoying but not absolutely necessary (bladder control). She was taking “safe” herbal supplements recommended by her doctor that she did not need. She was being prescribed drugs that were extremely dangerous when taken together at dosages that were not appropriate for her weight. Some of the classes of medications were recommended to never be taken together. For my mom, I’m still shocked that the pharmacy alarms were not triggered. Over time the medication had built up in her system. some were prescribed by her Primary, others were added during hospitalizations. My mom had been seeing highly regarded medical experts in a world-class hospital system — this should have never happened.

Mom was complaining of dizziness and she was having falls. She wasn’t thinking clearly. (All associated with normal aging). Her doctors write dementia in her chart.

When I went to her doctor and asked if the medications could be contributing to mom’s health problems I was basically turned away. I was told this was normal aging. I was told I was in denial. I decided to get a second opinion from a new cardiologist because some of her medications were heart related and I didn’t have faith in the highly regarded cardiologist she was seeing.

You should never alter anyone’s medication’s without strict supervision of a doctor. This can be very dangerous. This new doctor listened. He worked with me to slowly wean mom off unnecessary medication and her whole life and mental status changed.

Don’t ever ask your mom‘s primary care provider to prescribe anti-depressants. Seek out instead a geriatric psychiatrist. Even if the psychiatrist adds medication‘s, include them in the chart described above and make sure, even if you’re seeing an recommended expert, they’re appropriate for your mom.

Talking with a counselor about her losses may help her too. Geriatric psychiatrist should have the patience to provide counseling even if she is confused. Unraveling this pain (with someone new) may help. Change is hard, especially loss.

Your mother requires professional help that cannot wait. What about a social worker until you find a specialist physician?

What health insurance does she have? These staff shortages are ridiculous. Taking her to the ER might attract some attention.

I'm sorry for your Mom's loss (and yours). This is hard for any parent to endure. If she is still verbal, perhaps a therapist who knows how to handle people with dementia may help. Perhaps a local social worker can recommend some practitioners. When my mother was in a memory care facility they tried having a therapist come in to speak to her for her depression. I think they continued it too long, because eventually she declined to the point where she was no longer verbal and it could not have done much at that point. I don't know if it helped, but I thought that having someone to talk to who was giving her attention might be a good thing for her. What you are describing is not unusual for someone with dementia, including feelings of anxiety, suspicions that people are stealing or moving things, misinterpreting what people are saying and doing, talking to the TV as if it is a person, etc. Their minds often go in a loop, replaying the same thing over and over. People with dementia go through stages, this stage will probably pass. A good memory care facility will know how to handle this, and they have skilled staff who are familiar with the different ways people with dementia can behave. Have a plan for a time when her care may become too much for you to do alone. Sadly, people with dementia are likely to continue to decline mentally and physically. Be thankful she is not violent (hitting, kicking and biting) and still recognizes you. It's best not to try to explain or reason with people who have dementia. They just can't remember or process things well. Redirection to get her thinking about something else, and being positive and not contradicting her work best. Keep reasuring her and telling her that now is a good time to do what she needs to do. All the best to you.

Cappuccino42, you may wait for a very long time (never?) for a better diagnosis than you have now, and you may find that if you luck onto a helpful treatment that relieves some of her symptoms, you will have done the best you can.

My LO entered AL, then quickly went to MC, and was experiencing symptoms that seemed to emerge from her severe anxiety and u dealing depression.

We as her family were also seeing “forgetfulness”, “absent mindedness” and other thought process symptoms.

For purely practical reasons and no particular specific expectations, we asked the social worker at her facility to recommend a specialist in geriatric psychological/psychiatric/cognitive assessment, and they came through for us with a warm, gentle, soft spoken woman who spent time with her over few sessions, and ultimately revealed to us that her “confusion” was actually a part of her depression and anxiety, and that her dementia was much more significant than we’d previously thought. A vicious circle with no starting point and no end.

The specialist prescribed very small amounts of psychiatric medications, saw my LO on a schedule, and ultimately restored LO’s sense of peace. She still had anxiety and depression and dementia with cognitive loss, but she was becoming more comfortable and calm.

When she became infected by COVID her circumstances deteriorated, but she was by then over 90, so there were lots of different things causing her sad decline.

We all hope for something to fix what’s broken in our LOs, but sometimes it’s more complex than we’d planned for.

Hoping you can continue to find ways to help your mum, if only a bit at a time.

My mom had dementia and was acting out. She was taken to the emergency room, then the psych emergency, and then she was able to go to the senior psychiatric area so that they could evaluate her and find the right medication.

You can't reason with someone with both dementia and depression unless you are a trained medical professional.

I would say she needs to be medicated. Keep at it until you find someone or somewhere that will treat her.

She must really be beside herself, no pun, with the death of Queen Elizabeth II?

Even though this it was a TV show, this sounds like an Episode of "Two and a Half Men" where Alan dated a woman who was somewhat similar.

Sounds like the medical practitioners in your country like to 'pass the buck' right down the line until the patient is in her grave, huh? That's unfortunate, to say the very least.

My mother with dementia was on Wellbutrin, the max dose in fact, to treat her depression. Which was increased by her PA while her dementia was moderate to advanced, in fact. She didn't have a 'specialist' or a 'neuro psych' doctor or a Neurologist that I was willing to schlep her to, I saw no value in doing so. Her PA and the GP who oversaw the PA did a fine job managing mom and her various issues. Any doctor of any kind should be willing to write a prescription for an anti depressant for a depressed patient, period.

While your mother's particular case sounds odd and a bit off, SOME sort of doctor should see her, evaluate her, diagnose her, write her SOME sort of prescription to address what's going on, and allow you to get her placed, for crying out loud. To say this is a frustrating situation is a gross understatement.

I don't know where you live, but could you get her to the ER for SOMEONE to take a look at her? JUST the death of her son alone and the ensuing grief is enough of a reason to allow the poor woman to try anti-depressants!

Whether dementia is involved, or not, mental problems are very difficult to deal with. Dementia, of course, complicates matters in making it almost impossible for the practioner to assess what is working and what is not. Dementia and its manifestations as confusion, discomfort, anxiety involves also the person "grieving"their differences, their inability to make themselves understood, the discomfort of others.
I would be certain you are dealing with a good neuro-psyc doctor. The use of medications isn't always indicated, and usually involves low dose if it is. These medications have side effects that hinder balance and a whole group of side effects that often can worsen dementia.
We are each as complicated mentally as our own fingerprint. Adding dementia into the mix, with disinhibition, makes things every so much more complicated and difficult to address. And the truth is that there is NOT ALWAYS AN ANSWER. Some things simply cannot be "fixed" and they must be lived with best you can.
I sure do wish you good luck. Get on the waiting list and explore a second opinion neuro-psych doctor. If you are MPOA try to make your list of symptoms short and succinct. I hope you'll update us.

I'm so sorry you are going through this. My very elderly Aunt does exactly what you are describing -- and has never suffered grief. It is part of dementia. Her grief and the beginnings of her dementia overlapped. Grief can certainly ramp-up dementia behaviors because people with it have a more difficult time understanding and articulating what is going on inside them -- but grief doesn't cause dementia.

Anti-anxiety meds has helped my Aunt when she was crying all the time, yet as her dementia progresses she is increasingly more negative, paranoid, combative, vulgar, having dark thoughts, etc. She is 100 yrs old.

I learned a lot from watching Teepa Snow videos on YouTube. She teaches positive caregiving and also educates on what dementia is, how and why is changes our LOs, and strategies to better engage with them in more productive and peaceful ways. I wish you all the best on this journey.

Dementia has no rules or rhymes or reasons. It's a 'new' disease every day.

Some antidepressants will help with the low moods, but honestly, a lot of them are contraindicated in elderly use.

Maybe a low dose of an anti anxiety med.

And don't take what she mutters under her breath as being truly how she's feeling.

But first--a good overall physical and then address the mental status.

I have never heard of a death of a LO triggering Dementia. If they already have Dementia then it becoming worse yes. I would say that Mom has depression and the loss of a son has caused a mental episode/break but not Dementia.

Has Mom been diagnosed with a Dementia? I think time to find another doctor. She needs labs to rule out anything physical and then a Neurological work up. She may need a Psychiatrist.