Non-Drug Approaches for Treating Depression in Dementia

Treatments for Depression in Dementia
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Depression in dementia, while fairly prevalent, is also usually quite treatable. As the symptoms of depression in dementia are treated and decrease, a person's quality of life generally increases.

Depression in Alzheimer's disease and other related disorders can be treated using several approaches that fall into one of two categories: non-drug approaches and medications. Certain interventions may be more effective for one person than another, but non-drug approaches should generally be tried before proceeding to the use of a medication.

Non-Medication Approaches

Several non-drug approaches have demonstrated success in treating depression in dementia. The benefits of these approaches, in addition to improving mood, include the absence of side effects and drug interactions, as well as the potential for improved cognition and increased physical and mental activity.

The benefits of physical exercise for depression are many. From improving self-esteem and sleep habits to increase energy levels, exercise can clearly benefit people with dementia. As an added benefit, some research has shown that physical exercise may also improve cognitive functioning for those with dementia.

For some people, part of depression is a lack of purpose. Giving people the opportunity to do something that is important to them and related to their interests can be therapeutic for their emotional and mental health.

Group Music Therapy

Some research conducted with older adults who were diagnosed with both depression and dementia found that depression decreased after group music therapy sessions. Additionally, a slight improvement in cognition—specifically in short-term recall ability—was also noted following the music therapy sessions. 

Adding Structure to the Day

Having a routine and a schedule for the day can foster a feeling of control for people. Additionally, a scheduled mental activity such as a game or a class may provide something to look forward to during the day. For those with mid-stage dementia, sometimes the structure of an adult day care center can be beneficial.

Individual Counseling

Especially for those in the early stages of dementia, therapeutic counseling can be very helpful. There may be feelings of grief and loss after a diagnosis of dementia, and counseling can assist one in processing those feelings and in developing ways to cope with the challenge of dementia.

Social Interaction

Some people with dementia tend to isolate themselves, which can increase the likelihood of developing depression or exacerbate a mood that's already low. Although social interaction has the potential to be tiring for some people who are depressed, positive social stimulation can also benefit and encourage those with dementia and depression.

Support Groups

Support groups can be beneficial for people struggling with the adjustment of a new diagnosis of dementia. Sometimes, it can be encouraging to hear from others how they're coping with the challenges of dementia. Interacting with others in a group can also decrease feelings of loneliness and isolation.

Medications

Although some research questions the effectiveness of antidepressant medications, several antidepressants have been commonly utilized for people who are experiencing depression in dementia.

Selective Serotonin Reuptake Inhibitors (SSRIs) is a class of antidepressant medications that ​are frequently prescribed for people with dementia who exhibit signs of depression. SSRIs typically have fewer side effects and a decreased chance of interaction with other medications that people may be taking. These medications also can be helpful for some people who have symptoms of anxiety. Some popular SSRIs include citalopram HBr (Celexa), sertraline (Zoloft), escitalopram (Lexapro), and fluoxetine (Prozac).

An atypical antidepressant medication that may frequently be prescribed for people with dementia and depression is mirtazapine (Remeron). Remeron can have a side effect of stimulating the appetite, so this medication might be used if weight loss and depression are noted.

Additionally, some antidepressants such as trazodone (Deseryl) can help facilitate sleep as well as treat symptoms of depression.

It's important to remember that each medication has side effects and works differently in various people. While some side effects can be positive, such as helping someone sleep better at night or stimulate their appetite during the day, others can cause increased confusion, falls and drug interactions. Consult your physician if you have any questions about the use of medications to treat depression in dementia.

A Word From Verywell

Depression in people living with dementia is not uncommon, but there are some non-pharmacologic approaches and medications that may be helpful to improve quality of life. Be sure to report feelings or observations of depression to the physician in order to discuss possible treatment and support.

View Article Sources
  • Alzheimer's Association. Depression and Alzheimer's. https://www.alz.org/care/alzheimers-dementia-depression.asp
  • American Academy of Neurology. Should SSRIs for Depression in Patients with Dementia Be Revisited? 
  • Annals of Long-term Care. 2009 February 2; 17(2): 29–36. Treatments for Depression in Older Persons with Dementia. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3147175/
  • Chu, H., Yang, C., Lin, Y., Ou, K., Lee, T., O'Brien, A. and Chou, K. (2013). The Impact of Group Music Therapy on Depression and Cognition in Elderly Persons With Dementia: A Randomized Controlled Study. Biological Research For Nursing, 16(2), pp.209-217.
  • The University of Texas. Treatment of Depression in Patients with Dementia. www.utexas.edu/pharmacy/divisions/pharmaco/.../bassinger05-04-12.pdf