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When Depression Looks Like Dementia

We first met Margaret when she was 68 years old. She lived alone, and her family was worried because she appeared to have symptoms of serious dementia. She was ragged and unkempt, she often forgot the names of her own children, she frequently got lost and she had just had her driver’s license revoked after having four minor accidents in a six-month period. When she nearly burned the house down by leaving a stove burner on, her family finally admitted her to a psychiatric hospital. Some members of Margaret’s family had had enough and were ready to put her into a supervised living situation.

It seemed that Margaret was suffering from dementia. We ordered a SPECT study to see what was happening in her brain. The results showed full activity in her parietal and temporal lobes. If she had Alzheimer’s disease, there should have been evidence of decreased blood flow in those areas. Instead, the only abnormal activity shown on Margaret’s SPECT was in the deep limbic system at the center of the brain, where the activity was increased. Often, this is a finding in people suffering from depression.

Sometimes in the elderly, it can be difficult to distinguish between Alzheimer’s disease and depression because the symptoms can be similar. When depression “masquerades” as dementia, we call it pseudodementia. A person suffering from pseudodementia may appear demented, yet not be at all.

Depression & Dementia Are Two VERY Different Treatment Paths

The diagnosis makes a critical difference in a person’s life. Depression is highly treatable; dementia is a much tougher go.

The diagnosis of dementia would lead to prescribing to the family a set of coping strategies and possibly new medications to the patient, whereas a diagnosis of some form of depression would lead to prescribing an aggressive treatment of supplements or antidepressant medication, along with psychotherapy and exercise. You can see how the distinction would color the entire picture for not only the individual but his or her family. It changes relationships. It determines whether a person is able to live independently.

The Importance of Brain Imaging

Brain imaging is a critical tool in accurate diagnosis. Before brain imaging, most psychiatrists never looked at the organ they treated. They referred to a list of symptoms and did their best to accurately diagnose a patient. We have often thought of it as throwing darts in the dark. Because of the extreme difference in treatment directions – inaction, where the condition is guaranteed to persist versus action that can be very effective in restoring the quality of life – pseudodementia is a condition that is especially impacted by the lack of “sight” into the functionality of the brain.

A Hopeful Outcome

The results of Margaret’s SPECT study convinced us that she should try the antidepressant Wellbutrin (buproppion). After three weeks, she was talkative, well groomed and eager to socialize with other patients. After a month in the hospital, she was released to go home. Six months later we repeated her SPECT study and it was completely normal. She remained markedly improved. So much so that we felt comfortable writing a letter to the DMV, and it gave her back her license!

Dementia-like symptoms? Seek help.

People over the age of 65 are at highest risk for pseudodementia. If you or a loved one are experiencing symptoms of confusion, forgetfulness, poor concentration, slower speech and function, apathy and decreased energy, consider an evaluation for pseudodementia. At Amen Clinics, we use SPECT imaging to see blood flow and brain function, which goes a long way to indicate the true nature of the condition.

If you or someone you love is struggling with memory problems, you will find inspiration and all the information and resources you need in Memory Rescue: Supercharge Your Brain, Reverse Memory Loss, and Remember What Matters Most available HERE.

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COMMENTS

  1. Marguerite Gibson says:

    My 34 yr old son, a former college athlete,suffers from schizophrenia,depression and anxiety,as well as very severe diabetes, of which he was diagnosed with about 3 years ago. He is having an extremely difficult time adapting to a diabetic regimen and lifestyle, and as a result, has not only doubled in size, from 239 lbs, to now nearly 500 lbs. He is so miserably unhappy,tearsrun down his face all the time. How can I help him?What do I address first. He is in and out of the hospital on a constant basis, with glucose readings consistently at 600+,many times 700s,800s,and one time at 918,of which he went into a coma.Doctors say that he has high liver enzymes, and must turn this around fast, for he likely won’t live a year at these levels. His father, my husband, is deceased, as is most of the family. As a senior in my 60s myself, how can I help him. I don’t want to lose him. He’s a good young man, who tried to do everything right; graduated college, no criminal record, never married, no children. I would love to see him with a good wife and children, especially as Im getting closer to my 70s.Dr.Amen,what to do?

    • Amen Clinics says:

      Hello Marguerite, thank you for reaching out and sharing with us. We are going to have a Care Coordinator reach out to you. If you need to reach us, please call 888-288-9834.

    • Rosemary says:

      i am a cancer survivor. After my chemotherapy, my memory started to decline. It was so difficult to retrieve any information or anything from memory. Even names of people which i was so good at before the chemo. And i could ‘sense ‘ or ‘see’ a blank space in my brain in those times. But not anymore. i saw one time a documentary information of the benefit of taking vitamin B6 and 12 combined in one capsule. i have been taking it daily. And lo such an improvement of my memory loss. i now could remember names like i used to be and also i could retrieve information from my brain as if i did not have this problem of memory loss after my chemo. TRY IT. i used the Jamieson brand as they are more effective to me than other brand in the market.

    • Rosemary says:

      Marguerite, i am a mother myself of a young man almost the same age as your son. And i, too is in my 70’s now, i am so sorry of what you’re going through as a mother. While you are at this stage seeking help from Amen Clinic with their Care Coordinator, i am here to pray for your son. Hope i have his name as my prayer is very specific for what i ask for as a miracle from God…from above His Throne… from His Merciful Heart. He will answer our prayers for healing of your son. God bless you, and your son.

  2. Marguerite Gibson says:

    I would like to add, he remembers little, and comprehends even less. He can no longer sign his name.

    • Maria says:

      Margaret, I am very sorry for what you are going through. If they do not reply to your comment give them a call. I am sure they can help. I am giving them a call also because I feel I have memory issues. God bless you all.

  3. Janet c says:

    Are there any clinics in the Boston , Ma area

  4. Gail a Conneely says:

    Does this ONLY pertain people 65 and older? Can this occur to a 49 year old depressed person?

    • Amen Clinics says:

      Hello Gail, this does not only pertain to individuals of a certain age. Symptoms of memory loss and dementia occur decades earlier in the brain, before you begin to notice any signs that something is wrong. This is absolutely important for adults in their 20s, 30s, and 40s who want to preserve their brain health.

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