Apathy, anxiety and depression

5. Causes of depression and anxiety

Many of the things that can cause people to feel depressed can also cause people to feel anxious, and vice versa. The exact causes of these conditions vary from person to person and there are often several contributing factors. People with a past history of depression or anxiety are more likely to have them again.

Possible causes of depression and anxiety include:

  • traumatic or upsetting events – these can trigger high levels of anxiety that continue long after the event is over
  • the effects of certain illnesses or the side-effects of medication – agitation may be caused by pain, hunger or an infection, for example
  • lack of social support or social isolation – perhaps because the person can no longer get out as much
  • bereavement
  • lack of meaningful things to do, with feelings of boredom and aimlessness
  • feeling stressed or worried over issues such as money, relationships or the future
  • having a genetic predisposition to depression or anxiety.

The causes of depression and anxiety in someone who has dementia can be similar to those for someone without dementia. However, in the early stages of dementia these conditions may be linked directly to a person’s worries about their memory and about the future. People often retain their insight and awareness better in vascular dementia than in Alzheimer’s disease. This may help to explain why depression and anxiety are more common for people with vascular dementia. Damage to nerve pathways caused by reduced brain blood flow (vascular disease) is thought to cause depression in some people. Chemical changes in the brain, caused by the dementia, may also lead to depression or anxiety.

People living in care homes seem to be particularly at risk of depression. Anxiety in people living in care homes has been linked to unmet needs, including a lack of daytime activities and a lack of company. As dementia progresses, people become more disorientated, more forgetful and worse at thinking things through. This constant struggle to make sense of the world around them can therefore be an underlying cause of anxiety.