Apathy, anxiety and depression

9. Consulting the doctor

It is important to see the doctor if a person with dementia is behaving in an unusual or worrying way, or has deteriorated more rapidly than expected. These changes could be caused by apathy, depression or anxiety, or could be due to an illness or the effects of medication.

In order to diagnose apathy, anxiety or depression, the doctor will talk to the person with dementia and their carer. They will try to assess the person’s behaviour, mood and any changes that have occurred (for example, have they become more agitated or do they have less energy?)

It can be difficult for a doctor to diagnose depression in a person with dementia because the symptoms of depression and dementia are so similar. Symptoms of apathy and depression can also overlap. People with dementia may also have difficulty communicating their low mood or feelings of anxiety to others. Because of this, a person’s dementia is put down to depression, and occasionally people who are depressed are thought to have dementia. Key differences in symptoms between depression and dementia are as follows:

  • Depression tends to develop much more quickly than dementia (over weeks or a few months).
  • Problems with speech, reasoning, and orientation in time and space are unusual in depression but are common in people with dementia.
  • A person with depression may occasionally say they can’t remember things but will remember when prompted, whereas a person with dementia (particularly Alzheimer’s disease) will be forgetful and will often try to cover up memory loss.
  • Where people with depression have very bad impairments in their reasoning and memory (for example, when depression is severe), this is mainly due to poor concentration. These problems are reversible with treatment or when the depression lifts, which is not the case with dementia.