Anger and Depression
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Anger and Depression
A submission by KH …
Anger and Aggression…
Dementia causes the brain to lose its normal ability to control angry impulses, a problem called dis-inhibition. Anger becomes aggression when the person acts on these feelings by verbally or physically threatening another person or attacking objects.
It may occur because the person with dementia often misunderstands or misinterprets the actions of others, and then lashes out because he or she feels ignored, in danger, or mistreated. Another cause of anger is frustration at being unable to complete tasks that were once easy, such as fixing something that is broken, using the stove, or going to the bathroom.
Sometimes there is no obvious cause of frustration…
Anger and aggression can include verbal accusations and insults, aimless screaming, refusal to cooperate with requests to eat or bathe, and even physical assaults. Aggression can also include self-injury such as head banging or biting oneself.
When a person with dementia becomes angry and aggressive, it is important to evaluate the person’s environment to be sure it is safe and to see if some simple adjustments might reduce the problem.
Anger and aggression should not be ignored in the hopes it will go away by itself. Each is a treatable symptom. Although aggression is among the most distressing problems for Caregivers, it can usually be helped with extra attention and sometimes medication.
Depression…
An important cause of anxiety may be the diagnosis of dementia itself, especially in the early stages when a person can feel embarrassed by making mistakes, forgetting things, or having trouble joining a conversation.
Depression is an understandable reaction to an illness such as dementia. A person with depression feels sad or loses interest in things he or she normally enjoys. Agitation in depression can include extreme tearfulness, hand-wringing, an excessive need for reassurance, and other signs of extreme unhappiness.
Depression can also cause delusions, most often guilty feelings about having done terrible things in the past. Anxiety means being very worried, overly fearful, nervous, fidgety, shaky, or frightened, either because of exaggerated fears or some-times for no apparent reason.
An anxious person may not always be able to put the feelings into words, but instead may appear tense or have physical symptoms such as racing heart, nausea, or “butterflies in the stomach.” Anxious people worry about things such as being alone, or they may fear that visitors will be late, that loved ones have been harmed, or that plans will be disrupted. They may become especially nervous when they are separated from Caregivers, when schedules are changed, or when they are rushed or tired.
Treatment of Agitation in Dementia…
A diagnosis of depression should be considered if a person is often sad, tearful, or unable to enjoy anything; or expresses constant thoughts of discouragement, failure, being a burden, or wanting to die or commit suicide. Depression often includes physical symptoms such as loss of appetite and weight, trouble sleeping, or complaints of physical pain.
If no medical cause is found for these physical symptoms, depression should be considered, even if the person denies feeling sad but just seems more withdrawn, apathetic, or disinterested.
Successful treatment of depression
helps individuals with dementia
enjoy time with their families
and other pleasurable activities.
How soon should agitation be treated?…
Agitation should be treated early because it means the person with dementia is suffering emotionally or physically. Agitation doesn’t go away by itself. Research studies show that it usually persists for 2 or more years, especially if it is associated with aggressive behavior. If treatment is begun there is an opportunity to find the most effective and safest treatment before agitation poses safety or health risks for the person or the family.
How is agitation treated?…
…Providing the right environment.
…Supervising activities.
…Learning how to talk with a person
who has dementia.
…Getting support for families
and improving support for Caregivers.
…Developing coping skills.
…Medications.
Important considerations on ways to handle anger and depression…
