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Suggest Treatment For Depression Along With Dementia
Question: Hi,
My aunt is 55 years old and is married to my uncle for the last 32 years. My uncle and aunt are from families with different backgrounds. My aunt is educated while my uncle is not. He is into business and my aunt is a house wife. Early married life was difficult for my aunt as she had to live in a village but she was born and brought up in a city. My uncle often travelled to other cities for business purposes leaving my aunt all alone at home. They had 2 children (1 son and a daughter).
Her son/daughter completed their schooling in the same village but later went on to stay with their grand parents to purse higher education in a different city. Hence, she had to stay away from her children for many years which is continuing even now as her daugher is married and her son is working in another city. This loneliness lead to lot of depression for my aunt. They often quarrled over petty issues (for e.g. my aunt expects everyone to follow traditions and want everyone to keep the house very clean but my uncle is completely opposite)
She had lot of health issues. She had a uterus removal operation and for piles and is also taking medicine for Blood Pressure. She always preferred to use home remedies or ayurvedic v/s english medicine as they will have side effects. She was recently diagnoised with diabetics and skin problem Psoriasis which had actually started long back but because of her negligence and preference to get cured using home remedies, the problems increased and beacame severe. She is currently on medication for diabetics and was treated for Skin problem Psoriasis which has been cured.
Because of all the depression, issues in the married life, away from children and health problems she is very absent minded, cant remember things happening and what she even spoke. She is not even taking nutritious food and eating healthy food everyday. But, things that she likes the most (e.g. singing, liking towards shopping, sarees, cooking etc) she never forgets and can remember things that have happened many years back. She has kind off lost interest in life.
Having said this, how can we bring her back to normal? What can be done to ensure she comes out of this depression? We love her a lot and cant accept her situation. Please advise.
Regards.
My aunt is 55 years old and is married to my uncle for the last 32 years. My uncle and aunt are from families with different backgrounds. My aunt is educated while my uncle is not. He is into business and my aunt is a house wife. Early married life was difficult for my aunt as she had to live in a village but she was born and brought up in a city. My uncle often travelled to other cities for business purposes leaving my aunt all alone at home. They had 2 children (1 son and a daughter).
Her son/daughter completed their schooling in the same village but later went on to stay with their grand parents to purse higher education in a different city. Hence, she had to stay away from her children for many years which is continuing even now as her daugher is married and her son is working in another city. This loneliness lead to lot of depression for my aunt. They often quarrled over petty issues (for e.g. my aunt expects everyone to follow traditions and want everyone to keep the house very clean but my uncle is completely opposite)
She had lot of health issues. She had a uterus removal operation and for piles and is also taking medicine for Blood Pressure. She always preferred to use home remedies or ayurvedic v/s english medicine as they will have side effects. She was recently diagnoised with diabetics and skin problem Psoriasis which had actually started long back but because of her negligence and preference to get cured using home remedies, the problems increased and beacame severe. She is currently on medication for diabetics and was treated for Skin problem Psoriasis which has been cured.
Because of all the depression, issues in the married life, away from children and health problems she is very absent minded, cant remember things happening and what she even spoke. She is not even taking nutritious food and eating healthy food everyday. But, things that she likes the most (e.g. singing, liking towards shopping, sarees, cooking etc) she never forgets and can remember things that have happened many years back. She has kind off lost interest in life.
Having said this, how can we bring her back to normal? What can be done to ensure she comes out of this depression? We love her a lot and cant accept her situation. Please advise.
Regards.
Brief Answer:
This is not a simple depression
Detailed Answer:
Hi, thanks for your query. Welcome to HCM.
I have read and understood your concerns about your aunt. I am explaining the symptoms you have narrated for better understanding between us of the symptoms of your aunt.
She forgets things or events that have happened recently within hours and days but she can recall past events. In short her recent memory [registration and recall] is impaired but the remote memory is intact.
She is easily irritable on minor matters. She is neglecting her health. She is more interested in spending money even if it is not necessary. Her behavior or in short, personality has changed completely. She can not keep track of the words, she spoke and even lost the the track and gave answer that has not asked.
Here I feel that it is not simple depression, it is dementing illness in which person starts losing memory and other functions of daily living. Mostly I am thinking towards fronto temporal dementia.
Give reply to this question: Her behavior has changed first or her memory problems started first? Which symptom came earlier than the other one?
depending on this the diagnosis can be made.
How many years back her Psoriasis was treated? whether she has received steroids for it? If yes, then for how long? Long term steroids can also cause this.
I am waiting for your reply. Revert back with answers, if you do not know this then ask your uncle and inquire about the symptom's onset and treatment of psoriasis.
Give reply as early as possible.
This is not a simple depression
Detailed Answer:
Hi, thanks for your query. Welcome to HCM.
I have read and understood your concerns about your aunt. I am explaining the symptoms you have narrated for better understanding between us of the symptoms of your aunt.
She forgets things or events that have happened recently within hours and days but she can recall past events. In short her recent memory [registration and recall] is impaired but the remote memory is intact.
She is easily irritable on minor matters. She is neglecting her health. She is more interested in spending money even if it is not necessary. Her behavior or in short, personality has changed completely. She can not keep track of the words, she spoke and even lost the the track and gave answer that has not asked.
Here I feel that it is not simple depression, it is dementing illness in which person starts losing memory and other functions of daily living. Mostly I am thinking towards fronto temporal dementia.
Give reply to this question: Her behavior has changed first or her memory problems started first? Which symptom came earlier than the other one?
depending on this the diagnosis can be made.
How many years back her Psoriasis was treated? whether she has received steroids for it? If yes, then for how long? Long term steroids can also cause this.
I am waiting for your reply. Revert back with answers, if you do not know this then ask your uncle and inquire about the symptom's onset and treatment of psoriasis.
Give reply as early as possible.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you for quick response. About the symptoms, not everything are observed.
"She is more interested in spending money even if it is not necessary. Her behavior or in short, personality has changed completely. " - This symptom is not there at all.
"She can not keep track of the words, she spoke and even lost the the track and gave answer that has not asked." - This only to some extent. She will give answer properly for what has been asked.
Her behaviour has not changed very much. So memory problem might have come first.
She didn't take any steroids i guess. She took tablets for very short term then she used to apply some ointments. Will let you know the prescription details again. Initially she took prescription from a skin specialist. It didnt work out well then she left out in the middle. She just used some turmeric coconut oil etc stuff.
Then later after few months she was treated by another Skin specialist and it got cured. She was treated for Psoriasis around 8 to 10 months back.
"She is more interested in spending money even if it is not necessary. Her behavior or in short, personality has changed completely. " - This symptom is not there at all.
"She can not keep track of the words, she spoke and even lost the the track and gave answer that has not asked." - This only to some extent. She will give answer properly for what has been asked.
Her behaviour has not changed very much. So memory problem might have come first.
She didn't take any steroids i guess. She took tablets for very short term then she used to apply some ointments. Will let you know the prescription details again. Initially she took prescription from a skin specialist. It didnt work out well then she left out in the middle. She just used some turmeric coconut oil etc stuff.
Then later after few months she was treated by another Skin specialist and it got cured. She was treated for Psoriasis around 8 to 10 months back.
Brief Answer:
Things are very clear now
Detailed Answer:
Hi, thanks for writing again.
So, as per your answers then possibility of fronto-temporal dementia is ruled out. The memory complains can occur as a result of depression or due to dementia [alzheimer's disease]. You can read the symptoms of dementia from the internet, the memory complaints are first to appear in AD. Then there will be gradual problems in daily functioning, money handling, problems with orientation within home, about time, place, person, difficulty in finding words while speaking, forgetting names, calling by different names, apathy, sadness, suspiciousness, seeing objects, animals, hearing voices, talking alone, wandering without reason etc.
Mild memory complaints due to lack of concentration can occur in depression.
If it is depression then can be easily treated by antidepressant drugs like escitalopram, sertraline etc.
Treatment of dementia is difficult because there are no medications available that can cure it, the available drugs can decrease the progression of the illness. apart from the memory complaints drugs are given to control the behavioral and psychological symptoms of dementia [BPSD]. After onset and diagnosis life span is 6 to 10 years only.
You may have to go for brain imaging and other blood investigations like complete blood count, renal function test, liver function test, thyroid function test, serum vitamin B12, D3, Folic acid, serum lipid profile, urine examination etc. These are necessary investigations to rule out any reversible pathology. Discuss about it with your doctor during consultation.
I here suggest you to take her to psychiatrist or geriatric centre or dementia centre for proper evaluation where she can be managed properly.
Hope I have answered your query. If you do not have further query then close the discussion and rate the answer. Wish you good health.
Things are very clear now
Detailed Answer:
Hi, thanks for writing again.
So, as per your answers then possibility of fronto-temporal dementia is ruled out. The memory complains can occur as a result of depression or due to dementia [alzheimer's disease]. You can read the symptoms of dementia from the internet, the memory complaints are first to appear in AD. Then there will be gradual problems in daily functioning, money handling, problems with orientation within home, about time, place, person, difficulty in finding words while speaking, forgetting names, calling by different names, apathy, sadness, suspiciousness, seeing objects, animals, hearing voices, talking alone, wandering without reason etc.
Mild memory complaints due to lack of concentration can occur in depression.
If it is depression then can be easily treated by antidepressant drugs like escitalopram, sertraline etc.
Treatment of dementia is difficult because there are no medications available that can cure it, the available drugs can decrease the progression of the illness. apart from the memory complaints drugs are given to control the behavioral and psychological symptoms of dementia [BPSD]. After onset and diagnosis life span is 6 to 10 years only.
You may have to go for brain imaging and other blood investigations like complete blood count, renal function test, liver function test, thyroid function test, serum vitamin B12, D3, Folic acid, serum lipid profile, urine examination etc. These are necessary investigations to rule out any reversible pathology. Discuss about it with your doctor during consultation.
I here suggest you to take her to psychiatrist or geriatric centre or dementia centre for proper evaluation where she can be managed properly.
Hope I have answered your query. If you do not have further query then close the discussion and rate the answer. Wish you good health.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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