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Grief, Depression, and Dementia

Photo: Getty

Photo: Getty

Jean was married to Bob for well over 50 years.  When Bob died, Jean was so grief-stricken that she became physically sick.  She ate very little and was transformed from a vibrant, social butterfly to a timid, frail old lady.  She didn’t keep up with her normal routine: going to lunch with friends, cards on Wednesday nights, church on Sunday.  Nothing really mattered anymore.

Jean also became more confused and couldn’t keep appointments straight.  Even though she had handled the household finances for years, she suddenly couldn’t organize her checkbook.  She would call her daughter and ask the same questions over and over again.  Shortly after her husband’s death, Jean’s cognitive status declined to the point that she could no longer live alone.

Jean might be diagnosed with dementia.  Or depression.  Or both, depending who you ask.

Jean’s story is an all too common experience for older adults who lose a spouse.  Functional and cognitive decline after the death of a loved one is a complex issue, and can be impacted by a number of medical and psychosocial issues.  But straight-up grief is a physical blow at any age.  Temporary dysfunction is a normal part of the grieving process.

It is also common for grief to lead to depression, a withdrawal from activities and hobbies that used to bring joy and purpose.  Depression can in turn lead to cognitive deficits, like memory loss and confusion.

But there is a distinction to be made here:

Grief =  “I’m sad.”  It is temporary.

Depression =  “I don’t care.”  It is treatable.

Dementia =  “I’m sad” and/or “I don’t care”, but it is not temporary or treatable.

Anti-depressant medication is very effective in treating dementia symptoms related to to depression. Sometimes cognitive deficits clear up on their own, and sometimes anti-depressants work their magic.

I have seen many instances where a spouse seems to rapidly decline after losing the other.  But in reality, the deceased spouse had been compensating for the other’s deficits for quite some time.  This truth will slowly present itself, and it make take many family members off guard.

Support throughout the grieving process is crucial for averting depression.  Counseling, support groups, and minimizing isolation are helpful in navigating the grieving process.  If feelings of sadness seem to evolve into feelings of hopelessness, a consult with a physician for depression is strongly recommended.

Don’t be fooled by the person who denies depression because he says he doesn’t feel sad.  Depression can present itself in many ways, like not bothering to shower, change clothes, or eat.  Be extra wary and heed the warning if you hear the words, “I don’t care.”

It will be nice for them to hear that you do.




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  1. I googled trying to find some help distinguishing between grief, depression and dementia and landed here. My father died in January 2016, my mother has been battling depression for years and we suspected some cognitive decline last year. They were together 55 years and because of her poor balance and frequent falls she is now in residential care. Thank you. Support is hard to find for someone with difficulties communicating in words.

    • I’m so sorry for your loss. Death of a spouse can feel like an amputation… a loss and bodily blow. My sympathies to you and your mother.

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