Detecting Depression or Anxiety: At a Loss for Words

Depression or anxiety can be challenging enough, but some people have the additional challenge of being unable to tell anyone how they are feeling. For example, a person with dementia or a stroke may be unable to express the very kinds of feelings that indicate to others that they may be experiencing depression or anxiety. In such cases, other clues may become important.

Family members, friends, and caregivers may begin to suspect depression or anxiety if they note changes in the older person's behavior. If a person has become depressed, closer observation may reveal that the person no longer seems to derive pleasure from or take interest in activities that were once pleasurable or interesting. A person who normally enjoys being with others may begin to give signals of wanting to be left alone (such as frowning, ignoring others, or pushing others away), which may indicate depression. A person who normally has a good appetite may start picking at his food or ignore it completely, which also may indicate depression. A person who normally seems relaxed and calm under most circumstances may have developed anxiety if he seems to have tense muscles, an inability to remain seated for very long, or the appearance of being afraid for no apparent reason.

Anxiety symptoms are common in people with dementia and may develop in combination with impaired memory and thinking. However, anxiety symptoms in someone with dementia may also indicate that the person is experiencing pain; hunger, thirst, or other unmet needs; new medical problems; or side effects of prescription or nonprescription drugs.