Because doctors and lay people alike often leap to the conclusion that an elder with an Alzheimer's diagnosis, and exhibiting lack of interest in his or her surroundings, is depressed, I found a new study undertaken at the University of Florida intriguing.
In an article titled, "Emotional Flatness Can Be Mistaken for Depression in Alzheimer's Patients," researchers spelled out the difference between clinical depression and what they termed "emotional flatness." The study showed that doctors often prescribe anti-depressants for Alzheimer's patients who aren't clinically depressed. These Alzheimer's patients are just exhibiting a fairly normal response to their surroundings considering the disease they live with.
Alzheimer's patients who appear withdrawn and/or apathetic are often thought to be depressed. Onlookers feel that the patient's memory problems, word-finding abilities or other frustrations of Alzheimer's are causing this emotional state and anti-depressants may help them better cope with these symptoms of the disease. Often, this is the right diagnosis - but not always.
This University of Florida study found that people with Alzheimer's may have a decreased ability to experience emotions. The study was published online in the spring issue of the Journal of Neuropsychiatry & Clinical Neurosciences.
In the study, patients were asked to place an emotional value on pictures as to how pleasant or unpleasant they found the scenes. While clinical depression could cause people to act less interested in an object, these researchers felt that the Alzheimer's patients, regardless of the pictures, tended to view pictures much the same - meaning they saw them in a middle emotional range.
"They don't feel as positive toward the positive pictures or as negative toward the negative ones. They're not depressed, but their emotional experience appears to be flattened," said Dr. Kenneth Heilman, senior author of the paper and a professor of neurology at the College of Medicine and UF's McKnight Brain Institute.
"One important implication of this work is that when an Alzheimer's patient appears emotionally blunted, the clinician or caregiver should not assume the patient is depressed... as other organic factors could be at work," said Dr. Todd Feinberg, a professor of clinical neurology and psychiatry at Beth Israel Medical Center in New York. Dr. Feinberg was not involved in the research.
I found this study important for caregivers. Most caregivers try very hard to engage their loved ones who have Alzheimer's disease in some activity that will interest their elder. When the caregiver can't seem to get any response that shows a positive or negative effect, he or she is bound to keep trying new approaches.
To keep trying new approaches isn't bad. However, caregivers are prone to faulting themselves when they can't rouse some interest in their loved one. We try so hard to please, and when we are continually thwarted, we can be the ones who become depressed.
