This blog is aimed at the person with the Lewy body disorder, and especially at the person with PD. That’s because we were at a Parkinson’s support group when a gentleman asked us this question: “What about depression? Why am I so depressed? What can I do about it?”
The answer is two-fold. First, there’s the chronic (long-lasting) depression, a common Lewy body related symptom. People with a Lewy body disorder are much more likely to be depressed than those with Alzheimer’s. This type of depression is probably chemically related; that is, there is a lack of one of the body’s happy-inducing chemicals such as serotonin. This usually needs to be treated medically. Fortunately, there are drugs, such those in the SSRI family and several non-benzodiazepine based anti-depressants, which are usually fairly Lewy-safe.
Secondly, there’s situational depression, brought on by the losses that anyone with a degenerative disorder is apt to experience.
The gentleman nodded. “In the last year or so, I’ve lost my health, wife and my home.”
Well, that’s enough to make anyone depressed! The good news is that situational depression is usually shorter term and more receptive to non-drug interventions.
Talk about it.“You are talking,” we told the gentleman. “That’s the first step. You are already on your way to feeling better!”
You have to own where you are before you can change. Guys, especially, tend to bottle up anything like depression that might make them appear vulnerable and weak. Talking is not about being negative but about being open and honest and willing to ask for help. If you feel sad, don’t hold it in. Find a supportive ear and talk about what’s bothering you and how you feel. The listener’s job is not to tell you to shape up, but to listen, and then help you find ways to decrease the depression—some of the following, for instance:
Exercise. Most PD people know how important exercise is for slowing down their motor symptoms. LBD people know how important it is for slowing down the cognitive symptoms. Exercise is also a great deterrent for depression. It adds some of those chemicals that may be lacking and just plain makes a person feel better. “But”, we’ve heard, “My health doesn’t allow me to exercise—bad joints, bad heart, wheel-chair bound, etc., etc.” Nevertheless, there are still ways to exercise, perhaps only moving one’s arms, or even passive exercise, where someone else moves the limbs. A half-hour a day at least three times a week is recommended, but if you can only do five minutes at a time—do it. Do whatever you can do as long as you can. That’s ever so much better than none at all.
Socialize. Connect with people. We are social animals. Isolation tends to lead to depression and makes it worse when depression is already present. Get out and be with people. Play cards, visit, go out to lunch, or a movie. Or do more physical things like play tennis, or golf if you are able. Don’t worry about the score—just play. Or go for a walk. Make the walk in a place like a mall where other people are around. Then smile and keep track of how many people you have to smile at before someone smiles back. Just that small connection is very healthy.
Be positive. Depression makes it much easier to be negative than positive. Make an effort to put everything into a positive context, even if you have to stop and reword it as you go along. In the same vein, make an effort to be around people who are positive. Being positive is as catching as negativity is! Try not to use words like can’t, or won’t or don’t. Instead of saying, “I can’t walk fast,” say, “I take my time.”
Medication. Even with situational depression, the above medications can sometimes be beneficial for caregivers as well as their loved ones for a short period of time, just to get over the first hump. A future blog will be about depression and caregivers.
Read more about depression and LBD in our books,
A Caregiver’s Guide to Lewy Body Dementia
Managing Cognitive Issues in Parkinson’s and Other Lewy Body Disorders
Learn more about dealing with Lewy body disorders at LBDtools.com