Question

Briefly review a couple of different resources on the differences and similarities between Delirium, Demential, and depression.

onset

Duration

Reversible

Awareness

Attention

Hallucinations

Memory

Sleep

Thoughts

compare and contrast

Answer 1

Delirium is an abrupt change in the brain that causes mental confusion and emotional disruption. It makes it difficult to think, remember, sleep, pay attention, and more.

You might experience delirium during alcohol withdrawal, after surgery, or with dementia.

Delirium is usually temporary and can often be treated effectively.

If you’re over 65 or have numerous health conditions, you’re more at risk for delirium.

Others who have increased risk of delirium include:

• people who’ve had surgery
• people withdrawing from alcohol and drugs
• those who’ve experienced conditions that damage the brain (for example, stroke and dementia)
• people who are under extreme emotional stress

The following factors may also contribute to delirium:

• sleep deprivation
• certain medications (such as sedatives, blood pressure medications, sleeping pills, and pain relievers)
• dehydration
• poor nutrition
• infections such as a urinary tract infection

Symptoms of delirium

Delirium affects your mind, emotions, muscle control, and sleep patterns.

You might have a hard time concentrating or feel confused as to your whereabouts. You may also move more slowly or quickly than usual, and experience mood swings.

Other symptoms may include:

• not thinking or speaking clearly
• sleeping poorly and feeling drowsy
• reduced short-term memory
• loss of muscle control (for example, incontinence)

How is delirium diagnosed?

Confusion assessment method

Your doctor will observe your symptoms and examine you to see if you can think, speak, and move normally.

Some health practitioners use the Confusion Assessment Method (CAM) to diagnose or rule out delirium. This helps them observe whether or not:

• your behavior changes throughout the day, especially if you’re hospitalized
• you have a hard time paying attention or following others as they speak
• you’re rambling

Tests and exams

Many factors can cause changes in brain chemistry. Your doctor will try to determine the cause of the delirium by running tests relevant to your symptoms and medical history.

One or more of the following tests may be needed to check for imbalances:

• blood chemistry test
• head scans
• drug and alcohol tests
• thyroid tests
• liver tests
• a chest X-ray
• urine tests

How is delirium treated?

Depending on the cause of the delirium, treatment may include taking or stopping certain medications.

In older adults, an accurate diagnosis is important for treatment, as delirium symptoms are similar to dementia, but the treatments are very different.

Medications

Your doctor will prescribe medications to treat the underlying cause of your delirium. For example, if your delirium is caused by a severe asthma attack, you might need an inhaler or breathing machine to restore your breathing.

If a bacterial infection is causing the delirium symptoms, antibiotics may be prescribed.

In some cases, your doctor may recommend that you stop drinking alcohol or stop taking certain medications (such as codeine or other drugs that depress your system).

If you’re agitated or depressed, you may be given small doses of one of the following medications:

• antidepressants to relieve depression
• sedatives to ease alcohol withdrawal
• dopamine blockers to help with drug poisoning
• thiamine to help prevent confusion

Counseling

If you’re feeling disoriented, counseling may help to anchor your thoughts.

Counseling is also used as a treatment for people whose delirium was brought on by drug or alcohol use. In these cases, the treatment can help you abstain from using the substances that brought on the delirium.

In all cases, counseling is intended to make you feel comfortable and give you a safe place to discuss your thoughts and feelings.

Recovering from delirium

Full recovery from delirium is possible with the right treatment. It can take up to a few weeks for you to think, speak, and feel physically like your old self.

You might have side effects from the medications used to treat this condition. Speak to your doctor about any concerns you may have.

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life. Alzheimer's is the most common cause of dementia.

Memory loss and other symptoms of dementia

Signs of dementia can vary greatly. Examples include:

• Problems with short-term memory.
• Keeping track of a purse or wallet.
• Paying bills.
• Planning and preparing meals.
• Remembering appointments.
• Traveling out of the neighborhood.

Many conditions are progressive, which means that the signs of dementia start out slowly and gradually get worse. If you or someone you know is experiencing memory difficulties or other changes in thinking skills, don't ignore them. See a doctor soon to determine the cause. Professional evaluation may detect a treatable condition. And even if symptoms suggest dementia, early diagnosis allows a person to get the maximum benefit from available treatments and provides an opportunity to volunteer for clinical trials or studies. It also provides time to plan for the future.

Learn more: 10 Warning Signs, Stages of Alzheimer's

Causes

Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and feelings can be affected.

The brain has many distinct regions, each of which is responsible for different functions (for example, memory, judgment and movement). When cells in a particular region are damaged, that region cannot carry out its functions normally.

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Different types of dementia are associated with particular types of brain cell damage in particular regions of the brain. For example, in Alzheimer's disease, high levels of certain proteins inside and outside brain cells make it hard for brain cells to stay healthy and to communicate with each other. The brain region called the hippocampus is the center of learning and memory in the brain, and the brain cells in this region are often the first to be damaged. That's why memory loss is often one of the earliest symptoms of Alzheimer's.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by the following conditions may improve when the condition is treated or addressed:

• Depression.
• Medication side effects.
• Excess use of alcohol.
• Thyroid problems.
• Vitamin deficiencies.

Diagnosis of dementia

There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. Doctors can determine that a person has dementia with a high level of certainty. But it's harder to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnose "dementia" and not specify a type. If this occurs it may be necessary to see a specialist such as a neurologist or gero-psychologist.

Learn more: Memory Tests

Dementia help and support are available

If you or someone you know has been diagnosed with dementia, you are not alone. The Alzheimer's Association is one of the most trusted resources for information, education, referral and support.

• Call our 24/7 Helpline: 800.272.3900
• See our caregiving information for Alzheimer’s and dementia caregivers
• Locate a support group in your community
• Visit our Virtual Library

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Dementia treatment and care

Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer's disease, there is no cure and no treatment that slows or stops its progression. But there are drug treatments that may temporarily improve symptoms. The same medications used to treat Alzheimer's are among the drugs sometimes prescribed to help with symptoms of other types of dementias. Non-drug therapies can also alleviate some symptoms of dementia.

Ultimately, the path to effective new treatments for dementia is through increased research funding and increased participation in clinical studies. Right now, volunteers are urgently needed to participate in clinical studies and trials about Alzheimer's and other dementias.

Learn more: Medications for Memory Loss, Alternative Treatments for Alzheimer's

Dementia risk and prevention

Sprint for Discovery

New research shows there are things we can do to reduce the risk of mild cognitive impairment and dementia.

Read Dr. Carrillo's Blog

Some risk factors for dementia, such as age and genetics, cannot be changed. But researchers continue to explore the impact of other risk factors on brain health and prevention of dementia.

Research reported at the 2019 Alzheimer’s Association International Conference® suggests that adopting multiple healthy lifestyle choices, including healthy diet, not smoking, regular exercise and cognitive stimulation, may decrease the risk of cognitive decline and dementia.

Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person’s everyday activities.

Conditions that can get worse due to depression include:

• arthritis
• asthma
• cardiovascular disease
• cancer
• diabetes
• obesity

It’s important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But, if you’re feeling down or hopeless on a regular basis, you could be dealing with depression.

Depression is considered a serious medical condition that can get worse without proper treatment. Those who seek treatment often see improvements in symptoms in just a few weeks.

Depression symptoms

Depression can be more than a constant state of sadness or feeling “blue.”

Major depression can cause a variety of symptoms. Some affect your mood, and others affect your body. Symptoms may also be ongoing, or come and go.

The symptoms of depression can be experienced differently among men, women, and children differently.

Men may experience symptoms related to their:

• mood, such as anger, aggressiveness, irritability, anxiousness, restlessness
• emotional well-being, such as feeling empty, sad, hopeless
• behavior, such as loss of interest, no longer finding pleasure in favorite activities, feeling tired easily, thoughts of suicide, drinking excessively, using drugs, engaging in high-risk activities
• sexual interest, such as reduced sexual desire, lack of sexual performance
• cognitive abilities, such as inability to concentrate, difficulty completing tasks, delayed responses during conversations
• sleep patterns, such as insomnia, restless sleep, excessive sleepiness, not sleeping through the night
• physical well-being, such as fatigue, pains, headache, digestive problems

Women may experience symptoms related to their:

• mood, such as irritability
• emotional well-being, such as feeling sad or empty, anxious or hopeless
• behavior, such as loss of interest in activities, withdrawing from social engagements, thoughts of suicide
• cognitive abilities, such as thinking or talking more slowly
• sleep patterns, such as difficulty sleeping through the night, waking early, sleeping too much
• physical well-being, such as decreased energy, greater fatigue, changes in appetite, weight changes, aches, pain, headaches, increased cramps

Children may experience symptoms related to their:

• mood, such as irritability, anger, mood swings, crying
• emotional well-being, such as feelings of incompetence (e.g. “I can’t do anything right”) or despair, crying, intense sadness
• behavior, such as getting into trouble at school or refusing to go to school, avoiding friends or siblings, thoughts of death or suicide
• cognitive abilities, such as difficulty concentrating, decline in school performance, changes in grades
• sleep patterns, such as difficulty sleeping or sleeping too much
• physical well-being, such as loss of energy, digestive problems, changes in appetite, weight loss or gain

The symptoms can extend beyond your mind.

These seven physical symptoms of depression prove that depression isn’t just all in your head.

Depression causes

There are several possible causes of depression. They can range from biological to circumstantial.

Common causes include:

• Family history. You’re at a higher risk for developing depression if you have a family history of depression or another mood disorder.
• Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.
• Brain structure. There’s a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don’t know if this happens before or after the onset of depressive symptoms.
• Medical conditions. Certain conditions may put you at higher risk, such as chronic illness, insomnia, chronic pain, or attention-deficit hyperactivity disorder (ADHD).
• Drug use. A history of drug or alcohol misuse can affect your risk.

About 21 percent of people who have a substance use problem also experience depression. In addition to these causes, other risk factors for depression include:

• low self-esteem or being self-critical
• personal history of mental illness
• certain medications
• stressful events, such as loss of a loved one, economic problems, or a divorce

Many factors can influence feelings of depression, as well as who develops the condition and who doesn’t.

The causes of depression are often tied to other elements of your health.

However, in many cases, healthcare providers are unable to determine what’s causing depression.

Depression test

There isn’t a single test to diagnose depression. But your healthcare provider can make a diagnosis based on your symptoms and a psychological evaluation.

In most cases, they’ll ask a series of questions about your:

• moods
• appetite
• sleep pattern
• activity level
• thoughts

Because depression can be linked to other health problems, your healthcare provider may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.

Don’t ignore symptoms of depression. If your mood doesn’t improve or gets worse, seek medical help. Depression is a serious mental health illness with the potential for complications.

If left untreated, complications can include:

• weight gain or loss
• physical pain
• substance use problems
• panic attacks
• relationship problems
• social isolation
• thoughts of suicide
• self-harm

Types of depression

Depression can be broken into categories depending on the severity of symptoms. Some people experience mild and temporary episodes, while others experience severe and ongoing depressive episodes.

There are two main types: major depressive disorder and persistent depressive disorder.

Major depressive disorder

Major depressive disorder is the more severe form of depression. It’s characterized by persistent feelings of sadness, hopelessness, and worthlessness that don’t go away on their own.

In order to be diagnosed with clinical depression, you must experience 5 or more of the following symptoms over a 2-week period:

• feeling depressed most of the day
• loss of interest in most regular activities
• significant weight loss or gain
• sleeping a lot or not being able to sleep
• slowed thinking or movement
• fatigue or low energy most days
• feelings of worthlessness or guilt
• loss of concentration or indecisiveness
• recurring thoughts of death or suicide

There are different subtypes of major depressive disorder, which the American Psychiatric Association refers to as “specifiers.”

These include:

• atypical features
• anxious distress
• mixed features
• peripartum onset, during pregnancy or right after giving birth
• seasonal patterns
• melancholic features
• psychotic features
• catatonia

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It’s a milder, but chronic, form of depression.

In order for the diagnosis to be made, symptoms must last for at least 2 years. PDD can affect your life more than major depression because it lasts for a longer period.

It’s common for people with PDD to:

• lose interest in normal daily activities
• feel hopeless
• lack productivity
• have low self-esteem

Depression can be treated successfully, but it’s important to stick to your treatment plan.

Read more about why depression treatment is important.

Treatment for depression

Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your healthcare provider about possible options.

The Healthline FindCare tool can provide options in your area if you don’t already have a doctor.

You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best.

It’s common to combine medical treatments and lifestyle therapies, including the following:

Medications

Your healthcare provider may prescribe:

• antidepressants
• antianxiety
• antipsychotic medications

Each type of medication that’s used to treat depression has benefits and potential risks.

Psychotherapy

Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light therapy

Exposure to doses of white light can help regulate your mood and improve symptoms of depression. Light therapy is commonly used in seasonal affective disorder, which is now called major depressive disorder with seasonal pattern.

Alternative therapies

Ask your healthcare provider about acupuncture or meditation. Some herbal supplements are also used to treat depression, like St. John’s wort, SAMe, and fish oil.

Talk with your healthcare provider before taking a supplement or combining a supplement with prescription medication because some supplements can react with certain medications. Some supplements may also worsen depression or reduce the effectiveness of medication.

Exercise

Aim for 30 minutes of physical activity 3 to 5 days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid alcohol and drugs

Drinking or misusing drugs may make you feel better for a little bit. But in the long run, these substances can make depression and anxiety symptoms worse.

Learn how to say no

Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take care of yourself

You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.

Sometimes depression doesn’t respond to medication. Your healthcare provider may recommend other treatment options if your symptoms don’t improve.

These include electroconvulsive therapy (ECT), or repetitive transcranial magnetic stimulation (rTMS) to treat depression and improve your mood.

Natural treatment for depression

Traditional depression treatment uses a combination of prescription medication and counseling. But there are also alternative or complementary treatments you can try.

It’s important to remember that many of these natural treatments have few studies showing their effects on depression, good or bad.

Likewise, the U.S. Food and Drug Administration (FDA) doesn’t approve many of the dietary supplements on the market in the United States, so you want to make sure you’re buying products from a trustworthy brand.

Talk to your healthcare provider before adding supplements to your treatment plan.

Supplements

Several types of supplements are thought to have some positive effect on depression symptoms.

St. John’s wort

Studies are mixed, but this natural treatment is used in Europe as an antidepressant medication. In the United States, it hasn’t received the same approval.

S-adenosyl-L-methionine (SAMe)

This compound has shown in limited studies to possibly ease symptoms of depression. The effects were best seen in people taking selective serotonin reuptake inhibitors (SSRIs), a type of traditional antidepressant.

5-hydroxytryptophan (5-HTP)

5-HTP may raise serotonin levels in the brain, which could ease symptoms. Your body makes this chemical when you consume tryptophan, a protein building block.

Omega-3 fatty acids

These essential fats are important to neurological development and brain health. Adding omega-3 supplements to your diet may help reduce depression symptoms.

Essential oils

Essential oils are a popular natural remedy for many conditions, but research into their effects on depression is limited.

People with depression may find symptom relief with the following essential oils:

• Wild ginger: Inhaling this strong scent may activate serotonin receptors in your brain. This may slow the release of stress-inducing hormones.
• Bergamot: This citrusy essential oil has been shown to reduce anxiety in patients awaiting surgery. The same benefit may help individuals who experience anxiety as a result of depression, but there’s no research to support that claim.

Other oils, such as chamomile or rose oil, may have a calming effect when they’re inhaled. Those oils may be beneficial during short-term use.

Vitamins

Vitamins are important to many bodily functions. Research suggests two vitamins are especially useful for easing symptoms of depression:

• Vitamin B: B-12 and B-6 are vital to brain health. When your vitamin B levels are low, your risk for developing depression may be higher.
• Vitamin D: Sometimes called the sunshine vitamin because exposure to the sun supplies it to your body, Vitamin D is important for brain, heart, and bone health. People who are depressed are more likely to have low levels of this vitamin.

Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven’t shown themselves to be effective in clinical research.

Learn about herbs, vitamins, and supplements that have shown some promise, and ask your healthcare provider if any are right for you.

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Preventing depression

Depression isn’t generally considered to be preventable. It’s hard to recognize what causes it, which means preventing it is more difficult.

But once you’ve experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.

Techniques that may help include:

• regular exercise
• getting plenty of sleep
• maintaining treatments
• reducing stress
• building strong relationships with others

Other techniques and ideas may also help you prevent depression.

Read the full list of 15 ways you may be able to avoid depression.

Bipolar depression

Bipolar depression occurs in certain types of bipolar disorder, when the person experiences a depressive episode.

People with bipolar disorder may experience significant mood swings. Episodes in bipolar 2, for instance, typically range from manic episodes of high energy to depressive episodes of low energy.

This depends on the type of bipolar disorder you have. A diagnosis of bipolar 1 only has to have the presence of manic episodes, not depression.

Symptoms of depression in people with bipolar disorder may include:

• loss of interest or enjoyment from normal activities
• feeling sad, worried, anxious, or empty
• not having energy or struggling to complete tasks
• difficulty with recall or memory
• sleeping too much or insomnia
• weight gain or weight loss as a result of increased or decreased appetite
• contemplating death or suicide

If bipolar disorder is treated, many will experience fewer and less severe symptoms of depression, if they experience depressive episodes.

These 7 treatments may help ease symptoms of bipolar depression.

Depression and anxiety

Depression and anxiety can occur in a person at the same time. In fact, research has shown that over 70 percentTrusted Source of people with depressive disorders also have symptoms of anxiety.

Though they’re thought to be caused by different things, depression and anxiety can produce several similar symptoms, which can include:

• irritability
• difficulty with memory or concentration
• sleep problems

The two conditions also share some common treatments.

Both anxiety and depression can be treated with:

• therapy, like cognitive behavioral therapy
• medication
• alternative therapies, including hypnotherapy

If you think you’re experiencing symptoms of either of these conditions, or both of them, make an appointment to talk with your healthcare provider. You can work with them to identify coexisting symptoms of anxiety and depression and how they can be treated.