Big picture view: 3 tips for differentiating between dementia and mental illness

Aging isn’t always easy. Same goes for caregiving. Layer in the added complexity of dementia or mental illness, and small obstacles can become much bigger. What’s more, both of these health issues are increasingly common among Canadian seniors.
By Home Care Assistance - October 17, 2019

Home Care Assistance is Changing the Way the World Ages. This is the latest installment of our “How To” series, where we lay out smart and easy-to-understand advice on navigating the aging process.

Dementia becomes more prevalent as we age, affecting less than 1% of those 65 to 69, but 25% of people 85 and older. That means as the population of Canadians over 65 grows, so does the number of people living with dementia. Mental illness is another mounting concern. As recently as 2016, more than 18 million Canadians over the age of 60 were living with a mental health issue or illness.

Not every senior will experience dementia or mental illness. But those who do can suffer very real impacts and long-lasting effects. As a caregiver, knowing the red flags to watch for, and getting the right support, can go a long way towards maintaining – or improving – quality of life for someone you love. 

Keeping these three take-aways in mind can help you understand where dementia and mental illness differ from the signs of typical aging, and watch to watch for in the ones you love. 

Dementia and mental illness may seem similar – but they’re not the same. The most important things you can learn about dementia are what it’s not. Dementia is not a “normal” part of the aging process. It actually means a group of symptoms that affect thinking, memory and social abilities severely enough to interfere with daily life. Having memory loss alone doesn’t necessarily mean that a person has dementia. And dementia in and of itself isn’t a specific disease (although several diseases can cause it).

We tend to use the words “dementia” and “Alzheimer’s” interchangeably. But while Alzheimer’s disease is the most common cause of progressive dementia in older adults, it’s not the only one. Vascular, Lewy body, frontotemporal, and mixed dementia are all linked to different causes and diseases.

While mental illness shares some common symptoms with dementia (like confusion and mood swings), it’s a distinct and different issue. Mental illnesses are marked by altered thinking, mood or behaviour that’s associated with significant distress and impaired functioning. A mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect someone’s ability to function.

Much like dementia is bigger than occasional – or even frequent – forgetfulness, mental illness is more complex than simply experiencing good days and bad days. It’s a sustained issue that spans a number of disorders, including depression, bipolar, schizophrenia, anxiety, and more. 

Symptoms may overlap, but each comes with a distinct set. Like many health issues, symptoms of dementia or mental illness can vary. Dementia symptoms come to light as cognitive or psychological changes. Mental illness symptoms can affect emotions, thoughts, behaviour, and even cause physical problems like headaches or other unexplained aches and pains. Are you getting the sense that something’s may be going on with your loved one? Consider these questions as you assess possible red flags:

Dementia:

  • Are you noticing more memory issues than usual?
  • Do they seem to have difficulty communicating and finding words? 
  • Are they getting lost more often?
  • Are problem-solving and reasoning becoming difficult? 
  • Do complex tasks seem harder to handle? 
  • Is their coordination and motor function changing?
  • Are they often confused or disoriented?

  • Is their personality changing? 
  • Do they seem depressed or anxious more often? 
  • Is their behaviour inappropriate? 
  • Are they becoming paranoid, or agitated?
  • Are they hallucinating? 

Mental illness:

  • Are they regularly feeling sad or down? 
  • Have they started to withdraw from friends or activities? 
  • Are fears and worries becoming excessive?
  • Do the highs and lows of their moods seem more extreme?
  • Are they having trouble sleeping?
  • Do they seem low energy, or significantly more tired? 
  • Are they struggling to cope with daily problems or stress? 
  • Do they seem excessively angry, hostile or even violent? 
  • Are they expressing suicidal thoughts? 

Getting a diagnosis matters. Diagnosing dementia or mental illness isn’t always straightforward. It’s even harder for medical professionals to diagnose mental illness in people with dementia because of the overlapping symptoms. Even between Alzheimer’s and depression we see commonalities – from social withdrawal and memory problems to impaired concentration, sleeping too much or too little, and a loss of interest in once-enjoyable activities and hobbies.

Getting to the bottom of the issues and seeking a diagnosis is always important. Many mental illnesses can be treated with the right mix of counselling, medication and lifestyle changes. True, too in some specific cases where dementia’s underlying cause can be treated. Also this: some forms of dementia, like Alzheimer’s, can benefit from early intervention at the initial stages of the disease.

That’s what makes knowing specifically what you’re dealing with so important. Doctors rely on many different tests and assessments to diagnose dementia or a mental illness. As a caregiver, you’ll need to help the doctor paint that holistic view. That means keeping track of when you first started noticing someone’s symptoms, how they’ve changed over time, and whether you’ve noticed anything that makes the symptoms better (or worse). Risk factors – like family history – are also important for the conversation with the doctor. 

Closing thoughts

A diagnosis of dementia or mental illness doesn’t have to mean closing the door on quality of life. In fact, the opposite is true. Knowing what’s going on with someone you love enables you to find the right tools and resources for them, which can significantly improve someone’s day-to-day – including yours.

References (proper list):

Mental Health Commission of Canada  Canadian Institute for Health Information Public Health Agency of Canada Alzheimer’s Society Canada  Mayo Clinic – Dementia Mayo Clinic – Mental Illness  The Gerontological Society of America 

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