From the NYT: Dementia/Mental Illness

harshedbuzz

I thought this was an interesting article. Below a gifted link.

https://www.nytimes.com/2023/11/08/well/mind/mental-illness-depression-dementia.html?unlocked_article_code=1.9Ew.cthV.s96Pa3drjQ8b&smid=url-share

MN Chickadee

Interesting. Thanks for sharing, I had missed this one. Anecdotally it does seem there is a decent sized group of caregivers whose PWD was eccentric before dementia and it's a gray area between their "normal" mental state and when it truly became dementia because they already had some unusual or harmful behaviors/beliefs. An uncle I cared for at the end of his life definitely had a psychiatric disorder since young adulthood, then pile on alcoholism and it seemed like an inevitability he had some kind of dementia at the end (was undiagnosed but obvious.) This was my mother's brother, and while she didn't have severe mental illness prior to Alzheimers she did have depression and anxiety that came later in life, mostly typical stuff related to life circumstances around careers, money, child rearing etc. I also wonder about some genetic piece related to my uncle's life long mental struggles and if it was present in my mom in other ways. Even for the medical professionals it sounds like it's hard to parse out what's what but this does sound like it holds some clues.

harshedbuzz

@MN Chickadee

Some of the mental health issues do run in families. I believe people like your mom may have had a genetic tendency to depression/anxiety that was perhaps not as strong as her brother's and needed a stronger trigger to set symptoms off. I see this in my own family. Dad's side has a river of destructive conditions like borderline personality and bipolar with a lot of substance use running it through it.

My paternal great-grandfather returned from WWI a heroin addict, my sister died from complications of IV drug use and AIDS. Great-grandfather was weaned off it and turned to alcohol but managed to live a normal lifespan. His son died in an accident related to his alcohol use disorder when dad was not quite 2. My dad and his nephew both died from/with an ARD Wernicke-Korsakoff's. Dad lived into his 80s because he didn't start to self-medicate with alcohol until my sister died in his mid-50s. He was OK around alcohol (a moderate social drinker all my childhood-- NYE, a friend's wedding, a cocktail on vacation, maybe wine at home with friends a couple times a year) -- until he was crushed by my sister's illness, death and responsibility for her children kids not being his "thing".

Ironically, my dad was a life-long smoker who'd tried to quit multiple times because of health issues. The morning my sister died (his mini-me) he was using the patch to quit. In a fit of rage, he announced that he couldn't feel any worse than he did right then, ripped the patch off and successfully quit cold turkey with no relapses in the next 25+ years.

It is hard to parse out behavior. My mom is my non-dementia parent. She brings significant ADHD issues and anxiety to the party which makes her a seriously quirky individual. A month ago, she developed a silent UTI and was goofier (more forgetful, distractable, unfiltered and even a little paranoid) than usual- so much so that I brought her into the ED with altered mental status and elevated BP as her complaints. With abx she went back to her usual self. But the evening after the 3rd ED visit of since late July I shared my dementia-fears with my husband and he straight-faced looked at me and said "how would we tell?"

HB

Anonymousjpl123

@harshedbuzz such a good article! It’s so interesting because my family has mental illness and trauma threaded throughout my history (ironically we have a lot of adoption in our family and it still Carries over, so not only genetic). The only two people I know who had dementia are my paternal grandfather and my mom. In fact my moms side - with the borderline, trauma, depression, and anxiety - tends to live much longer than my dad’s side, with its low key alcoholism and depression.

What I found most interesting is teasing out the chicken or the egg thing. Like does mental illness create a more fertile breeding ground for dementia, or are some people genetically predisposed to both?

Also: interesting that past psychiatric hospitalization correlates with dementia. Doesn’t surprise me: our minds are so sensitive, and once they take a beating it’s likely they are even more fragile.

This experience definitely has me thinking about how I want to take care of myself. I’ve always sought out health care but it has made it seem like that much more of a priority. Thank you! also gives me a little break from being right in the middle of the mess.