While some drugs, including antidepressant drugs, are widely used to treat depression, these drugs don’t work as well or as effectively in people with dementia. However, new search suggests psychological/psychotherapeutic treatments and interventions also referred to astalking therapycan be used to reduce depression and anxiety in people with dementia and mild cognitive impairment (MCI).
Talking therapies usually involve a therapist working with an individual or a small group of people. It is also a method used to help individuals deal with mental health issues such as dealing with serious mental disorders as well as daily life stressors, Bisma Anwar, LHMCa licensed mental health counselor, told SeniorsMatter.
Psychotherapy uses many different approaches to treat depression and anxiety in adults, including cognitive behavioral therapy (CCT), behavioral activation (BA), problem solving therapy (TVP), interpersonal therapy (IPT) and integrative approaches such as counselling. These types of therapies can be used in combination with other therapies and/or medications.
Approaches to psychotherapy:
The study is the first review showing how effective and helpful psychological interventions are, particularly because there is no standard treatment for depression in patients with dementia.
“Our findings break the stigma that psychological treatments are not worth it for people with cognitive impairment and dementia, and show that we need to invest more in research in this area and work to increase access to psychological services. for people with dementia and their families around the world,” said Vasiliki Orgeta, PhDlead author of the study University College of London. “We want people with cognitive impairment and dementia and their carers to have the same access to mental health treatment as everyone else.”
What else you need to know about the study
Orgeta and colleagues reviewed psychological interventions, including CBT and support and counseling interventions based on evidence from 29 trials that altogether included nearly 2,600 people with dementia or MCI. The treatments were all generally aimed at supporting the general well-being of the patient, reducing distress and improving coping.
Researchers have found cognitive-behavioral therapies – a type of treatment which helps people learn to identify and change disruptive thought patterns that negatively influence behavior and emotions – were slightly better than ‘usual treatment or active control conditions’ in reducing depressive symptoms in people with dementia and MCI.
Orgeta said cognitive behavioral therapies may also increase depression remission rates, while improving patients’ quality of life and activities of daily living at the end of treatment compared to usual care.
“Support and counseling interventions may not improve symptoms of depression in people with dementia, but may slightly improve quality of life,” Orgeta added. “It is encouraging that CBT treatments were favored over control conditions for several outcomes other than depressive symptoms, such as quality of life and activities of daily living.”
The researchers noted that they could only be moderately certain of the small positive effects of CBT-based treatments on depression, quality of life, and daily activities, meaning they can be relatively confident in their results. However, they were less sure about other results, including the effect of CBT on anxiety at the end of treatment.
“For all types of psychological treatment, the evidence related to anxiety symptoms was of very low certainty and therefore inconclusive, so further research on the effectiveness of psychological interventions in reducing anxiety symptoms is needed,” said said Orgeta. “It is unclear whether these changes are clinically significant, and most of the evidence is for people with mild dementia in community settings. Most people with dementia probably don’t have access to these types of treatments.
Although there are limitations to the current study, she said the results show some benefits and are encouraging, especially in light of the lack of evidence of potential benefits and harms compared to pharmacological treatments.
How does talk therapy improve symptoms of depression?
Although not enough is known about the power of talk therapy, Orgeta said it’s likely that when people engage in these types of treatments many changes will occur, including changes in the brain.
People with dementia and their caregivers likely become psycho-educated about depressive symptoms, she said, and can identify what triggers them, as well as relaxation techniques that can help.
In general, therapy can help people in the early stages of dementia understand and process their thoughts and behaviors as well as what triggers their depressive symptoms, Anwar said. It can also help them overcome feelings of anxiety, sadness, and depression.
Therapy can help people in the early stages of dementia understand and process their thoughts and behaviors and what triggers their depressive symptoms.
Talk therapy further provides healthy coping strategies and problem-solving skills to manage these types of emotions. However, a patient in the later stages of dementia may find it difficult to engage in talk therapy, as concentrating and articulating thoughts and feelings may become more difficult.
“Talk therapy can provide a safe and confidential space for patients to process their thoughts and feelings around their situation,” Anwar said. “It can provide alternative ways of coping with ineffective treatments, outcomes and symptoms of depression. Therapy is a source of support for patients with dementia.
What does this mean for caregivers and older people?
According to Orgeta, CBT treatments do not necessarily improve outcomes for caregivers, but the results suggest that CBT treatments have a small positive effect on depressive symptoms in people with dementia and MCI immediately after treatment and may improve quality of life. This can be important and meaningful for caregivers and families caring for a loved one with dementia or MCI.
Because the therapy is not considered an effective treatment option for these patients, this study clearly shows that there are some benefits, Anwar said. The study helps caregivers understand the benefits of therapy for loved ones with dementia or MCI and allows them the space to process feelings and thoughts around their diagnosis.
“It gives patients another source of emotional support and gives caregivers a sense of relief,” Anwar added.
This gives patients another source of emotional support and gives caregivers a sense of relief.
Families, caregivers, and loved ones with dementia or MCI should speak with their doctor to see if talk therapy or other forms of psychotherapy are available or suitable for them.
Orgeta said the review showed that older people with cognitive impairment and dementia can potentially experience the same benefits from psychological treatments as older people who do not live with dementia or cognitive impairment, including a slight reduction depressive symptoms and an improvement in daily life. or quality of life.
The authors said that while their research is encouraging, more research into non-drug treatments is desperately needed. They added that more clinicians need to choose talking therapies for their patients and that more funding needs to be applied to this area to better understand psychological treatments and the effects on people with dementia.