Dear Carol: My father has Alzheimer's disease, an adrenal gland problem and now, major depression. He suffered a heart attack 20 years ago, and responded well to surgery. He then quit smoking and became an avid runner, however after his adrenal dysfunction was diagnosed, he seemed to give up. His doctor has tried two antidepressants and neither has helped. His Alzheimer's is still in a fairly early stage, but it's hard to tell what's going on since he doesn't want to do anything but watch TV. He has lost a lot of weight. The doctor seems to be baffled. - Richard
Dear Richard: I'm not a medical person, but it does seem to me that your dad's depression will need to be addressed even more aggressively. Some people respond to nearly any antidepressant medication, but many people need to try several different ones. The fact that most antidepressants take several weeks to fully kick in makes finding the right one even harder. Also, some people can react negatively to certain antidepressants.
All of this would be hard enough if depression were his only problem. Alzheimer's can affect judgment and perception of reality, so trying to juggle the symptoms of Alzheimer's and depression is a challenge for any doctor. Add an adrenal problem, and this has got to be a case for a specialist or two.
Your dad may already be seeing an excellent specialist, but even then, you may want to take him to another doctor. I'm not implying that the first doctor isn't good. Rather, I feel that a fresh look by another qualified professional may yield new ideas.
There are medications for Alzheimer's disease, as well, that for some people can slow down the cognitive decline. However, like all medications, these have side effects. If your dad is on any medications for Alzheimer's, this should be taken into consideration with his depression. Again, if he's on medication for his adrenal problem, that can figure in.
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You may want to talk to a pharmacist and ask for some information on interactions between the medications your dad is on. I'd get as much information as possible and then ask for a second opinion, or even a different type of specialist. A geriatric psychiatrist could be helpful for both the Alzheimer's and the depression. I assume he's already getting specialized help for is adrenal disorder. Also, he may benefit from counseling for his depression.
Don't give up. Keep looking. Hopefully, you'll find a doctor who can coordinate the treatment of these disorders.
Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com . She can be reached at carol@mindingourelders.com .
