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The 3 D's of Confusion: Depression, Delirium, & Dementia

October 13, 2023
September 15, 2020
Posted by
Bre'anna Wilson
September 15, 2020
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It's important to distinguish the 3 D's of confusion because we must not assume that everything is dementia. Not all confusion = dementia. It could hint towards something being wrong, but that wrong does not necessarily lead to or mean dementia.  

The tricky part is that their symptoms can look a lot alike and a person can have more than "1D" at a time which can make it difficult to distinguish. So, the take away is that, if you notice any of these symptoms (overlapping or otherwise) it's important to get your partner to a doctor for further assessment. And hopefully you will see why, by the time you finish reading this blog.  

The 3 D's are Depression, Delirium, & Dementia

Depression: A biological-based illness that affects a person's thoughts, feelings, behaviors, and even physical health. Now, the difference between depression and delirium or dementia is that this a prolonged state of 2 weeks of more where the person is in a decreased mood, diminished interest in once enjoyable things, and overall increased sense of hopeless. Some of the things you may notice are impairments in memory, concentration, and self-esteem. You might hear a lot of negative talk or talks about death or suicide (or they may just say they don't want to be here anymore)...or on the flip-side, they may not talk much at all and you may notice them start to withdraw or become increasingly agitated. You may noticed disturbed sleep patterns or oversleeping. You may notice changes in their appetite they may over eat or they may not eat much at all.  

So, the biggest defining factor of depression is that they are remaining in this low mood for most of the day, nearly every day for at least two weeks and may even last months and months.  The good thing about depression and it's symptoms is that often reversible, especially if you are able to identify the symptoms early on.  

Delirium: An acute or sudden onset of mental confusion as a result of a medical, social, or environmental condition. One moment they are fine, the next moment, not so much. You notice the person is more confused, they may be so sleepy that that they are difficult to arouse, they be speaking more nonsensical. Their thoughts are disorganized, they have increased agitation, an onset of hallucinations, tasks that they were able to do yesterday are all of sudden difficult.  

Delirium is actually considered a "medical emergency." Why?  Because it could be a sign of a fever, infection, vitamin deficiencies, a medication side-effect, signs of withdrawal, hypoxia, or exposure to toxins. Other things that can cause delirium include anesthesia used for surgeries, drug/alcohol abuse, or severe chronic mental illness.  

So, if you notice a sudden change in your partner's behavior, mood, or thought processes. Get them to the doctor for medical assessment. And like I mentioned previously, a person can have more than "1D." Therefore, it's not uncommon for those with dementia to experience delirium...and often times when they's indicative of something like a UTI.  So, for example, a sudden change in behavior can often indicate something like a UTI. The good thing is that it's treatable, but you have to get the appropriate medical attention! You definitely don't want to wait too long and risk your parner becoming septic, which is a widespread infection that can cause organ failure.  

Dementia: Unlike depression and delirium it is not reversible and it doesn't have this more sudden type of onset that is more recognizable and discernable. These symptoms are going to be gradual and progressive and you notice little changes over the months and over the years.  

There are currently 5 FDA approved  medications that manage some of the symptoms of dementia with varying effectiveness, but overall the condition will worsen over time. There are going to be overlapping symptoms with delirium and depression like inattentiveness, becoming withdrawn, difficulty communicating, reading, or writing, memory loss, becoming disoriented, but again, these are going to be small changes that you notice are worsening overtime. This is not going to be waking up the next day and dad is a completely different person than he was yesterday. If dad is completely different the next day, first, suspect delirium and get dad to the doctor as soon as you can for assessment.  

So what is the biggest take away!?

Early detection, Early diagnosis. It's important to know if what your partner is experiencing depression, delirium, or dementia because it guides us into knowing what is the best way to intervene and what is the best plan of action. What your partner may be experiencing could very well be treatable and if it's not, at least you know because there are important decisions that will need to be made if it does turn out to be dementia.  

Image credit: freepik

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