Depression

Persons with Down syndrome are just as susceptible to depression as the general population. Specifically, the incidence of depression in persons with intellectual disability in particular has been estimated at 6 to 7%.

Depression can occur as a result of current stress (acute), such as the death of a family member, leaving school, loss of siblings for college or home, or illness. Depression rather may develop as a more chronic condition. A recent history of the person's life is necessary to define the problem, if possible, and identify available support systems. Mental health assessment must accommodate the individual's specific cognitive/developmental level.

It is important that any of the signs and/or symptoms of depression be closely assessed to determine if they are symptoms of a biological/medical condition (e.g., seizures, hypothyroidism ) or a condition in itself (i.e., depression). Possible signs and/or symptoms of depression include withdrawal, sadness, sleep disturbances, behavioral changes (either quieting or aggressive), weight loss or gain, recurrent thoughts of death, lack of energy and/or feelings of worthlessness. Often the diagnosis of depression is missed because the family is told that the particular signs/symptoms are just "Down syndrome." Signs and/or symptoms might also be misinterpreted as dementia or Alzheimer's disease. It is important when symptoms are present to consult a therapist experienced in the treatment of individuals with developmental disabilities. Timely treatment may prevent or diminish the need for inpatient service.

Many physicians, psychologists and other mental health professionals currently have had little training in the relationship of psychiatric conditions to intellectual disability, leaving room for missed or misdiagnosis. The clinical presentation of depression in persons with Down syndrome may be quite different from someone without a cognitive deficit.

As the person with Down syndrome ages, mental function and social support may decrease, creating an opportunity for depression to occur. Adults with Down syndrome may experience isolation, changes in residence, and a lacking of social opportunities and adaptive skills. All of these factors contribute to decreased self-esteem, an inability to care for themselves, and depression. It is often the case that adults with Down syndrome lack the opportunities to make their own decisions in areas where they are capable (e.g., social activities, hair style, clothing choice, etc.). They are often treated as children and thus feel they have little, if any, control over their lives. Additionally, individuals who care for adults with Down syndrome may overlook support systems, over-protect the person, and/or inappropriately take punitive actions toward the person with Down syndrome.

Adapted from: Patterson, Bonnie (2003). "Down Syndrome Medical Issues Research." PowerPoint Presentation given at Healthcare Symposium. Shriner's Hospital, Lexington, Kentucky, June 21, 2003.