How depression is different in people with intellectual disability

In our winter edition of Enable we explored the causes, types and signs of depression and where to get help. In this follow up article, we delve a little deeper into how the signs of depression can be different in people with intellectual disability.  

Dr Rachael Cvejic, Lecturer at the Department of Developmental Disability Neuropsychiatry, School of Psychiatry at UNSW Sydney, provides some key insights into what these differences can be, the signs to look out for and current research and resources that are available for the community.  

How are the signs of depression in people with intellectual disability different?  

For people with a mild intellectual disability and those with reasonable verbal skills, the signs of depression can be similar to those in people without an intellectual disability. But for people with a more severe intellectual disability, or those with limited communication skills, symptoms of depression can be harder to identify. This is because when considering changes in mood and other signs of depression we usually rely a lot on a person’s verbal skills and their ability to recognise and describe their feelings.  

How can the signs of depression in people with intellectual disability be picked up?  

To identify signs of depression in people with more severe intellectual disability or those with limited communication skills, we rely a lot more on descriptions provided by someone who knows the person well, such as a family member or carer, about any changes in a person’s behaviour.  

What are some of the changes to look out for?  

These changes could include the person having a sad facial expression more often than usual, being tearful or crying more frequently, seeming irritable, refusing to take part in activities they previously enjoyed, or spending a lot more time alone. Other changes in behaviour could include changes in appetite, sleeping patterns, and changes in their activity levels.  

But, these sorts of changes could also be due to physical health problems. They might indicate that the person is in pain, or they could be a side effect of medications. So it is really important that health professionals consider these possible causes of changes in behaviour as well. 

Can depression or other mental health conditions in a person with intellectual disability sometimes be overlooked?  

Sometimes, it might be incorrectly assumed that behaviours are related to the person’s intellectual disability, rather than to a health or mental condition. Carers should always seek help if they notice changes in a person’s behaviour. And health professionals should always rule out physical causes before evaluating possible mental health changes.   

What treatments are available to assist a person with intellectual disability who is experiencing depression 

It is important to know that there are treatments, both medication and non-pharmacological, that can assist someone with an intellectual disability and depression. The first step is to talk to your General Practitioner.  

Is there any research currently underway to help improve the outcomes for people with disability?  

There is a lot of research happening that aims to improve outcomes for people with an intellectual disability experiencing depression and other mental health conditions, both in Australia and overseas. For example, the Department of Developmental Disability Neuropsychiatry at UNSW Sydney is leading a number of studies that aim to improve the health and mental health of people with an intellectual disability, as well as their access to quality health services. A full list of our projects can be found by visiting 3dn.unsw.edu.au/our-projects 

Are there any resources available in relation to your research?  

As part of our work we have also developed resources for health professionals, disability professionals and carers, to help them to better meet the needs of people with an intellectual disability and co-occurring mental health conditions. These include written guides, videos, podcasts, and eLearning modules. These resources are all available for free and can be accessed through our website. 

For further information and to access additional resources, visit 3dn.unsw.edu.au/content/education-resources 

Dr Rachael Cvejic, Lecturer at the Department of Developmental Disability Neuropsychiatry, School of Psychiatry at UNSW Sydney
Dr Rachael Cvejic

Rachael is a registered psychologist and early career researcher with broad research interests including neuropsychology and neuropsychiatry. Her clinical and research experience includes working with people with mild and major neurocognitive disorders, intellectual and developmental disabilities, and inherited neurodegenerative disorders including fragile X-associated tremor ataxia syndrome and Huntington disease.

Copyright © 2018 Achieve Australia