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Depression & Bereavement

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Depression

Depression is at least as common in children and adults who have Down’s syndrome as it is in the general population and affects them in the same way.

Depression is not part of the condition or inevitable, but it is one of the most frequently diagnosed mental health issues for those who have Down’s syndrome. It is much more than just feeling sad or low for a while. There are a wide range of symptoms, some more common than others, which persist for at least two weeks and often considerably longer. There is a list of common symptoms in our resource about depression (see link below).

Dr Kerim Munir (Boston Children’s Hospital) has written that children and adults who have Down’s syndrome and symptoms of depression often lose the ability to enjoy many activities they used to love, they lose skills and they become very withdrawn.

Depression may appear relatively quickly or it may develop gradually over many months. In people who have Down’s syndrome, as with the general population, there are a number of factors that can lead to the development of depression:

  • Illness – the health problems that are more likely to contribute to depression in a person who has Down’s syndrome may include hypothyroidism, sleep apnoea, coeliac disease, Vitamin B12 deficiency and vision or hearing impairment.
  • Biochemical or structural differences in the brain
  • Stress

There is a list of possible causes, with particular emphasis on how certain issues may disproportionately affect people who have Down’s syndrome in our resource about depression (see link below). Sometimes there will be no apparent cause for a person’s depression, it just happens. There is nothing that could be done to prevent it.

In people who do not have learning disabilities, depression is diagnosed through a face-to-face interview with a health professional. Laboratory tests and a physical exam may help the health professional make the diagnosis. It may be more difficult to diagnosis depression in people who have Down’s syndrome, particularly if they are children because they cannot give a history of the changes they have experienced and/or describe how they feel. Where this is the case, it is important that relatives, professionals and supporters are able to provide evidence of any changes they have noticed. Sometimes it can help if the person making the diagnosis observes the person going about their everyday life at home, school, college or work.

    If you are worried about any changes you have noticed in a child, young person or adult, make an appointment with the GP. The GP may feel confident to make a diagnosis or they may make a referral, if the patient is a child, to the local Child & Adolescent Mental Health Service (CAMHS) or, if the patient is an adult, to a psychiatrist working for the local Community Learning Disability Team (CLDT).

    You should expect to have your concerns taken seriously by health professionals. The changes you have noticed should not be attributed to the fact a person has Down’s syndrome. Appropriate investigation for underlying medical causes should be carried out in the same way as it would be for anyone in the general population.

    The range of treatment options should be the same as for anyone diagnosed with depression:

    • Counselling
    • Identifying and reducing stress
    • Medication
    • Treatment of any associated medical conditions
    • Encouraging exercise and getting involved in activities that help build self-esteem.

     

    Depression resources

    Down’s Syndrome Association

    Other

    Books Beyond Words

    Resources for people who have learning disabilities.

    Bereavement

    The grieving process for someone who has Down’s syndrome is the same as it is for anyone else.

    However, for some people it may take longer and show itself in ways that are not instantly recognisable. Some people who have Down’s syndrome may have a delayed response to grief; this may be up to 6 months or more after their loss. It may be that people take longer to understand the finality of death and their own thoughts and feelings. Grieving may be complicated for people who have Down’s syndrome by difficulties around placing events in time and their strong visual memory.

    Our resource contains further information about supporting people through bereavement.

    Bereavement resources

    Down’s Syndrome Association

    Other

    Books Beyond Words

    Resources for people who have learning disabilities.

    Further Info & Advice

    If you have any questions about health issues, you can call DSA’s Helpline (Tel: 0333 1212 300) or email using info@downs-syndrome.org.uk. If an information officer is unable to answer your question, they can make a referral to the medical adviser at the UK Down Syndrome Medical Interest Group (DSMIG).

    Please note DSMIG can provide general advice about health issues but they are not able to comment on individual test results. DSMIG are happy to take enquiries from health professionals but they will not take direct from enquiries from families or supporters.