Which one of the following statements about depression at end-of-life is true:
a) Clinical depression is a normal stage of the dying process
b) Depression associated with HIV is more difficult to treat than in cancer patients
c) Feelings of hopelessness/worthlessness are indicators of a clinical depression
d) The degree of appetite and sleep disturbance is predictive of response to anti-depressant medication
Answer: c.
Distinguishing between normal grief and depression in patients near the end of life can be challenging. It is a common misconception that a clinical depression is a normal part of the dying process. The common symptoms of a clinical depression such as appetite and energy level changes are not helpful in the dying as these are often present and due to the underlying disease. In contrast, anticipatory grief is common, noted by alternating periods of normal mood with introspection and sadness. What is helpful in diagnosing depression is a constant sense of personal hopelessness/worthlessness; these findings are not present in normal anticipatory grief.
See Fast Fact #43 Is it Grief or Depression>
