Dementia encompasses different symptoms of cognitive decline. Researchers believe that dark humor can be a significant symptom and one of the early signs of dementia. Treatments can offer tremendous benefits to people who have an altered sense of humor due to dementia.
Dark humor, also known as black comedy or morbid humor, is a style of comedy that some people may find distasteful or consider off-limits.
It aims to make light of subject matters that people may consider severe or painful to discuss.
This article explains the relationship between dementia and dark humor and considers whether there is any scientific research confirming the link between them. It also looks at coping strategies and treatment options for people with the condition.
It is important to note that although cultural and social factors can influence whether humor is inappropriate in specific settings, jokes or comments containing elements of dark humor can make other people uncomfortable.
However, dark humor alone may not necessarily be a cause of concern. Some people without a medical diagnosis may use it to cope with difficult situations or may simply find this type of humor amusing. There is no approach to humor that is objectively acceptable or unacceptable.
Different people may find different things funny depending on many factors, including:
- context
- mood
- beliefs
- identity
- cultural background
- lived experience
- their relationship to the person participating in the conversation or joke
However, dark humor can sometimes signify the progression of a medical condition such as dementia. Dementia is a general term that encompasses a range of conditions affecting neurocognitive decline, including Alzheimer’s disease, Lewy body dementia, vascular disease dementia, and Huntington’s disease.
The symptoms of these conditions can range from mild to severe and may affect memory, thinking, language, judgment, and behavior.
According to a study in the Journal of Alzheimer’s Disease, dark humor can be a sign of dementia. The study evaluated humor behavior and preferences in 48 people with dementia using questionnaires that their friends and family members completed. Those who filled out the survey had known the people with dementia for at least 15 years before the onset of the condition.
The authors collected data on people with dementia-related conditions, including behavioral variant frontotemporal dementia, semantic dementia, progressive nonfluent aphasia, and Alzheimer’s disease. They compared the results with those of healthy age-matched individuals with no history of neurological conditions.
The study found that regardless of the specific condition they were living with, all of the participants had a high preference for childlike or slapstick humor and derived less pleasure from other genres of comedy.
However, individuals with behavioral variant frontotemporal dementia and semantic dementia had a higher chance than others of developing dark humor in response to unpleasant and impersonal stimuli.
Examples include laughing or assigning humorous value to highly inappropriate contexts that other people might not view as funny, such as a badly parked car, news stories on natural disasters, or watching a partner injuring themselves.
The authors also noted that these participants’ comedy preferences shifted to “fatuous and farcical” with the progression of the condition.
However, it is essential to note that this study did have some limitations. The sample of participants was small in number, and assessments involved third-party reports. Additionally, the researchers cited the need for additional studies to get a better understanding of the links between humor behavior and neurodegenerative conditions.
Before this study, scientists knew little about the connections between humor expression and awareness in neurodegenerative diseases.
However, an older study from 2014 suggests that social attributes and humor abnormalities can be a biomarker for neurodegenerative conditions that affect social and emotional signal coding.
A 2016 study that assessed two people with a diagnosis of pathological humor indicates that both individuals exhibited an altered sense of humor, making families and friends uncomfortable. The study also noted that both people had sustained damage to the prefrontal cortex — the humor appreciation center of the brain. Stroke caused this damage in one case, and dementia was responsible in the other case.
Depending on the severity of the dementia, many people who have developed a dark sense of humor may be unaware of it.
Psychoeducation — which educates people about a condition they or a loved one has — can provide close friends and family with basic information and coping strategies for dealing with dark humor in a loved one with dementia.
This can help prevent stigmatization and anxiety in the loved one.
Caregivers can help a loved one with coping strategies. These may include:
- discussing the condition with friends and families
- avoiding locations or situations that can trigger dark humor
- changing body position when an episode feels imminent
- engaging in meditation to calm the mind
- practicing deep breathing to stimulate the brain and control the humor
- using distraction techniques, such as taking a walk or counting nearby objects after an episode
According to a
The following are symptoms that
- repetition
- memory loss
- poor judgment
- mood changes
- language problems
- acting impulsively
- difficulty following storylines
- difficulty following instructions
- performing familiar tasks in a longer time
- lack of interest in normal daily activities
- losing track of time, place, and season
- trouble recognizing spatial relationships
- hallucinating or experiencing delusion or paranoia
According to the Alzheimer’s Society in the United Kingdom, some coping strategies that might help a person with dementia include:
- making a list of complex tasks
- setting up prompts and reminders
- accepting unusual statements
- exercising regularly
- eating a nutritious diet
- refraining from smoking and drinking alcohol
- seeking spiritual support
- joining dementia support groups
- relying on family and friends to help
- focusing on the positive aspects of the journey
Caregivers can help people with dementia by:
- listening
- exercising patience
- communicating in simple, clear words
- limiting distractions that can cause miscommunications, such as a TV, laptop, or phone
- assisting the person with exercise
- administering recommended medications
- attending regular medical appointments with them
- discussing their medical symptoms with the doctor
- including them in important decisions affecting their health
- maintaining a positive attitude
- keeping a good sense of humor
Currently, no disease-modifying medications are available to cure a dementia-related dark sense of humor. However, treating the underlying condition may help improve the severity of the symptoms. A doctor can recommend medications to help treat dementia, including:
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs increase serotonin levels in the brain by blocking its reuptake. This can help stabilize a person’s mood.
Examples of SSRIs include:
Anticonvulsants
Anticonvulsants or antiepileptic drugs treat conditions that cause seizures but can also help manage manic symptoms in people with a dark sense of humor in dementia.
Some common types of anticonvulsants include:
- lamotrigine (Lamictal)
- valproic acid (Depakene)
- carbamazepine (Equetro)
Dextromethorphan and quinidine drug combination
Evidence from 2016 suggests that the dextromethorphan and quinidine combination indicated for pathological laughter may reduce laughter intensity without altering the need for humor. However, the Food and Drug Administration (FDA) have not approved this treatment for dementia.
Antipsychotics
Doctors may recommend second-generation antipsychotics in low dosages when other treatments prove ineffective.
Examples include:
- olanzapine (Zyprexa)
- risperidone (Risperdal)
- quetiapine (Seroquel)
Cognitive behavioral therapy (CBT)
Having a dark sense of humor due to dementia can adversely affect a person’s life.
A certified therapist can help the person learn how to control dark humor through CBT, a short-term form of talking therapy that can help people discover ways to regulate their behavior by changing their thought patterns.
There are presently no reports on the number of people with a dark sense of humor due to dementia. However, according to the
Although there is no cure for dementia with a dark sense of humor, an early diagnosis can help healthcare professionals choose the best treatment. People with this condition can participate in clinical trials if they receive a diagnosis early. This can help researchers develop new treatments and eventually find a cure.
According to some research, people living with dementia have an increased risk of developing a darker sense of humor than they had before the onset of the condition. They are more likely to develop a sense of humor that many may consider “twisted” or socially awkward and make inappropriate jokes or statements.
More research can help scientists understand the relationship between dementia and dark humor.
Although there is no cure, an early diagnosis is key to starting treatment promptly. A doctor may recommend CBT alongside a combination of medications that effectively treat other neurodegenerative conditions.