According to epidemiological studies, nearly one-third of stroke survivors will develop depression at some point in their stroke recovery. In fact, depression is the most frequent psychological complication of stroke, and the condition has a variety of negative effects, ranging from decreased quality of life to poorer stroke rehabilitation outcomes. (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515899/)
Risk Factors for Post-Stroke Depression
While anyone can develop depression after a stroke, certain factors may increase the risk for some stroke survivors. They include:
- Previous episode of mood disorder
- Female gender
- Living alone
- Co-morbidities that limit functioning (such as Parkinson’s Disease)
- Previous traumatic brain injury
Regardless of whether you have one of these risk factors, you should still self-monitor for the symptoms of depression so that you can seek effective treatment if needed. Untreated depression can not only detract from your quality of life, but it can also contribute to poorer stroke rehabilitation outcomes.
Symptoms of Depression
What are the signs and symptoms of depression? According to the Diagnostic and Statistical Manual of Mental Disorders, which details symptoms of all mental health issues, depression presents with:
- Persistent feelings of sadness
- Loneliness, isolation
- Loss of interest in pleasurable activities
- Feelings of worthlessness, hopelessness
- Fatigue
- Changes in physiological functions, such as sleep or appetite
Such symptoms must persist for at least two weeks in order to indicate a depression diagnosis.
Be aware that depression may also present alongside other mood symptoms, such as anxiety, irritability or apathy, so consider meeting with a therapist if you experience any of these as well. Some people with depression may also experience suicidal thoughts. If this happens to you, reach out to mental crisis services, go to your nearest ER or call 911 for assistance.
Treatment Options
Fortunately, depression can be effectively treated so that it won’t derail your stroke rehabilitation.
Depression treatments may include:
- Antidepressant medications
- Talk therapy using approaches such as cognitive behavior therapy, mindfulness or acceptance and commitment therapy
- Behavior activation techniques that encourage you to engage in activities that you enjoy
- Transcranial Magnetic Stimulation or Electroconvulsive Therapy, which is reserved for depression that doesn’t respond to more conservative treatments
Additionally, functional rehabilitation can help to alleviate depression if the mood symptoms occur in response to physical limitations post-stroke.
Stroke survivors who are experiencing signs of depression should follow up with their PCP or a mental health care provider for further evaluation. Don’t feel like you have to pull yourself out of it on your own. Depression doesn’t work that way. Consult with a professional for help.