Overcoming depression after stroke

After a stroke, depression is a common problem survivors face, says the National Stroke Association (NSA). The NSA describes it as grieving a loss — a loss of mobility, coordination or just feeling normal. It could also be related to the brain damage that stroke may cause, preventing survivors from experiencing positive feelings.

But what causes a stroke and the ensuing depression, and how do stroke survivors get help?

A stroke happens either when a clot in an artery blocks blood flow to the brain or when a blood vessel in the brain ruptures, causing a hemorrhage. A stroke can cause any number of issues, including loss of movement in one or more body parts. According to the NSA, other affects can include:

• Bladder and bowel problems
• Muscle and nerve problems
• Muscle spasms
• Speech problems
• Swallowing and eating problems
• Thinking and memory problems

“Though each stroke survivor responds differently many people who survive a stroke feel fear, anxiety, frustration, anger, sadness and a sense of grief for their physical and mental losses,” says Dr. Jan Remer-Osborn, PhD, neuropsychologist at Advocate Good Samaritan Hospital in Downers Grove, Ill. “These feelings are a natural response to the psychological trauma of stroke.”

Education regarding the specific role of psychology in rehabilitation helps the patient and family make informed choices, Osborn says. “Individuals who have suffered a stroke often must make adaptations in their lives and learn to cope with new limitations, both physical and cognitive.”

Osborn encourages family members of stroke survivors to know the signs and symptoms of depression, so that they can better help their loved one:

• Sleep disturbances
• A radical change in eating patterns that may lead to sudden weight loss or gain
• Lethargy, or a strong feeling of sluggishness
• Social withdrawal
• Irritability
• Fatigue
• Self-loathing
• Suicidal thoughts

A study from the Department of Neurology at Aalborg Hospital in Denmark says that 79 percent of people experienced depression within the first few months following a stroke, even with improvement in physical and cognitive symptoms.

Osborn also says some emotional disturbances and personality changes are caused by the physical effects of brain damage: “Tearfulness and angry outbursts are more common with damage to the left hemisphere of the brain, while impulsive behavior and difficulty understanding tone of voice and facial expressions are seen with damage to the right hemisphere.” 

Treatment options
Stroke survivors experiencing these symptoms, should know that post-stroke depression can be treated. Osborn says there are some things you can do on your own to lift the depression, including:

• Increase pleasant social interactions, such as being with family and friends
• Do things you like to do, like listening to music, reading or gardening
• Keep your mind active with your favorite puzzles
• Get exercise; physical activity can elevate your mood

Osborn also says to ask your physician about psychological counseling.

“Each person may have a different way of coping and getting treatment,” she says. “It’s important that you speak with your physician first to decide what is best for you.”