Many stroke survivors experience feelings of anger, frustration, anxiety, sadness, fear, and hopelessness in varying degrees. These emotions are common with post-stroke depression, which affects more than a third of stroke survivors. According to medical experts, post-stroke depression is underdiagnosed.
WHAT IS POST-STROKE DEPRESSION?
Your emotional health is just as important as your physical health and can promote or disrupt post-stroke recovery. Post-stroke depression is frequently described as a feeling of hopelessness that interferes with one’s quality of life and functioning abilities. If not treated and managed appropriately, post-stroke depression can slow down your recovery. Depression can set in within weeks, months, or even years after a stroke and can stop one’s progress of recovery and rehabilitation, thereby impacting quality of life. A combination of factors can lead to post-stroke depression. The sudden nature of stroke itself can have a life-changing impact. Also, the damage to the brain after a stroke, including genetic and social factors, can also contribute to depression.
SYMPTOMS
Symptoms of post-stroke depression vary in severity, frequency and duration. Signs and symptoms of depression include:
- Persistent sad, anxious or empty feelings
- Sleep disturbances
- Increase or decrease in appetite and eating patterns
- Feelings of helplessness, hopelessness, and/or worthlessness
- Social withdrawal
- Loss of interest in activities or hobbies
- Irritability
- Fatigue
- Difficulty concentrating or remembering details
- Aches, pains, headaches and digestive problems that do not ease with treatment
- Suicidal thoughts
Caregivers, family members, friends and co-workers can be very helpful in recognising post-stroke depression symptoms. It is recommended that a healthcare professional is consulted.
CAN POST-STROKE DEPRESSION BE TREATED?
If depression is left untreated and unmanaged, it can worsen a number of other common post-stroke conditions, such as malnutrition, incontinence, pain, fatigue, and sleep issues.
Depressive emotions can increase when frustrated over the lack of progress in recovering. There are a variety of treatment options for post-stroke depression. Consult your healthcare professional to determine the best course of action.
Common treatments include:
• Medication – anti-depressants are common treatments for post-stroke depression and may be prescribed by your psychiatrist, primary care doctor, or other physicians. These medications interact with chemicals in the brain called neurotransmitters to improve mood.
• Mental Health Therapy – Medication is often combined with mental health therapy provided by a psychologist, psychiatrist, social worker, or counsellor.
• Cognitive Behavioural Therapy – Focuses on helping to identify thoughts and feelings that lead to undesirable behaviour.
• Other Therapy – Sometimes post-stroke depression is fuelled by other after-effects of stroke, such as spasticity or aphasia. Physical or speech therapy can improve such conditions, and, in turn, help with post-stroke depression.
HOW TO COPE?
Treatment alone is not always enough to fight depression. A variety of practical management strategies can help:
Medication – anti-depressants are common treatments for post-stroke depression and may be prescribed by your psychiatrist, primary care doctor, or other physicians. These medications interact with chemicals in the brain called neurotransmitters to improve mood.
Improve nutrition – Certain foods can help improve mood and fight depression:
- Omega-3 fatty acids (fish, flaxseed, walnuts) promote brain health
- Complex carbohydrates (brown rice, oatmeal and whole wheat) boost neurotransmitter chemicals in the brain that affect mood
- Dark chocolate helps fight fatigue and reduce stress
- Folic acid (found in beans, oranges and broccoli) deficiency is linked to depression. It boosts neurotransmitters and promotes cognition
- Vitamin B12 (eggs, milk, liver) increases energy and alertness
Attend a stroke support group – Check with your therapist at NASAM.
Set realistic goals and prioritise – Break up tasks or projects into smaller ones.
Practise stress and anxiety management techniques – Deep breathing, squeezing a stress ball, guided visualisation, aromatherapy, meditation, walking or writing your thoughts down can be very helpful.
Be patient with yourself and loved ones– Stroke can be traumatic and recovery takes time.
Stay as active as possible – Aids, such as canes, braces and walkers can improve fitness. Walking, yoga and swimming, are low-impact and promote recovery.
Get out into the community – Volunteering for a cause, return to work or join a club. Do more activities that you consider fun and enjoyable. Encourage friends and family to visit.
Maintain a healthy lifestyle – Whatyou put into your body matters. Tryto minimise or eliminate alcohol
consumption and smoking.
Extracts from the National Stroke Association – US (www.stroke.org)