What is post-stroke depression?

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Depression often occurs following stroke. Neurologist Raul Guisado, MD, of Regional Medical Center of San Jose, explains why.

Depression is considered to be a major hindrance to a successful recovery for stroke victims. An estimated 35 percent stroke victims who are age 65 or older experience depression, which may have been triggered by the stroke, or may be an emotional response to the effects of the stroke. Depression can stall recovery because patients sometimes feel hopeless and stop trying. Because of this, anti-depressants and therapy may be other components of the patient's stroke recovery process.

Depression can have negative effects on recovery from a stroke. Researchers studied more than 1,600 people recovering from strokes after they left the hospital. At two times, three and six months after their strokes, the researchers found those diagnosed with depression before having a stroke were 56 percent more likely than those without depression to report functional declines and a greater negative stroke-related impact on health and life.

Depression is common in stroke patients: Of the approximately 600,000 people who suffer from stroke or recurrent stroke every year in the U.S., 10% to 27% experience concurrent major depression (for an average duration of just under a year) and an additional 15% to 40% experience depressive symptoms.

As a leading cause of disability in older people, stroke may cause a person to experience loss of control and independence, feelings known to contribute to depressive disorders. The negative effects of stroke are compounded in people who experience concurrent depression because these individuals may be less motivated to follow a rehabilitation program.

Certain factors affecting the likelihood and severity of depression in stroke patients include:

  • location of the brain lesion
  • family history of depression
  • prior depressive episodes
  • prestroke social functioning

Although often co-occurring with stroke, clinical depression is not an expected result of stroke. When present, clinical depression should always be treated.

About 25% of people who've had a stroke develop major depression. Left untreated, depression can undermine efforts at rehabilitation and worsen cognitive disabilities. For some people, depression is a reaction to the impairments caused by the stroke. But for many, it may stem from injury or changes to the brain caused by the stroke.

The following test can help determine whether you are suffering from serious depression after a stroke (answer yes or no):

  • I feel downhearted, blue, and sad.
  • I don't enjoy the things I used to.
  • I've felt so low that I've thought of suicide.
  • I feel that I'm not useful or needed.
  • I notice that I am losing weight.
  • I have trouble sleeping through the night.
  • I am restless and can't keep still.
  • My mind isn't as clear as it used to be.
  • I get tired for no reason.
  • I feel hopeless about the future.

You may be suffering from depression if you answered yes to at least five of these questions, and these symptoms have persisted for at least two weeks. If you answered yes to statement 3, and have thought of suicide, seek professional help immediately regardless of your other responses.

If you think you are suffering from depression after a stroke, talk to your doctor. If you are getting rehabilitation therapy, find out if there is a psychologist affiliated with the rehab program. Psychotherapy, antidepressants, or both may be helpful.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.