Post-Stroke Depression

8.9.23

Mental health is getting quite a bit of attention these days, and the effects of that attention are rippling into every area of our society. Those effects are making their way to the stroke survivors’ community as well, and post-stroke depression (PSD) has become an area that is garnering more and more interest. PSD presents similarly to generalized depression, but it is different in its pathology and treatment.

When a stroke happens, a portion of the brain is robbed of oxygen either from a blockage or a bleed. This lack of oxygen causes damage to the brain tissue, which is difficult or impossible to repair. The damage is typically seen in physical disabilities, such as weakness of one side of the body or loss of speech, but less obvious damage can also occur. The stroke itself can lead to inflammation of the structures in the brain that help regulate our neurotransmitters or our “feel good” chemicals. When these structures aren’t operating as they normally do, it can lead to a chemical imbalance, which can then lead to depression.

Approximately one third of stroke survivors will experience post-stroke depression. Physical damage to the brain is one culprit, but the psychosocial effects that stroke survivors live with are also a factor. PSD exacerbates the symptoms of the stroke and can make rehabilitation a longer and harder process. It’s important to identify and treat PSD as soon as possible so recovery from the stroke can continue to be the main priority.

How to tell if you or your loved one is experiencing post-stroke depression:

According to the American Stroke Association, the following are potential symptoms of post-stroke depression:

Persistent sad, anxious, or “empty” mood
Restlessness and irritability
Feelings of hopelessness, pessimism, guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities, including sex
Decreased energy and fatigue, and feeling “slowed down”
Difficulty concentrating, remembering, and making decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts

If you or your loved one experiences five or more of the preceding symptoms for more than two weeks, it may be time to take action.

What to do if you or your loved one is experiencing post-stroke depression

Finding a good psychiatrist is important. There are many new therapies available to people living with PSD, and your psychiatrist can help get that process started.
Find and stay connected to a support group. Sharing your experiences with the group members and listening to theirs will help keep you from slipping into isolation.
Take care of your body, exercise, sleep well, and maintain a healthy appetite. The healthier your body is, the easier it is for the brain to heal.

Written by Laura Tsim, RN BSN CCRN

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8069768/
https://www.ahajournals.org/doi/10.1161/str.0000000000000113
https://www.stroke.org/en/about-stroke/effects-of-stroke/emotional-effects-of-stroke/depression-and-stroke