What is Post-Stroke Depression?

The news of a senator seeking treatment for depression following his stroke is a reminder that depression does not have to go unrecognized or untreated in patients following serious cardiac or vascular events. There are safe and effective treatments for stroke survivors. 

“A stroke is often a serious, abrupt, and unsettling medical event after which depression and anxiety can be common,” says Jeffery Huffman, MD, a psychiatrist and Director of the Cardiac Psychiatry Research Program in the Department of Psychiatry at Massachusetts General Hospital. “It is important to address mental health issues following a stroke to optimize recovery and improve quality of life.  Fortunately, there are many good treatment options.”

It’s not uncommon to experience strong emotions following an abrupt medical event like a stroke or heart attack. Both involve your blood vessels narrowing, containing plaques, and not getting enough oxygen. But one occurs in the brain (stroke) rather than in the heart (heart attack). Risk factors like diabetes, high blood pressure, and high cholesterol are the same, and recovery can look similarly life-changing with drastic changes to diet and exercise.

“Studies have found as many as one-third of stroke survivors will experience significant depression,” Dr. Huffman explains. “Stroke can influence brain pathways and brain chemicals that are important in regulating mood and preventing depression while also sometimes resulting in physical and cognitive limitations. Those effects can certainly throw one’s life into turmoil.”

Signs of Post-stroke Depression & Actions You Can Take

1. Pay attention to post-stroke depression symptoms. Are you feeling down, sadder than usual, or less interested in activities you’d typically enjoy? If your sleep is suffering and your appetite is decreasing, those can also be signs it’s time to seek our help.
2. Be mindful of subtler clues of depression. Even if you’re not feeling sad all the time, if you’re having trouble focusing, feeling like life if duller than it used to be, those are still important clues to share with your health care provider.
3. Lean on family and friends. Social connections can make a meaningful difference during recovery. Spend time and continue talking with trusted people in your life. They can notice aspects of your emotional and mental well-being that are helpful clues about when to seek more professional mental health support.
4. Do things that are good for everyone. Eating a healthy diet, exercising based on your physical mobility and recovery plan, and getting restful sleep—these practices are valuable for everyone to do but become even more important when recovering from a significant medical event like a stroke.

If you think you might be experiencing depression, share that with your neurologist, primary care physician, and/or another member of your recovery care team. They can help get you connected to mental health specialists. The good news is the usual treatments for depression are also safe for post-stroke depression, whether that’s counseling or therapy, antidepressant medications, and more.

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