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Dealing with Post-Stroke Depression

  • Category: Stroke, Living Well
  • Posted On:
  • Written By: Sheryl Martin-Schild, MD, PhD, FANA, FAHA

Stroke is the number 5 cause of death in the United States and the number 1 cause of adult disability. Disability after a stroke can be mild (e.g. slight facial droop) to severe (e.g. completely bed-bound) depending on size and/ or location of the infarct. Strokes can also lead to personality changes, increased anxiety, impulsivity, or apathy.

What is post-stroke depression?

Depression after stroke is common, affecting about 1 in 5 people. It is normal to feel frustrated and upset with an inability to perform regular tasks, like dressing yourself or speaking. Stroke potentially changes chemicals in the brain, promoting depression. Depression is highly associated with more severe physical impairment and less improvement after stroke, compared with non-depressed patients with stroke, and can become a barrier to improving with therapies.

Common symptoms of depression:

  • Feeling sad, hopeless or “empty”
  • Feeling worthless and helpless
  • Feeling irritated, anxious, angry
  • Slowed processing, impaired concentration, poor memory
  • Unexplained aches and pains
  • Poor energy
  • Loss of interest in pleasurable activities
  • Sleeping too much or too little with trouble getting or falling asleep
  • Eating too much or not enough
  • Suicidal thoughts

Feelings of grief and loss are normal after a stroke. Many of the listed symptoms are common during the adjustment phase after stroke. If symptoms accumulate or worsen over time, you need medical attention.

Can post-stroke depression be treated?

Depression is largely treatable with medications and therapy. It is important to seek treatment as if left unmanaged, it can lead to worsening of other conditions that may exist, like sleep problems, pain, continence issues, and nutrition. Treatment of depression is associated with lower death rates after stroke. Antidepressants given to stroke patients, even those without depression, may lead to greater improvement in cognition, communication, and motor function than placebo during rehabilitation. Other ways to prevent or treat depression include:

  • Learning more about stroke
  • Document progress in rehab
  • Talk about your feelings with family and friends
  • Stay as active as possible with prior hobbies
  • Abstain from alcohol.

Depression should not be confused with pseudobulbar affect (PBA), which is characterized by inappropriate emotional responses like laughing at a funeral, or crying without cause. Treatment of PBA is different than treatment for depression.

If you or a loved one have symptoms of depression, please communicate this with your doctor. If there are thoughts of suicide, immediate attention is needed.

Lastly, it is important to remember the common signs of a stroke. Call 911 immediately if you suspect a stroke is occurring. If all of a sudden you cannot do something you used to be able to do, or you experience the worst headache of your life, think stroke.

Click here to learn more about stroke and prevention.

Click here to learn more about Touro’s Certified Primary Stroke Center.

Recovering after Stroke Seminar

Thursday, May 31
12pm to 1pm
Presidents Room
1401 Foucher Street, 2nd Floor
New Orleans, LA, LA 70115

Join Touro Neurologist Digvijaya Navalkele, MD and the Touro Rehabilitation Center for an informative seminar on life after stroke. If you or someone you love has suffered a stroke, you may wonder what lies ahead. A stroke can cause problems with speech, vision, memory, balance, or coordination. It can leave part of the body weakened or paralyzed, among other physical problems.

It may help to know that rehabilitation can help people regain life skills and learn new ways to do tasks. We’ll share resources and tips for stroke recovery, including navigating depression and emotional support. Plus learn steps to prevent stroke recurrence and improve brain health.

A light lunch will be provided.

Click here to register or call 504-897-8500.

Dr. Sheryl Martin-Schild, MD, PhD, is a New Orleans native and has spent the majority of her training and career in New Orleans. Prior to joining Touro, Dr. Martin-Schild served as an Associate Professor of Neurology and Director of the Stroke Program at Tulane University School of Medicine for eight years where she developed and award winning comprehensive stroke center. She currently also serves as the Stroke Medical Director for the New Orleans East Hospital. Dr. Martin-Schild enjoys mentoring medical students and residents in healthcare outcomes research in acute stroke. Her number one priority is her patients and making sure they receive the best care during and after their hospital stay. Dr. Martin-Schild is the State Medical Director for Stroke of the Louisiana Emergency Response Network (LERN) and enjoys traveling to facilities throughout Louisiana, educating healthcare providers and the public on stroke risk factors, prevention, and acute treatment.