5 Facts About Stroke and Depression

Stroke is a serious, life-changing and often overwhelming event. Most people who suffer a stroke will experience some sort of emotional changes, including feelings of shock, anger, anxiety and depression. It’s normal to feel sad and upset after a stroke, but depression is when those negative emotions just won’t go away, and last for weeks or even months. (1)

1. Around 30% of stroke survivors will suffer from depression

Depression is common among stroke survivors, affecting approximately 30% of people, and is linked to worse ‘functional outcome’ (2). This means how a person gets on with day-to-day physical and cognitive tasks, such as speaking and socializing. However, if you have the support of friends and family around you, the impact is said to be less evident on the right hemisphere of the brain. This is the side of the brain that controls problem solving, memory and reasoning (3).

2. Depression is 15% less common in intracranial hemorrhage

Not to be confused with intracerebral hemorrhage, in which bleeding occurs around or within the brain itself, an intracranial hemorrhage is a type of bleeding that occurs inside the skull. Depression is 15% less common in people who suffer from intracranial hemorrhage, regardless of their age, sex and other demographic characteristics or the severity of their attack. But the people in this group who do get depression are more likely to deteriorate over time. (4)

3. Depression is linked to poorer recovery in the first 3-12 months post-stroke

Post-stroke depression is one of the most common psychological consequences of stroke, affecting almost half of all survivors (5). Depression has also been linked to poorer recovery within the first 3-12 months after the initial event. Early intervention, such as being able to talk to someone in the first few days after a stroke, is key to a positive outcome for stroke survivors.

4. At least one third of stroke survivors display mood symptoms

It is very common for people to experience a range of challenging emotions after stroke. In fact, approximately one third of stroke survivors report feeling angry, anxious or experiencing feelings of intense emotion (6). This could be because the part of the brain that normally controls emotions has been damaged. Some people also experience changes in personality. For example, a previously mild-mannered person may become angry and aggressive.

5. People with stroke and depression are 3 times more likely to die

Depression also negatively impacts stroke outcome, with a higher chance of death and poorer recovery (5). One study found that patients with acute post-stroke depression were 3.4 times more likely to have died ten years after their stroke than those without depression (7). People with stroke and depression also have increased mortality rates, for both natural and unnatural causes of death (8).

Depression is classed as a modifiable risk factor for stroke. Which means that, with the right support and rehabilitation, it is a problem that can be improved, altering outcomes for patients before and after stroke.

References:

1. https://www.stroke.org.uk/sites/default/files/user_profile/depression_and_other_emotional_changes.pdf

2. Stefano Paolucci. Epidemiology and post-stroke depression. Neuropsychiatr Dis Treat. 2008 Feb: 4 (1): 145-154. Published online 2008 Feb.

3. Ahn DH, Lee YJ, Jeong JH, Kim YR, & Park JB (2015). The effect of post-stroke depression on rehabilitation outcome and the impact of caregiver type as a factor of post-stroke depression. Annals of rehabilitation medicine, 39(1), 74-80.

4. Stern-Nezer S, Eyngorn I, Mlynash M, Snider RW, Venkatsubramanian C, Wijman C A, & Buckwalter MS (2017). Depression one year after hemorrhagic stroke is associated with late worsening of outcomes. NeuroRehabilitation, 41(1), 179-187.

5. Isabelle Loubinoux, Golo Kronenberg, Matthias Endres, Pascale Schumann-Bard, Thomas Freret, Robert K Filipkowski, Leszek Kaczmarek, Aurel Popa-Wagner. Post-stroke depression: mechanisms, translation and therapy.

6. https://www.stroke.org.uk/sites/default/files/Emotional%20changes%20after%20stroke.pdf

7. Robert G Robinson, MD; Giantranco Spalletta, MD, PhD. Poststroke Depression: A Review. PMC 2013 May 8. Can J Psychiatry. 2010 Jun; 55(6): 341-349. Doi: 10.1177/070674371005500602.

8. Jørgensen TS, Wium-Andersen IK, Wium-Andersen MK, Jørgensen MB, Prescott E, Maartensson S, & Osler M (2016). Incidence of depression after stroke, and associated risk factors and mortality outcomes, in a large cohort of Danish patients. JAMA psychiatry, 73(10), 1032-1040.