Depression is linked with an increased risk of stroke, but it is also very common for people to develop emotional disorders after stroke. According to some studies, nearly 30% of stroke survivors develop depression, either in the early or late stages after stroke, which can affect recovery and quality of life (1).

Post-stroke depression (PSD) is more common after a major stroke than a minor one; and is seen more in elderly stroke patients than in younger ones. But it can be difficult to diagnose, because of other cognitive impairments, including speech problems; memory problems; and difficulty recognizing objects and people (2,3).

Everyone will suffer some degree of emotional problems after stroke. But it’s time to seek help if several of these symptoms appear together, or are frequent and prolonged:

1. Persistent sad, anxious or empty feelings

It’s normal to feel sad or worried after a stroke. People are often naturally concerned about financial pressures or the reaction of family and friends. However, if these feelings of anxiety become overwhelming, it’s time to seek help.

2. Sleep disturbances and fatigue

Around two-thirds of stroke survivors have sleep-disordered breathing (SDB), which means their sleep is interrupted several times a night (4). Getting a good night’s sleep is an important part of how well people recover after stroke.

3. Changes in eating habits

Problems with swallowing are very common after stroke, and so it’s only natural that a stroke survivor’s eating patterns may change. But if there is a noticeable difference in weight loss or gain, or levels of appetite, this can be a symptom of depression.

4. Loss of interest in activities or hobbies

Strokes often lead to paralysis, which can not only make day-to-day activities difficult, such as eating and washing, but also stop a stroke survivor taking part in things they previously enjoyed. It’s the lack of interest in these activities, rather than the ability to do them, that is a warning sign for depression (2).

5. Irritability

People naturally feel angry and frustrated after a stroke, when things they previously found easy, such as tying shoelaces, become incredibly difficult. But irritability can also be a sign of depression and can hinder health and recovery if it lasts for a long time.

Depression is classed as one of the top ten modifiable risk factors for stroke (5). While recurrent strokes are more commonly associated with high blood pressure, heart disease and an irregular heartbeat, these psychological disorders also need to be addressed as they can prevent people from taking medications or following medical advice that is also designed to reduce their risk of stroke (6).

References:

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

2. Depression after a stroke. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072397/

3. Johan Lökk, Ahmad Delbari. Management of depression in elderly stroke patients. Neuropsychiatr Dis Treat. 2010; 6: 539-549. Published online2010 Sep 7. Doi: 10.2147/NDT.S7637.

4. https://www.stroke.org/sites/default/files/resources/NSAFactSheet_SleepDisorders_2014.pdf

5. Martin J O’Donell, Siu Lim Chin, Sumathy Rangarajan et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet 2016; 388: 761-75. Published Online July 15, 2016 https://dx.doi.org/10.1016/S0140-6736 (16) 30506-2.

6. Modrego PJ, Pina MA, Fraj MM, Llorens N. Type, causes and prognosis of stroke recurrence in the province of Teruel, Spain. A 5-year analysis. Neurol Sci. 2000 Dec;21 (6): 355-60.

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