Many studies have highlighted perceived psychosocial stress and depression as a key risk factor for stroke (1). While depression is often the result of a stroke, it also increases your chance of having a stroke in the first place – and, also, the risk of dying from it (2,3). People suffering from intense psychological stress are also more likely to have a stroke later in life (4).

Psychosocial stress and depression are linked to cardiovascular conditions

The association between psychosocial stress and coronary heart disease is strong (1). Similarly, depression has been associated with an increased risk of diabetes, high blood pressure and cardiovascular disease, all of which are strongly linked to stroke (5). Therefore, a person with psychosocial stress or depression may have a higher overall risk of having a stroke in the future.

More women are affected by psychosocial stress and depression

Stroke is a leading cause of death and disability worldwide and, overall, more women die from stroke than men (6). Likewise, an independent study on psychosocial stress and stroke identified a higher stroke risk for women and, of the 300 million people affected by depression worldwide, the majority are also female (1, 7). One study suggests this may be due to many factors, including internalising emotions; hormonal changes; and even the use of the contraceptive pill (8).

Psychosocial stress is one of ten modifiable risk factors for stroke

A major global study found ten modifiable risk factors were associated with around 90% of all strokes around the world, regardless of ethnicity, gender or age. Psychosocial factors, such as home- and work-related stress, life events, and depression were all identified as a contributor to stroke risk and as one of the potential factors that could be changed through prevention and/or treatment (6).

What can be done to prevent or treat psychosocial stress?

There are many interventions that can help to manage psychosocial stress, anxiety and depression. Prevention programs are sometimes put in place for children who have suffered mental or physical abuse, or adults who are overcoming major life traumas, for example.

Cognitive behavior therapy and psychotherapy may be used to effectively treat mild-to-moderate depression; and medication, such as antidepressants, may also be prescribed. But healthcare provision varies all over the world. For instance, up to 85% of people in low-to-middle-income countries will receive no treatment for mental disorders (9).

If you, or someone you know, suffers from depression or stress, it’s important to get the support and care needed. Treating psychological disorders can help to improve quality of life and reduce the risk of stroke and other cardiovascular conditions.

References:

1. Joanne Booth, Lesley Connelly, Maggie Lawrence, Campbell Chalmers, Sara Joice, Clarissa Becker, Nadine Doughall. Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta- analysis. BMC Neurol. 2015; 15:233. Published online 2015 Nov. doi: 10.1186/s12883-015-0456-4.

2. Jonas BS, & Mussolino, ME. (2000). Symptoms of depression as a prospective risk factor for stroke. Psychosomatic medicine, 62(4), 463-471.

3. Pan A, Sun Q, Okereke OI, Rexrode KM, & Hu FB. (2011). Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA, 306(11), 1241-1249.

4. Booth J, Connelly L, Lawrence M, Chalmers C, Joice S, Becker C, & Dougall N. (2015). Evidence of perceived psychosocial stress as a risk factor for stroke in adults: a meta-analysis. BMC neurology, 15(1), 233.

5. Dr. An Pan, PhD; Dr. Qi Sun, MD, ScD; Dr. Olivia I. Okereke, MD, SM; Dr. Kathryn M. Rexrode, MD; Dr. Frank B. Hu, MD, PhD. Depression and the risk of Stroke Morbidity and Mortality: A Meta-analysis and Systematic Review. JAMA. 2011 Sep 21; 306 (11): 1241-1249. Doi: 10.1001/jama.2011.1282.

6. 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.

7. https://www.who.int/news-room/fact-sheets/detail/mental-disorders

8. Paul R. Albert PhD. Why is depression more prevalent in women? J Psychiatry Neurosci. 2015 Jul; 40 (4): 219-221. Doi: 10.1503/jpn.150205.

9. https://www.who.int/news-room/fact-sheets/detail/depression

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