Mental health conditions are among the 10 potentially modifiable risk factors collectively associated with about 90% of strokes¹.

Can stress cause a stroke?^2,3 

Both sudden (acute) and long-term (chronic) stress should be considered risk factors for stroke. Sudden stress may activate the sympathetic nervous system and cause narrowing of the blood vessels in vulnerable individuals. Long-term stress may lead to behaviours such as inactivity or excessive alcohol or tobacco use, all of which independently increase stroke risk. It may also affect blood vessel walls, making arteriosclerosis more likely. It is possible that established stroke risk factors like pollution increases long term stress.

Some things may affect our vulnerability to stress, including levels of social support, coping style, personality type, experiences of discrimination (due to race, gender or perceived gender), socioeconomic status, childhood trauma and profession. Gaining more control over home or work situations may reduce stress.

What is the link between depression and stroke?⁴

Depression after stroke is well documented and should be discussed as part of secondary prevention interventions and advice. Depression is also associated with increased risk of a first stroke, although exactly how they are linked is not fully understood. Several studies have found that individuals with depression may have higher rates of stroke compared to those without depression.

The relationship between depression and stroke is complex. Depression can contribute to unhealthy lifestyle factors, such as smoking, physical inactivity, poor diet and medication non-compliance, all of which are risk factors for stroke. Additionally, depression may lead to changes in the body, such as inflammation and changes in the autonomic nervous system (which operates unconsciously and regulates body functions). This could increase the risk of stroke.

Depression often exists alongside other medical conditions such as high blood pressure, diabetes and cardiovascular disease, all of which are established risk factors for stroke. Managing depression effectively through therapy, medication or other interventions may help reduce the risk of stroke.

What is the link between anxiety and stroke?⁴

Anxiety, like depression, has been associated with an increased risk of stroke, although the relationship has not been as extensively studied. Anxiety can contribute to unhealthy lifestyle habits such as smoking, excessive alcohol consumption, physical inactivity and poor diet, all of which are risk factors for stroke.

Long-term anxiety can also lead to changes in the body, including increased levels of stress hormones such as cortisol, which can contribute to inflammation and cardiovascular changes that may raise the risk of stroke over time.

The relationship between stroke and anxiety may be influenced by several things, including the severity of anxiety, the presence of other risk factors and individual differences in how anxiety is experienced and managed. As with depression, managing anxiety effectively through therapy, medication, lifestyle changes and stress reduction techniques may help reduce the risk of stroke.

Mental health and stroke risk: Key points

Research shows that poor mental health can be both a cause and a consequence of stroke. The causes of mental health problems are complex and often exist at a structural level. For example, discrimination, poverty and insecure work and housing are often detrimental to mental health, yet these issues can be difficult or impossible for individuals to address on their own⁵.

Remember that help is available.

• Seek social connection
• Talk to your family doctor and ask to see a mental health professional
• Get enough sleep
• Eat nutritious meals on most days
• Try not to blame yourself for times when you struggle to be proactive about your health