Managing Post Stroke Depression

People who survive a stroke will frequently experience depression. The condition is prevalent enough (thought to affect 30% of stroke survivors) that it has become increasingly acknowledged, and even “acronymized” as ‘PSD’. Distress in response to the loss of independence and brain function should not be surprising. However it is a potentially manageable impact, one that can have a huge influence on quality of life, and therefore on ultimate levels of recovery. Therefore it’s important to not only recognize its occurrence, but to treat it as well.

Strokes can produce a lot of physical problems that resemble symptoms of depression, such as interference with physical activity, sleep, and appetite- as well as loss of fun. It’s important to look beyond these symptoms and also consider whether a person is interested in things, or shows any positive mood or initiative. Otherwise the problem might be ignored as just another feature of the stroke. Friends or family may see these symptoms more plainly than clinicians.

If depression has been identified as a concern, treatment options include medications and cognitive-behavioral therapy. Some level of intact language and reasoning skills are needed to successfully participate in cognitive-behavioral therapy. In fact, the therapy may need to be highly customized. Not all patients are able to receive treatment in conventional ambulatory settings, and the impact of stroke is quite variable depending on what part of the brain was affected. This can make it hard to compose equivalent groups for research comparisons.

Sorting out the ‘biochemical’ and ‘emotional’ causes can become a pointless exercise when what really matters is to address someone’s immediate needs.   Cognitive-behavioral therapy works directly on how people look at themselves and their future. These are topics that became critically important as a result of stroke, so it is logical to explore this kind of method as a way to alleviate suffering caused by stroke.