At least 30% of post-stroke patients will have clinically-recognizable depressive symptoms and approximately 20-25% will experience anxiety. Many will experience both at the same time. Anyone who has experienced even mild anxiety or depression knows that it can have a profound effect on one’s motivation and outlook. Even just having a “bad day” can temporarily throw us off. Depression, anxiety, and other mood disorders can have a profound effect on the recovery of stroke patients, and every effort must be made to address and lessen such symptoms in order to bring about the best recovery results.
Effects on recovery
A recent study looked at the effect of depression and anxiety on recovery. The study found that each condition affects post-stroke patients differently, with the worst outcomes in those who experience both conditions.
Post-stroke anxiety (PSA) was associated with poor self-control, immobility, and fatigue. People with post-stroke depression (PSD) had a 3.4- to 7-times higher mortality rate than those without PSD. These patients also experienced poor recovery of physical function, daily living skills, and cognitive recovery, including memory and problem-solving. Having anxiety along with depression deepened the depressive symptoms and worsened the recovery.
Many factors impact the presence or severity of anxiety and/or depression, including the severity of the stroke and the part of the brain impacted, because some mood changes are physiological rather than purely emotional. Various psychosocial factors were associated with the increased risk of depression, such as previous psychiatric history in the individual and in the family; living alone or having little social contact; and being younger than age 59. Women also have a higher risk than men.
Overcoming Depression and Anxiety
If you or a loved one has experienced a stroke, your medical team should thoroughly educate you on the signs and symptoms of depression and anxiety, as well as other mood disorders, such as uncontrolled emotions (laughing, crying, or shouting for unclear reasons), apathy, anger, or impulsivity. The doctors should be able to explain what emotional changes to expect due to the physiological damage to the brain, as well as what emotions to expect during the recovery process.
Your health team should also be providing emotional and psychological support right from the start, in order to avoid or lessen the onset of depression and anxiety. It is natural to experience a certain grief and sense of loss after a stroke, concern about the recovery that lies ahead, and a sense of uncertainty about the final outcome. By addressing those feelings head-on, right from the outset, you can create a positive mental outlook that can dramatically improve your chance of recovery.
Constructive integrative psychosocial interventions (CIPI) have been found to significantly decrease feelings of depression and anxiety, most dramatically in the first month post-stroke, but continuing to show benefits into the sixth month. These CIPI treatments include:
- Psychological education, so patients know what to expect, including cognitive, emotional, and physical changes, as well as prognosis, rehabilitation, and recovery
- Sharing narratives of difficult experiences in the past and how they were overcome, creating a sense of resilience in the patient
- Nurturing a sense of self-management and problem-solving in the stroke patient, creating a sense of empowerment and control over aspects of the situation
- Identifying resources that are available in the case of necessity, creating confidence that help is available if needed
- Engagement in at least three activities per day
To these common-sense approaches, you may choose to add some other methods that are known to support mood health, such as mindfulness, coping strategies, and relaxation techniques.
Taking care of caregivers
Caregivers can also feel anxious or depressed, both from seeing their loved one struggling and from feeling overwhelmed by their new responsibilities and the changes in their lives. If you are a caregiver of a stroke survivor, you also need to take care of your emotional health.
Take breaks so that you can recharge and revitalize through doing things you love, resting, worshiping, or spending time with others. You may want to join a support group for caregivers. Always get plenty of sleep, eat well, and exercise so you can enjoy your own life while also supporting your loved one in need.
One of the most common sources of anxiety, for both the stroke survivor and loved ones, is the risk of another stroke. Unfortunately, 25% of strokes are repeat strokes. Neuralert is committed to decreasing the devastating effects of stroke with our stroke detection monitor, combining a unique, non-invasive wristband technology with a state-of-the-art patented algorithm that detects signs of a possible stroke and alerts medical personnel and caregivers, speeding up treatment before valuable time is lost. Ask your healthcare team about adding Neuralert to the stroke prevention plan.