Depression and Stroke

Introduction

Depression can strike anyone, but people with serious illnesses such as stroke may be at greater risk. Appropriate diagnosis and treatment of depression may bring substantial benefits to persons recovering from a stroke by improving their medical status, enhancing their quality of life, and reducing their pain and disability. Treatment for Depression also can shorten the rehabilitation process, lead to more rapid recovery and resumption of routine, and save health care costs (e.g., eliminate nursing home expenses).

Stroke can occur in all age groups and can happen even to fetuses still in the womb; but three-fourths of strokes occur in people 65 years of age and over, making stroke a leading cause of disability in older persons.

Of the 600,000 American men and women who experience a first or recurrent stroke each year, an estimated 10 to 27 percent experience major depression. An additional 15 to 40 percent experience some symptoms of Depression within 2 months following a stroke.

The average duration of major depression in people who have suffered a stroke is just under a year. Among the factors that affect the likelihood and severity of depression following a stroke are the location of the brain lesion, previous or family history of depression, and pre-stroke social functioning. Stroke survivors who are also depressed, particularly those with major depressive disorder, may be less compliant with rehabilitation, more irritable, and may experience personality change.

Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated. Stroke survivors, their family members and friends, and even their physicians may misinterpret depressive symptoms as an inevitable reaction to the effects of a stroke. But depression is a separate illness that can and should be treated, even when a person is undergoing post-stroke rehabilitation. Although depressive symptoms may overlap with post-stroke symptoms, skilled health professionals will recognize the symptoms of depression and inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.

Depression Facts

Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. NIMH-sponsored studies estimate that 6 percent of 9- to 17-year-olds in the U.S. and almost 10 percent of American adults, or about 19 million people age 18 and older, experience some form of depression every year. Although available therapies alleviate symptoms in over 80 percent of those treated, less than half of people with depression get the help they need.

Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person's level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or other environmental factors. Whatever its origins, depression can limit the energy needed to keep focused on treatment for other disorders, such as a stroke.