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Depression and Stroke

Depression is common after a stroke and after taking on the caregiving role. Here are some ideas about what it is and what you can do about it! Depression, though common, needs to be treated. Depression will not just go away. It will limit the energy you need as a caregiver to care for your loved one. For your loved one with a stroke, depression will interfere with their recovery. Treatment for depression may improve a person's medical condition, quality of life, and reduce pain and disability. Treatment for depression can often shorten the rehabilitation process, leading to more rapid recovery and return to a routine.

Common Signs of Depression

-depressedContinuing sad, anxious, or "empty" mood
-Feelings of hopelessness and/or negativeness
-Feelings of guilt, worthlessness, helplessness
-Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
-Decreased energy, tiredness, or being "slowed down"
-Difficulty concentrating, remembering, or making decisions
-Not sleeping, early-morning awakening, or oversleeping
-Appetite and/or weight changes
-Thoughts of death or suicide, or suicide attempts
-Restlessness and/or irritability
-Sudden change in how easily you are annoyed
-Bouts of crying often

If some of these symptoms are:

1. present in your loved one with stroke for at least two weeks AND
2. get in the way of routine daily activities such as work, self-care, childcare or social life

Get an evaluation for depressions immediately!

Treating depression can improve your life and relationship. Remember, depression is not inevitable; that is, it does not have to continue after a stroke. There is something that you can do about it. Depression is a separate disease of the brain and can be treated. depressed2Treatment frequently involves medications and "talk" therapy. Treatment takes time, but is well worth the wait ~ depression can be successfully treated!
Caregivers are especially prone to depression, due to taking on a new role in caring for their loved one with stroke. Besides the huge physical and mental impact of caregiving, there may be isolation, change in relationships, physical intimacy changes, and maybe changes in both of your personalities. The challenges of caregiving are many and depression can get in the way of meeting them in a positive way!

Tips to Deal with Depression and Stroke

For both of You:

1. Get treatment! Be good to yourself, call your healthcare provider - doctor, nurse practitioner, or physician assistant - and ask to be evaluated for depression.
2. Take any prescribed drugs faithfully. It may take 4-6 weeks to see any results, so start on these drugs as soon as possible. Patience is key here.
3. Know that you are not "weak" because you are depressed, but that you are human and have a brain disease that is treatable. You are strong for recognizing your need for help!
4. Go to therapy appointments and try to do any homework assigned. This will help you get better quicker!
5. Use positive self-talk. For example, "I may be depressed, but I am a good person; I am strong." You get the idea.

For Caregivers:

1. Know that to help care for your loved one, you must be as healthy as possible, in mind and body.
2. Have a positive attitude. Attitude makes a big difference! Believe that getting help for and treating depression is important for you. Take the time to do it!
3. Take time for yourself and try not to feel guilty about it. Get out of the house at least once a week for a break, even if it is shopping for groceries.
4. Take time to refresh and recharge your own batteries, before you can give some more.

-Five minutes in the bathroom alone, or a cup of tea/coffee/soda alone in a quiet room with some music can do wonders.
-Light those candles and enjoy the moment(s)!
-Get up before your loved one or staying up after he/she is asleep may steal you these precious moments.
-Put time on your planner or calendar and commit to keep your appointment with yourself. You are worth it.

Your loved ones with stroke:

depressed31. Give them the courage and strength to get treated; make the call and take them to the appointment(s) that will get them there.
2. Assure them they are not "crazy." Depression is a brain disease.
3. Fight the myth that "of course I'm depressed, I've had a stroke!" Get the person treatment.
4. Give them some quiet time. They need a break from you, too.
5. Allow them a day to slack off on all those therapies and other difficult things that they to do. Just allow them and yourself to relax. It is okay.
6. Give encouragement. While your encouragement can not cure depression, it will motivate them to keep going.
7. Take a deep breath, recognize that they are depressed and it is not your fault. Rejoice that once again, the two of you can face anything.
8. Make the most of rehab; the more you recover the better you will feel!
9. Maintain your quality of life by staying active and doing things you enjoy
10. Spend time with family or friends

Additional Information:

The following are some web sites to provide you with more information about depression.

Mental Health Matters

The Internet Stroke Center: Recognizing Depression

Click here to try our Fun Activities


References:

Braddom, R. (2000). Physical medicine and rehabilitation (2nd ed.). New York: W. B. Saunders.

Depression and stroke.(2011). Retrieved from  http://www.nimh.nih.gov/health/publications/depression-and-stroke/index.shtml

Derstine, J., & Hargrove, S. (2001). Comprehensive rehabilitation nursing. New York: W. B. Saunders.

National Stroke Association, (2009). Stroke Facts: Recovery After Stroke: Coping with Emotions. Retrieved from
www.stroke.org

Post stroke depression affects caregivers too. July August, 2009). Retrieved from http://www.rorc.research.va.gov/rescue/docs/newsletters/2009-JulyAug-RESCUE-Newsletter.pdf

Developed in 2002 by Amy Govoni, MSN, RN, CS at The University of Toledo for the Caring~Web©

Revised: 2010, 2012

Last Updated: 6/17/14