- Depression is a common, serious, and costly illness that affects
1 in 10 adults in the United States each year; costs the nation between
$30 billion to $44 billion annually; and causes impairment, suffering,
and disruption of personal, family, and work life.
- Though 80 percent
of depressed people can be effectively treated, two-thirds of those
suffering from this illness do not seek or receive appropriate treatment.
Effective treatments include both medication and psychotherapy, which
are sometimes used in combination.
- Though depressed feelings can
be a common reaction to a stroke, Clinical Depression is not the
expected reaction. For this reason, when present, specific treatment
should be considered for Clinical Depression even in the presence
of a Stroke.
- There are approximately 3 million Stroke survivors
in the United States. In addition, an estimated 400,000 to 550,000
people experience strokes each year, of which an estimated 10
to 27 percent experience Major Depression. An additional 15 to 40
percent exhibit depressive symptomatology (not Major Depression)
within two months following Stroke.
- Three-fourths of Strokes occur
in people 65 years and over. With Stroke as a leading cause of
disability in older persons, proper recognition and treatment of
Depression in this population is particularly important.
- The average
duration of Major Depression in stroke patients has been shown
to be just under a year.
- Post-Stroke patients who are also depressed,
particularly those with Major Depressive Disorder, are less successful
with rehabilitation, more irritable and demanding, and may experience
personality change.
- If a person has five or more of these
symptoms for more than two weeks, it is important for these symptoms
to be brought to the attention of the individual’s health
care provider.
Symptoms
- Persistent sad or “empty” mood
- Loss of interest or pleasure in ordinary activities, including
sex.
- Decreased energy, fatigue, being “slowed down”
- Irritability
- Excessive crying
- Eating disturbances (loss of appetite and weight,or weight
gain)
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- Difficulty concentrating, remembering, making decisions
- Feelings of guilt, worthlessness, helplessness
- Thoughts of death or suicide; suicide attempts
- Sleep disturbances (insomnia, early- morning waking, or oversleeping)
- Chronic aches and pains that do not respond to treatment
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Causes
- Of particular significance, Depression often Co-occurs with Stroke.
When this happens, the presence of the additional illness, Depression,
is frequently unrecognized, leading to serious and unnecessary consequences
for patients and families.
- Appropriate diagnosis and treatment
of Depression may bring substantial benefits to the patient through improved
medical status, enhanced quality of life, a reduction in the degree of
pain and disability, and improved treatment compliance and cooperation.
- 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.
Treatment
The association between Depression and Stroke has long been recognized
for its negative impact on an individual’s rehabilitation, family relationships,
and quality of life. Appropriate diagnosis and treatment of Depression can
shorten the rehabilitation process and lead to more rapid recovery and resumption
of routine. It can also save health care costs (e.g., eliminate nursing home
expenses).
Action Steps
- Do Not Ignore Symptoms! Health care professionals should always
be aware of the possibility of Depression Co-occurring with Stroke. Patients
or family members with concerns about this possibility should discuss these
issues with the individual’s physicians. A consultation with a psychiatrist
or other mental health clinician may be recommended to clarify the diagnosis.
- Get
the Word Out! NAMI IOWA emphasizes the importance of professional and public
awareness of the Co-occurrence of Depression with Stroke and proper diagnosis
and treatment of Depression.
- Community, professional, and advocacy
organizations, as well as the media can help spread important messages
about Depression Co-occurring with Stroke.
Information provided by National Institute of Mental
Health.
If you or someone you know would like more information on
mental illness or wish to request an educational presentation, please contact:
NAMI IOWA (Alliance for the Mentally Ill
of Iowa)
5911 Meredith Drive Suite E
Des Moines IA 50322-1903
Phone: (515) 254-0417 or (800) 417-0417 IOWA ONLY
Fax: (515) 254-1103
Email: info@namiiowa.com
