Stroke and Depression | Delaware Stroke Resources

DSM-V Definition:

Lasting 2 weeks or more
- Depressed mood (sad, tearful)
- Loss of interest or pleasure
Any four of the following:
- Weight loss
- Changes in sleep patterns
- Slowed movements/restlessness
- Fatigue/loss of energy
- Feelings of worthlessness or guilt
- Diminished ability to think or concentrate
- Recurrent thoughts of death or suicidality

These symptoms are not attributable to medication, drugs/alcohol, or other medical condition, and cause distress/impairment in social, occupational, or other important areas of functioning.

How is Depression Different from Grief?

Depression is prolonged, interferes with a person’s ability to function normally, gets worse over time, and is disproportionate to the event(s). People with depression may also experience suicidal thoughts.

Grief is usually swift (up to one year), and does not interfere with a person’s ability to carry out daily tasks. Grief gets better over time.

Broad Causes of Depression

Internal Factors (genes, personality)
External Factors (alcohol, social environment, medical illnesses)
Adversity (trauma, childhood loss)

Treatment Options

Recognition (diagnosis)
Destigmatization
Treatment plan (antidepressant medications, psychotherapy, care management, exercise/diet/sleep, etc)
Maintenance

Medications

Please discuss any and all depression medications with your doctor to find the one that works best for you!

All medications may have side effects (gastrointestinal effects, sexual dysfunction, lethargy/sleepiness, weight gain, etc).

Psychotherapy

Cognitive-Behavioral Therapy (identify distorted beliefs and exercises to reduce symptoms)
Interpersonal Psychotherapy (focus on interpersonal difficulties like grief, roles, disputes, etc.)
Family & Couples Therapy (focus on relationship, family problems)
Psychodynamic Psychotherapy (focus on developing insight into how past experiences/conflict affect us)
Supportive Psychotherapy (focus on encouragement, empathy, services available to help)

Other Supportive Care

Treatment of insomnia / screen for sleep apnea
Exercise
Behavioral Activation (get out and do things)

Post-Stroke Depression

Frequently feeling sad, down, depressed, or not interested in life
Results in problems doing things that should be done
Occurs sometime after a stroke

Depression After Stroke is Common

Of over 20,000 patients, 29% said they suffered from depression.
It can occur anytime after a stroke
- 36% at hospital discharge
- 48% at 3 weeks after a stroke
- 39% at 1 month after a stroke
- 52% at 3 months after a stroke
- 25% in the first 2 years