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CARING FOR SOMEONE WITH EMOTIONAL & BEHAVIORAL NEEDS

Depression After Stroke

After a stroke, your loved one may have many negative feelings. Your loved one may think that things will never get better. This is not true - help is available!

Almost half of all stroke survivors have depression. Depression is a normal response to the losses that occur from a stroke.

What Are the Signs and Symptoms of Depression?	Helpful Tips
What Do You Need to Know?	Remember
Why Is It Important to Get Help?	More Resources
What Treatments Should You Discuss with Your Healthcare Team?

What Are the Signs and Symptoms of Depression?

Here is a list of the signs and symptoms of depression. Five or more of these signs or symptoms that last more than two weeks are warning signals for depression.

• Sadness or an “empty” mood
• Feeling guilty, worthless or helpless
• Problems concentrating, remembering or making decisions
• Appetite and/or weight changes
• Feeling hopeless
• Lack of energy or feeling tired and “slowed down”
• Problems with sleep, such as trouble getting to sleep, staying asleep or sleeping too much
• Feeling restless or irritable
• Loss of interest or pleasure in hobbies and activities, including sex, that were once enjoyed

RED FLAG: Suicidal Thoughts If the stroke survivor talks about suicide, has thoughts of suicide, or attempts suicide, get help right away. Call emergency services or your healthcare provider. This is a serious problem.

What Do You Need to Know?

Depression is real − People need help when they have depression.

Physical and emotional changes are common after a stroke − Accept your loved one’s changes.

Expect improvements over time − Things often get better.

Why Is It Important to Get Help?

Treatment of depression will help the stroke survivor recover faster. It will make your job as a caregiver easier. For instance, treating depression helps with:

• Thinking skills and memory
• Physical recovery and rehabilitation
• Language and speech
• Emotions and motivation

What Treatments Should You Discuss with Your Healthcare Team?

Get help from your healthcare team quickly. The stroke survivor and family members may explain away the person’s depression. Make sure that the stroke survivor receives treatment.

• Medicines, such as anti-depressants, improve symptoms.
• Psychotherapy (talk therapy) is used along with medicines. Talk therapy gives your loved one a safe place to talk about feelings.
• Support groups provide help from other stroke survivors and caregivers. They know what you and your loved one are going through. There are support groups for stroke survivors and caregivers like you. Learn more about stroke support groups.

Helpful Tips

• Know the warning signals of depression. Watch for the signs and symptoms of depression. Get help quickly.
• Be patient with your loved one. After a stroke, it will take time for your loved one to understand the changes.
• Help your loved one exercise and take part in fun activities. Learn more about exercising after stroke.
• Encourage friends and your family to visit and talk with your loved one.
• Have a good attitude. Focus on how much your stroke survivor can do. Smile and relax about things you can’t change.

Remember

• Depression is real and should be treated.
• You are the key person to watch for the warning signals of depression.
• Get help quickly if you think your loved one has depression.

More Resources

The following resources are related to this fact sheet only. View a full list of the resources from all RESCUE fact sheets.

Caregiver Library Web: www.caregiverslibrary.org* Phone: 1-804-327-1111 The Caregiver Library has several fact sheets on dealing with emotional issues after stroke*.
Eldercare Locator Web: www.eldercare.gov* Phone: 1-800-677-1116 The Eldercare Locator helps you find resources in your loved one’s area. It can also find your local Area Agency on Aging. The Area Agency on Aging helps you assess your loved one’s needs and find services. This organization helps you find ways to pay for care.
My HealtheVet Web: www.myhealth.va.gov My HealtheVet (MHV) provides trusted information on stroke and other health conditions. It also provides resources for stroke caregivers and tools to track your loved one's health. Take a screening test for symptoms of depression. Visit the My HealtheVet Caregiver Assistance Center for more information on caregiving.

References:American Stroke Association. (2008). Depression Trumps Recovery. Retrieved June 16, 2008, from: http://www.strokeassociation.org/presenter.jhtml?identifier=3030377.*; and Robinson, RG, at al. (2008). Escitalopram and problem-solving therapy for prevention of post-stroke depression: a randomized controlled trial. JAMA, 299(20): 2391-400.

These materials were created for the project:

Web-Based Informational Materials for Caregivers of Veterans Post-Stroke

Project Number SDP 06-327 funded by VA HSR&D Quality Enhancement Research Initiative (QUERI); Supported by the
Stroke QUERI

Visit the Stroke QUERI Website