Co-Occurrence of Depression with Stroke: Awareness and Treatment Can Improve Overall Health and Reduce Suffering.

Awareness and Treatment Can Improve Overall Health and Reduce Suffering

* Depression is a common, serious and costly illness that affects 1 in 10 adults in the U.S. each year, costs the Nation between $30 - $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, nearly two out of three 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.

DEPRESSION CO-OCCURS WITH STROKE

* 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.

* 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.

* 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.

MORE FACTS

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).

* Of the 600,000 Americans who experience a first or recurrent stroke each year, an estimated 10-27 percent experience major depression. An additional 15-40 percent experience depressive symptomatology (not major depression) within two months following the stroke.

* Three-fourths of strokes occur in people 65 years of age and over. With stroke a leading cause of disability in older persons, proper recognition and treatment of depression in this population is particularly important.

* The mean duration of major depression in stroke patients has been shown to be just under a year.

* Among the factors that effect 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 

* Post-stroke patients who are also depressed, particularly those with major depressive disorder, are less compliant with rehabilitation, more irritable and demanding, and may experience personality change.

ACTION STEPS

Don't 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 individuals' physicians. A consultation with a psychiatrist or other mental health clinician may be recommended to clarify the diagnosis.

Get the Word Out! Emphasize the importance of professional and public awareness of the co-occurrence of depression with stroke and proper diagnosis and treatment of depression.

Community, Professional, Advocacy Organizations, and the Media Can Help spread important messages about depression co-occurring with stroke.

For free brochures on depression and its treatment, call: 1-800-421-4211 or use the online order form.

SYMPTOMS OF DEPRESSION

* Persistent sad or "empty" mood

* Loss of interest or pleasure in ordinary activities, including sex

* Decreased energy, fatigue being "slowed down"

* Sleep disturbances (insomnia, early-morning waking or oversleeping)

* Eating disturbances (loss of appetite and weight, or weight gain)

* Difficulty concentrating, remembering, making decisions

* Feelings of guilt, worthlessness, helplessness

* Thoughts of death or suicide; suicide attempts 

* Irritability 

* Excessive crying

* Chronic aches and pains that don't respond to treatment

If person has five or more of these symptoms for more than two, weeks, it is important that these symptoms be brought to the attention of the individual's health care provider.

For More information About NIMH

The Office of Communications and Public Liaison carries out educational activities and publishes and distributes research reports, press releases, fact sheets, and publications intended for researchers, health care providers, and the general public. A publications list may be obtained by contacting:

Office of Communications and Public Liaison, NIMH Information Resources and Inquiries Branch 6001 Executive Blvd., Room 8184, MSC 9663 Bethesda, MD 20892-9663 Phone: [phone] TTY: 301-443-8431 FAX: [phone] Mental Health FAX 4U: 301-443-5158 E-mail: [e-mail] NIMH home page address: http:/www.nimh.nih.gov

For information about NIMH and its programs, please email, write, or phone us,

NIMH Public Inquiries 6001 Executive Boulevard, Rm. 8184, MSC 9663 Bethesda, MD 20892-9663 U.S.A. Voice [phone]; Fax [phone]

This page was last updated: June 1, 1999.