Depression and anxiety after stroke

We’re becoming more open, as a community, to conversations about depression. This is welcome change considering how common depression really is. On average, 1 in 5 Australian women and 1 in 8 Australian men will experience depression.

For stroke survivors, the incidence of depression is even higher. One in three people experience depression at some point during the five years after their stroke. Depression is most common in the first year after a stroke, however it can happen at any time.

Having a stroke is a life-changing event. It can change how you feel about yourself and your future. Changes to responsibilities, relationships, work and finances can cause stress and sadness. The impact of stroke on the brain can also cause personality, mood and emotional changes. All this means there is a strong link between stroke, depression and anxiety.

If you feel sad, down or miserable for more than two weeks, you may have depression. You may lose interest or pleasure in things you normally enjoy. You may lack energy, have difficulty sleeping, or sleep more than usual. You may find it difficult to concentrate, to solve problems and to keep appointments.

In regards to anxiety, feeling anxious is normal when we feel under pressure. The feelings usually go away when the stressful situation is over. If anxious feelings do not go away, or if you are anxious for no particular reason, you may have anxiety. You may experience anxiety on its own, or together with depression.

While depression and anxiety are common, they are also highly treatable. Recovery is possible and there are many things that can help.

If you think depression or anxiety may be an issue for you, speak to your doctor. It is important to have a medical diagnosis and a treatment plan that takes into account your personal situation, needs and preferences. Some medications can make you lethargic, which can feel like the symptoms of depression, so a medication review can be helpful as a part of this process.

Medication

Anti-depressants are very useful in the treatment of moderate to severe depression. Your doctor may prescribe antidepressant medication along with psychological treatments. Anti-depressants are sometimes prescribed when other treatments have not been successful. They are also used when psychological treatments are not possible.

Research shows that psychological therapies are the most effective treatment option for people with anxiety. However for severe anxiety, medication may be helpful.

Psychological treatments

If you have mild or moderate depression, psychological treatment and lifestyle changes may work for you.

Cognitive behaviour therapy (CBT). Helps you identify and change unhelpful thought patterns, creating a more positive and problem-solving approach. It is one of the most effective treatments for depression.

Behaviour therapy. Behaviour therapy focuses on doing activities that are rewarding, pleasant or satisfying. It aims to get you involved in life again.

Interpersonal therapy. Helps you recognise patterns in your relationships that make you more vulnerable to depression. You focus on improving relationships, coping with sadness and grief, and finding new ways to get along with others.

Mindfulness-based cognitive therapy. Group therapy that involves meditation. Mindfulness meditation teaches you to focus on the present moment without trying to change it. It can help to stop your mind wandering off into thoughts about the future or the past. It helps you notice feelings of sadness and negativity early on, before they become fixed.

The Better Access to Mental Health Care scheme provides Medicare subsidised therapy for people with a diagnosed mental health condition. Your GP can organise this for you and may be able to point you towards the right therapist. You can also check out the Australian Psychologists Association website’s find a psychologist page. You can also use your private health insurance extras cover if you have it.

Finally, don’t underestimate lifestyle factors. Having a healthy lifestyle can help you feel good in body and mind. Eat well and limit alcohol. Exercising regularly is especially helpful. Make time to do the things you love, and spend time with people who you love and who make you feel good. Find a trusted family member or friend to talk to about your feelings.

beyondblue provides information and support about depression and anxiety.

Lifeline provides 24 hour crisis support and suicide prevention support. Call 13 11 14.

StrokeLine’s health professionals provide information, advice, support and referral. StrokeLine’s practical and confidential advice will help you manage your health better and live well. Call 1800 787 653. Email strokeline@strokefoundation.org.au