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July 24, 2008  
VEIN NEWS: Feature Story

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  • Depression Among Stroke Survivors: A Hidden Crisis

    Depression Among Stroke Survivors: A Hidden Crisis


    November 01, 2006

    By: Diana Barnes-Brown for Veins1

    A recent study published in Stroke: Journal of the American Heart Association showed that although stroke survivors suffer from higher depression rates, few of them use antidepressants to treat their depression.

    Stroke survival has been connected to mood disturbances – including depression – by a number of studies, but there had been few findings on actual rates of depression and drug therapy in this group. Until now.
    Take Action
    Any of the following symptoms of stroke require IMMEDIATE medical attention:
  • Sudden, often one-sided, weakness or numbness in the face, arm or leg.
  • Vision changes or difficulty seeing.
  • Sudden confusion, difficulty speaking or difficulty understanding others’ speech.
  • Sudden difficulty walking or standing, trouble keeping balance, and poor coordination.
  • Sudden severe headache that seems to have no specific cause.

    Don’t be ashamed to seek help if you are depressed – it is a very common and very treatable condition.
    However, depression can escalate to life-threatening situations if not addressed. To get started and locate a qualified caregiver, go to http://mentalhealth. samhsa.gov/publications
    /allpubs/KEN980046/default.asp

  • The Stroke study was completed by Seana L. Paul, B.Sc. (Hons) and her research team at the National Stroke Research Center in Victoria, Australia. The report, if supported by further research, may eventually lead to better and more holistic treatment for patients after stroke. “Stroke patients suffering from depression have been found to have reduced quality of life and a higher rate of death,” noted Paul, “so it is important to identify and treat depression after stroke.”

    To conduct the study, the researchers selected from a group of 306,631 people who had participated in the North East Melbourne Stroke Incidence Study (NEMESIS), excluding those who also had subarachnoid hemorrhage (brain bleeding). The participants were assessed for signs of depression and asked for comprehensive information about medications they were taking.

    Five years after a stroke, survivors’ incidence of depression was 17 percent, and of this group, only 22 percent were on antidepressants. Further, drug therapy seemed to be effective for about three-quarters of those on antidepressants. “We have confirmed that depression is common even up to five years after stroke,” and also that antidepressants seem to work for most of the stroke survivors who take them, Paul noted.

    According to Paul, the study findings indicate that more research involving larger numbers of participants is called for. Small sample sizes in previous studies, as well as limited follow up, have contributed to the currently limited knowledge base about the role and efficacy of treating post-stroke depression, as well as the safety of prescribing widely-used antidepressants in this population.

    The National Institute of Mental Health notes that stroke is the most common cause of disability in those over 65 years of age, with nearly three-fourths of all strokes occurring in the elderly. With 600,000 strokes occurring in the United States each year, this means that the number of older patients dealing with stroke and its aftermath in this country alone is around 450,000. Depression is a commonly-reported complication of the recovery and rehabilitation period, and may occur due to the location of the brain damage caused by the stroke, family history, or the mental and physical difficulties associated with stroke recovery.

    Common symptoms of depression include feelings of worthlessness and hopelessness, lack of motivation to do basic life tasks, mental and physical fatigue, sleep disturbances, memory and cognitive difficulties, and weight and appetite changes. For those recovering from any serious medical setback, such symptoms can make the process of recovery go more slowly, or possibly seem daunting or even insurmountable in spite of positive prognoses about the original medical problem.

    It is not unusual for sufferers of serious injuries or illness to experience depression; such events are listed by numerous experts as one of the common precipitating factors of clinical depression. These new findings reinforce this fact, and help call attention to a population in need of greater consideration and treatment.

    Last updated: 01-Nov-06

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