What is worth knowing about the relationship between stroke and depression?

Cerebral stroke results from abnormalities related to cerebral circulation. In vast majority of the cases we deal with ischaemic strokes that limit the blood supply to the brain. In the result of a stroke, areas of the brain are damaged, which results in changes in mobility and in cognitive and emotional functioning. Depression is a serious medical issue related to stroke.

Consequences of stroke

The effects of stroke depend on various factors, including the type of stroke, the scale of damage, the location of the area affected by the damage. Common awareness of the consequences of stroke is centred around the consequences of movement impairment. This is probably due to the fact that the consequences in terms of mobility are most visible as those hindering functioning and independence. In fact, brain damage caused during a stroke can lead to consequences in the form of paralysis or paresis of the limbs. A vascular episode of the brain can result in the inability to perform movement or severely limit the range of motor functions. Painful spasticity may also occur. As a result of stroke, other problems arise, such as speech, communication and cognitive difficulties. The effects of stroke are not limited to the aforelisted consequences. They also reach to the area of mental health. Depression is a serious and widespread consequence of stroke.

Post-stroke depression

It is worth knowing that post-stroke depression ( PSD) is the most common mental health complication that occurs after a stroke. Depression is estimated to occur in approximately 30% of stroke patients. This is higher than for depression in the global general population, where the depression rate oscillates in the range of 4%. Post-stroke depression limits the recovery of functional capacity, and thus keeps the patient in a state of disability. It is worth remembering this when there is no visible progress in rehabilitation process – depression may be the underlying cause. Diagnosis of post-stroke depression includes the same diagnostic criteria as in other circumstances. However, it should be borne in mind that symptoms of depression overlap with symptoms of somatic disease. Post-stroke depression also presents another diagnostic difficulty in form of the communication barrier that may appear after a stroke and cognitive difficulties. It is crucial to observe the behaviour of patients in such cases. Even if a person is unable to communicate their mood or thoughts directly, certain visible behaviours may indicate that the patient is affected by depression. Post-stroke depression affects the course of motor rehabilitation and, if left untreated, may limit the return to proper functioning.

Stroke and depression

Post-stroke depression should be considered as a neuropsychiatric complication following a stroke, i.e. a consequence of this event. It is noted, however, that depression can also become the cause of stroke. We may be dealing with a stroke patient, who was already depressed before the stroke. Post-stroke depression develops multifactorially. The development of post-stroke depression is influenced by biological factors in the form of biochemical changes in patients after a stroke. Psychosocial factors, such as stress and lack of support in this difficult experience, also have a significant impact on the development of depression. It should be borne in mind that depression increases the risk of stroke and its mortality rates. Treatment of symptoms of depression is necessary for each person, both before and after the stroke. Some difficulties in treating post-stroke depression are also determined by the characteristics of the group of patients, who suffered a stroke. These are usually elderly people with a number of other comorbidities. On the one hand, old age and multiple illnesses increase the risk of depression, and on the other hand, it requires caution in proceedings, e.g. due to possible drug interactions. Treatment of depression may require the use of pharmacological agents. In a situation of mild and moderate depression, treatment can be carried out with the help of psychotherapeutic intervention. Psychotherapy in relation to people after a stroke can have both therapeutic and preventive effect. Psychoeducation also plays an important role. Innovative virtual therapy supports the set of non-pharmacological treatments for post-stroke depression. The therapy was scientifically tested in a group of stroke patients, who experienced symptoms of depression, anxiety and stress. The official title of the study in this group of patients is: Evaluation of the Effectiveness of the “VRTierOne” Virtual Therapeutic Game as a Method Supporting the Post-stroke Rehabilitation. You can find the list of scientific research here. Virtual therapy conducted with the VR TierOne medical device has been introduced into treatment and serves patients in post-stroke rehabilitation. Virtual therapy is conducive to improving mood, motivation to exercise, supports cognitive functions and engages motor skills. This method is safe and well tolerated by the elderly. You can read more about VR TierOne therapy for depression in stroke patients here.

Summary

1. 1. Depression is the most common psychiatric complication of stroke.
   2. Some 30% stroke patients are diagnosed with depression. 
   3. Depression and stroke share a set of common risk factors.
   4. Post-stroke depression delays recovery and worsens the lives of patients.
   5. Post-stroke depression is associated with a decrease in mood and motivation to exercise.
   6. Post-stroke depression requires treatment to support rehabilitation.
   7. Post-stroke depression can be treated both pharmacologically and non-pharmacologically.

VR TierOne therapy may support the treatment of post-stroke depression.