After a stroke, many people — up to a third — sink into clinical depression, disturbed by their body and brain’s betrayal. A stroke brings uncertainty about one’s future and can be an unwelcome reminder of our mortality.
That’s why testing and treating of depression can help improve a person’s functioning after a stroke, according to new research examining stroke patients and depression.
Researchers reported that individuals who remain depressed three months after a stroke are more likely to have decreased functional capabilities than those whose depression was successfully treated.
Functional capabilities include getting dressed, feeding oneself, and accomplishing other tasks. These capabilities increased significantly in those individuals who were treated for depression.
Post-stroke depression appears to be linked to chemical changes in the brain, clinical evidence indicates.
According to study author Arlene A. Schmid, Ph.D., “The relationship between post-stroke depression and recovery of function after a stroke has not been well understood. Previous researchers have looked at both depression and function after stroke but they did not investigate whether identifying and managing depression improved ability to accomplish tasks of daily living and other function related issues.”
The researchers in the new study report that successful depression management led to better functionality that might enable the individual to return to work or more thoroughly enjoy leisure functions while decreasing the caregiver burden.
“Restoring lost function after stroke is the number one reason individuals visit occupational therapists,” said Schmid. “Since treating depression helps improve function, occupational therapists should screen for post-stroke depression and, in conjunction with other members of the patient’s health care team, help manage depression.”
In the study, whether an individual was depressed or not was determined through use of the Health Questionnaire-9 (PHQ-9), a widely used and easy to administer depression screening tool.
According to Schmid, since occupational therapists are trained in mental health issues and see patients frequently, occupational therapists could use the PHQ-9 to screen for depression after stroke and alert a post-stroke patient’s physician to the individual’s mental status.
In addition to improving functionality, management of depression would lower health care costs associated with functional impairment and other post-stroke treatment issues.
“Post-stroke depression often impacts quality of life after stroke more than even functional impairments. Since it is treatable with common medications, cognitive behavioral therapy and exercise, it is important to recognize it so patients can be treated.
“This study is one of the first to show not just the link between depression and worse function post-stroke, but that successfully treating depression symptoms actually improves post-stroke outcomes,” noted the researchers.
The study is published in the March 15, 2011 issue of the journal Neurology.