FROM OUR experts
Stroke patients can be at risk for depression BY JIM HOWE
AT LEAST A THIRD of people who have a stroke become depressed or show some symptoms of depression, according to an expert who oen treats such patients. It’s called post-stroke depression, explains rehabilitation psychologist Michelle Woogen, PsyD, who works in Upstate’s department of physical medicine and rehabilitation.
common symptoms of depression can include any of the following: l
a sad mood and possibly thoughts of wanting to die or commit suicide
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excessive crying
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feelings of worthlessness
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low motivation or energy
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changes in eating or sleeping behavior
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agitation
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loss of interest in activities the patient used to enjoy
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poor concentration or ability to make decisions
a stroke involves a lack of oxygen to the brain, due to a blocked or broken blood vessel, and this can cause a number of problems, such as: l
physical: difficulty walking, talking and dressing
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mental: having trouble solving problems, remembering things, doing tasks like paying bills and knowing what’s safe and what isn’t.
reasons for depression after stroke It is believed that there are two reasons why someone may become depressed aer a stroke: It may be in response to the stress of having a stroke in general, which is an upsetting experience, or it may be that as the brain is rewiring itself (and we know that our emotions are housed in our brain), it is accidentally rewiring itself to be more depressed. It could also be a combination of the two, Woogen said. Strokes that limit patients’ ability to move around and take care of themselves on their own put those patients at a higher risk of developing depression, as do cognitive (thinking) difficulties and a history of depression.
Is it depression or stroke recovery? Post-stroke depression can be tricky to diagnose, Woogen cautions, since something like sleeping more might simply be part of the recovery process. “We are looking for symptoms of depression, but a brain injury can mimic those symptoms. e brain needs to sleep aer injury. It’s easily fatigued, so they might be sleeping a lot, but maybe they are just recovering. ey also might look like they have poor motivation, but that is also something that can be caused by brain injury. e brain has trouble telling the body to get going, so you have a plate of food in front of you, and you know it’s time to eat, but the brain is just not telling the body, ‘OK, pick up the fork, put the food on the fork, fork to the mouth,’ so it can be tricky,” she said. continued on page 13
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U P S TAT E H E A LT H
upstate.edu l winter 2019
